Humana Health Insurance Claims

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					                     10 Things to Remember about Humana Group
1) COMMISSIONS: Medical: Level per capita commissions. With the increasing popularity of higher
deductible plans and lower premium options, brokers are losing commission. But with Humana,
commissions are capitates so no matter how low a premium, the commission is expectable.

2)BONUS PROGRAMS: Humana has the best bonus program in the industry. Special period promotions
based upon new sales, eg. The Blockbuster, FUD bonuses. Also, perpetual bonus programs that are paid
quarterly based upon new: medical sales and retention; ancillary sales and retention.

3) FUD: Humana has great success with UW outcomes with their FUD. The UW loads are considerably
lower than a regular pre-screen process. The better the FUD participation, the higher the close ratio is.

4) RENEWALS: Humana provides a dedicated Account Executive to assist in all 2-99 renewals.

5) CLAIM: Humana is rated as the number one claims payer in the health insurance industry based up
important criteria, not anecdotal surveys.

      a. On all plans (except the Value plans), the family deductible and out of pocket is 2x’s the single.
      b. Wellness covered at 100%
      c. A competitive full model line: HMO, PPO, Coverage First, HDHP, HRA (PCA), Low Cost
      Options (Value Plans- Copay and coinsurance).
      d. Higher deductible options up to $5,000

7) Rx INNOVATION: All Rx plans are based upon levels, not generic or brand. So there are many brand
name drugs with the lowest co-payment option.

8) MULTI-LOCATION: Humana is the multiple location expert. We provide the power of ONE:
      a. ONE plan design (or up to 3 depending on your group size)
      b. ONE set of rates
      c. ONE network
      d. ONE invoice
      e. ONE point of contact
      f. ONE stop for medical, dental, vision, life, disability, and worksite benefits.

9) ACCESS: Full access to Humana claims, underwriting, and billing and enrollment.

       a. PPO: National CHC Network includes almost all middle and large size metropolitan areas that
       provides complete provider reciprocity. Local Chicago focused Choice POS includes all of the
       hospitals in the National CHC Network with similar physician coverage (a 0.002% difference)
       but at substantially lower
       b. HMO: The Platinum Network is the largest capitates HMO network in Illinois. It includes all
       of the Advocate facilities and many more physicians than any other capitates HMO network. The
       Select HMO is the more economical capitates network, but still includes all of the Advocate
       facilities as well as
       considerable physician coverage that competes with all other HMO carriers in the Illinois market.

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