Humana, Healthcare Reform and You Dave Vanden Heuvel Director, Medical Products.

Slides:



Advertisements
Similar presentations
QHP Training NEW MEXICO HEALTH INSURANCE EXCHANGE BeWellNM.com.
Advertisements

Obamacare and UC Students Heather Pineda, MPH Director - UC Student Health Insurance Plan.
HEALTH INSURANCE MARKETPLACE & MEDICAID TRANSITION KEVIN R. HAYDEN Chief Executive Officer Group Health Cooperative of South Central Wisconsin.
Healthy Indiana Plan Hoosier Innovation: Health Savings Accounts 1992: Hoosier pioneers medical savings accounts 2003: Tax advantaged HSAs authorized.
Humana, Healthcare Reform and You What you need to know.
Assurant Provides A Choice of Dental Plans Freedom Preferred PPO Plan $25 Deductible In or Out of Network $2,000 Annual Maximum InOut Preventive*100%100%
1. Essential Health Benefits (10 categories of services): (1) ambulatory patient services (2) emergency services (3) hospitalization (4) maternity and.
The Health Law: It’s Working! About 10 million more people have insurance this year as a result of the Affordable Care Act The biggest winners from the.
Your Health, Your Choice: Guide to the Marketplace Nykita Howell Health Insurance Navigator.
UPMC Advantage 2014 Individual & Family Plans Producer Training.
Disability Program Manager
It’s a new world for health care Anthem is leading the way
 Indemnity or Fee-for-Service coverage- -allow you go to the doctor of your choice and pay for services at the time of the visit. -The amount that your.
ARKANSAS BLUE CROSS and BLUE SHIELD An Independent Licensee of the Blue Cross and Blue Shield Association Health Care Reform From an Insurer’s Perspective.

State Insurance Exchange & Individual Plans Presented by D. Mark Baker, Director of Healthcare Access, Lifelong.
2014 Delaware Qualified Health Plans Individual Market and SHOP Overview HCC Meeting: October 10,
This presentation is a high-level summary and for general informational purposes only. The information in this presentation is not comprehensive and does.
Creation of Consumer Operated and Oriented Plans (CO-OPs) CO-OP program created by ACA, s. 1322, to introduce greater competition and choice within Marketplaces.
New York’s only CO-OP. Consumer Operated and Oriented Plan 501(c)29 non-profit organization, a signature program of the Affordable Care Act Over half.
Information Only Always review all options with an experienced Health Care Benefits Specialist Review the Facts at:
ACA Simplified The Affordable Care Act (PPACA) was signed into law on March 23, 2010— putting in place measures to improve access to affordable health.
EHA Early Retiree Plan Benefit Options.
Triple Choice Enrollment THE BASICS DEFINITIONS HMO (Health Maintenance Organization): A form of health insurance combining a range of coverage.
Patient Advocacy. Access, Affordability, and understanding treatment costs.
There’s So Much More to Medicare, Let’s Talk Humana Medicare Advantage Health and Prescription Drug Plans M0006_GH210S6RR KC0906.
Insert Client Logo Your Guide to Health Care Benefits.
0 Disclaimer - This presentation is brought to you by Aetna Life Insurance Company and/or its affiliates to educate you on the Aetna plan options available.
Overview of El Cuero Benefits Health Insurance Options Health, life, dental Savings and Retirement Plans Vacation and Leave Benefits Vacation, sick leave,
New York’s only CO-OP. Consumer Operated and Oriented Plan 501(c)29 non-profit organization, a signature program of the Affordable Care Act Over half.
Agribusiness Library LESSON: HEALTH INSURANCE. Objectives 1. Determine the function of health insurance, and define common health insurance terms. 2.
Today’s Issue Is more choice always better? How much choice is too much? Should the Exchange manage the number and type of products on its store shelves?
City of Plano Retiree Non-Medicare Open Enrollment Plan Year 2010.
Health Insurance Affordable Healthcare Act Video.
1 California Health Benefit Exchange California Health Benefit Exchange: A centerpiece of health reform The Exchange: Consumer empowerment, choice, healthy.
Healthcare Reform Updates: Choices For Employers And Individuals.
2016 Humana Individual–Medical Plan Designs
HealthCare Reform (PPACA). Employer Mandate Employees are impacted by Employer decision to offer healthcare – Employee enrolling in non-compliant plan.
Health Care Reform September 18 th, Individual Marketplace O Which individuals can purchase insurance on the exchange? O Individuals who do not.
The Next Generation Distribution Model Leading the way into the ACA! o.
Do we continue with: OEA Choice Trust as our Insurance Provider? Do we move to the State Insurance Pool (OEBB)?
Pharmacy Benefits Rx4 Traditional replaces Rx3
Health Insurance Update November Goals of Franciscan University’s Health Insurance Program Protect University employees and their families from.
Presentation to: Alliance for Health Reform Congressional Briefing Kaitlyn Kenney Director, Policy & Research Health Connector May 24, 2010.
The Arkansas Health Care Independence Program An Alternative to Medicaid Expansion Richard Armstrong Director Department of Health and Welfare December.
Quality health plans & benefits Healthier living Financial well-being Intelligent solutions Finding the path to a healthier plan choice Aetna Medicare.
1 Exchanges The Basics. Public Marketplace Qualified employees receive tax credits See plans from all participating carriers Private Marketplace Broader.
1 HORIZON BLUE CROSS BLUE SHIELD OF NEW JERSEY. Individual Exchange Products The products offered on and off the Exchange will comply with the Accountable.
Health Republic Insurance of New Jersey (HRINJ) One of 23 non-profit, member-governed health insurance companies in America. Part of the Affordable Care.
Health Care Reform 401: A New Jersey-Oriented Review of the ACA & Its Impact on the Small Group Marketplace.
Healthcare Industry NAICS CODE Health Care History  Organized medicine took shape dating back to 1900s  Franklin D. Roosevelt approved public.
Duke University & Health System Oct. 24 – Nov. 4, 2016 Open Enrollment for 2017 Benefits.
Comprehensive Health Insurance Plan Plan Year 2018 (July 1, June 30, 2018) Medical Vision Dental Term Life Insurance Long Term Disability.
Teachers’ Retirement Insurance Program (TRIP)
The Power of the Tree of Life
Purchasing ACA Insurance
State Health Benefit Plan
Davidson College Plan Comparison
Special Olympics southern california
Health Plan Overview & Updates
Navigating the Health Insurance Marketplace
Medical and Prescription Drug Deductibles
Benefits Overview.
Selecting Benefit Coverage that is Right for Your Needs
Davidson College Plan Comparison
Health Insurance Marketplace Survey of the 2019 Virginia QHP Options
Health Care Reform: What It Means for You Jewish Family Service Austin Alamo Breast Cancer Foundation December 16, 2010 Stacey Pogue, Senior Policy.
Health Insurance Marketplace Survey of the 2019 Virginia QHP Options
State Corporation Commission Bureau of Insurance Rate Presentations
Ohio Small Business Health Insurance Market Guide
Presentation transcript:

Humana, Healthcare Reform and You Dave Vanden Heuvel Director, Medical Products

About Humana Headquartered in Louisville, KY Over 50 years experience in the health industry Diverse portfolio of products Over 13.8 million medical members nationwide Over 6.8 million Medicare members nationwide Over 7.7 million members in specialty products Corporate Social Responsibility – Humana Foundation – KaBOOM! – Humana Walkit Challenge – Arbor Day Foundation – Habitat for Humanity 2

2015 Individual Plans: On & Off the Marketplace

2014 Recap In 2014 Humana offered a variety of individual medical & dental plans on & off the Health Insurance Marketplace in Ohio. On the Marketplace, we offered: Medical Plans in Cincinnati & Dayton We offered a Basic (catastrophic) plan as well as a plan in each metallic level, except Bronze. These plans leveraged a HMOx network, which encouraged strong relationships with local primary care providers who help members manager their healthcare We offered a standalone statewide Dental plan which could be purchased with a Humana medical plan or another carrier’s medical plan Off the Marketplace, we offered: The HMOx plan offerings listed above in Cincinnati & Dayton We also offered a variety of Bronze & Silver plans as well as a Basic (catastrophic) plan statewide which included a national PPO network 4

2015 Approach - Medical Humana’s goal in 2015 is to maintain consistency within our plan offerings and avoid disruption to our existing membership where possible. Medical plan changes for 2015: Based on federal guidance, changes are required to our Basic (catastrophic) plan offering Addition of a Bronze plan to the Dayton & Cincinnati/Northern KY HMOx offerings Expansion of the Dayton HMOx network to 5 new counties Adding the Dayton HMOx network in Butler & Warren counties, in addition to the existing Cincinnati/Northern KY HMOx network Note the Dayton HMOx network offering will not include a Silver plan in Butler & Warren To enhance the shopping experience for consumers, Humana will be updating our plan names to include the network Old Name: Humana Local Preferred Bronze 6300/6300 New Name: Humana Bronze 6300/Dayton HMOx 5

2015 Approach - Dental Dental plan changes for 2015: Children’s maximum out-of-pocket changed to $350 per child / $ children Children’s deductibles increased from $100 to $125 to meet Actuarial Value requirements Moving to a calendar year benefit period (Jan. – Dec) to align with the MarketPlace 6

HMOx in Cincinnati & Dayton Plans offered in 7 Counties both on & off the Marketplace Advantages of our HMOx plan offerings: Helps keep healthcare costs down by utilizing a network of select healthcare providers and facilities Encourages members to build a strong relationship with their Primary Care Physician Primary Care Physicians help members manage their healthcare by connecting them to specialists or other providers when necessary Rx network (Walmart, Sam’s Club, CVS, RightSource) Closed RX5 formulary Offered in markets where we are competitively priced Offered in all metallic tiers + catastrophic 7

Humana/ChoiceCare Network PPO Plans offered statewide off the Marketplace Advantages of our Humana/ChoiceCare Network PPO plan offerings: Freedom to choose any doctor, hospital or specialist nationwide Plans follow Metallic tiers National Network Humana National Pharmacy Network (includes major retailers) Rx4 Open Formulary Offered in Bronze and Silver metallic tiers + Basic (catastrophic) Allows for OON coverage, but consumers receive the most benefit when utilizing an in-network provider 8

Humana Smart Choice Dental Humana Smart Choice Dental (On the Marketplace) Immediate and affordable benefits Competitive adult/family rates Comprehensive child coverage, additional coverage for major services and a limited orthodontic benefit for kids is available No annual max for kids New for 2015: $350 max out of pocket per child, $700 for 2+ children (previously $700/$1400) Increased deductibles from $100 to $125 to meet necessary Actuarial Value requirements Moving to a calendar year benefit period to align with the exchange renewal process 9