Profile: Humana Inc (HUM)
8 Dec 2016
Humana Inc. (Humana), incorporated on July 27, 1964, is a health and well-being company. The Company's medical and specialty insurance products allow members to access healthcare services primarily through its networks of healthcare providers. The Company's segments include Retail, Group, Healthcare Services and Other Businesses. The Retail segment consists of Medicare benefits, marketed to individuals or directly via group accounts, as well as individual commercial fully-insured medical and specialty health insurance benefits, including dental, vision, and other supplemental health and financial protection products. The Group segment consists of employer group commercial fully-insured medical and specialty health insurance benefits, including dental, vision, and other supplemental health and voluntary insurance benefits, as well as administrative services only (ASO) products. The Healthcare Services segment includes services offered to its health plan members, as well as to third parties, including pharmacy solutions, provider services, home-based services and clinical programs, as well as services and capabilities to advance population health. The Other Businesses segment includes its closed-block long-term care insurance policies.
Retail Segment Products
The Retail segment's product categories include Medicare, Group Medicare Advantage and Medicare standalone prescription drug plans (PDP), State-based Medicaid Contracts and Individual Commercial Coverage. The Company offers a range of Medicare plans. The Company contracts with CMS under the Medicare Advantage program to provide a range of health insurance benefits, including wellness programs, chronic care management and care coordination, to Medicare eligible persons under Health Maintenance Organization (HMO), Preferred Provider Organization (PPO) and Private Fee-For-Service (PFFS) plans. It offers standalone PDPs under Medicare Part D, including a PDP offering co-branded with Wal-Mart Stores, Inc., or the Humana-Walmart plan.
The Company offers products that enable employers that provide post-retirement healthcare benefits to replace Medicare wrap or Medicare supplement products with Medicare Advantage or standalone PDPs from Humana. Humana's state-based contracts allow it to serve members enrolled in state-based Medicaid programs including Temporary Assistance to Needy Families (TANF), Long-Term Support Services (LTSS) and dual eligible demonstration programs. Its individual health plans are marketed under the HumanaOne brand. Humana offers products both on and off of the public exchange. Its off-exchange products are primarily PPO and point-of-service (POS) offerings. Humana also offers optional benefits, such as dental, vision, life and a portfolio of financial protection products. The Retail segment includes the Company's contract with the Centers for Medicare and Medicaid Services (CMS) to administer the Limited Income Newly Eligible Transition (LI-NET) PDP.
Group Segment Products
The Group segment's product categories include Group Commercial Coverage, Military Services and Wellness. The Company's commercial products sold to employer groups include a range of various medical benefits with in-network coinsurance levels and annual deductible choices that employers can offer to their employees on either a fully-insured, through HMO, PPO or POS plans, or self-funded basis. Humana's plans integrate clinical programs, plan designs, communication tools and spending accounts. The Company participates in the Federal Employee Health Benefits Program (FEHBP) primarily with its HMO offering in certain markets. Its ASO products are offered to employers who self-insure their employee health plans.
Under its TRICARE South Region contract with the United States Department of Defense (DoD), Humana provides administrative services to arrange healthcare services for the dependents of active duty military personnel, and for retired military personnel and their dependents. The Company offers wellness solutions, including its Humana Vitality wellness and loyalty rewards program, health coaching and clinical programs. The Humana Vitality program provides its members with access to a science-based, actuarially driven wellness and loyalty program that features a range of well-being tools and rewards that are customized to an individual's needs and wants. It also provides employee assistance programs and coaching services, including a turnkey coaching program.
Healthcare Services Segment Products
The Healthcare Services segment's products include pharmacy solutions, provider services, home-based services and clinical programs. Humana Pharmacy Solutions (HPS) manages traditional prescription drug coverage for both individuals and employer groups, along with providing a range of pharmacy solutions. HPS also operates prescription mail order services for brand, generic, and specialty drugs and diabetic supplies through Humana Pharmacy, Inc., as well as research services. Humana operates multi-specialty medical centers, primarily in Florida, staffed by primary care providers and medical specialists practicing cardiology, endocrinology, geriatric medicine, internal medicine, ophthalmology, neurology and podiatry. It also operates Transcend, a Medical Services Organization (MSO) that coordinates medical care for Medicare Advantage beneficiaries primarily in Florida, Arkansas, Alabama and Kansas. Transcend provides resources in care coordination, financial risk management, clinical integration and patient engagement.
The Transcend Insights business focuses on population health and wellness capabilities across the sector and serves healthcare systems, physicians and care teams. The Company is involved in the care management of its customers via in-home care, telephonic health counseling/coaching, and remote monitoring. Its home-based services include the operations of Humana At Home, Inc. (Humana At Home). As a chronic-care provider of in-home care for seniors, Humana provides care coordination services for individuals living with multiple chronic conditions, individuals with disabilities, fragile and aging-in-place members, and their care givers. It offers care management, behavioral health services and wellness programs. Humana's clinical programs include Personal Nurse, chronic condition management and case management, as well as programs supporting maternity, cancer, neonatal intensive care unit and transplant services.
500 W Main St
LOUISVILLE KY 40202
Company Web Links
- U.S. attorneys argue Aetna-Humana deal violates antitrust law
- Mega-M&A risks morphing into breakups by command
- BRIEF-Third Point cuts share stake in Allergan, takes share stake in Humana
- BRIEF-Extendicare Inc - qtrly AFFO earnings per share $0.223
- BRIEF-Extendicare announces solid 2016 third quarter results