Full Portfolio of Products
Medical
Dental
Vision
Supplemental
Senior
Products
FullIndividual
portfolio ofTraditional
products that
meet theCash
needs
of your
clients
Medicare
Vision Focus
Cancer
Major Medical
Short Term
Medical
Plus*
Advantage
Loyalty Plus
Part D
Prescription
Drug Plans
Vision Care
Critical Illness
Preventive
Plus
Hospital Cash
Simple Choice
Junior Estate
Builder
Value
(HI215/C550)
Memorial
Fund
Other
Preventive
Plus Package
for Veterans
Med Supp
(A,B,C,F,G,K,L,N)
Supplemental
Accident
Benefit Rider*
*Sold only with Major Medical
Life Rider*
FOR AGENT USE ONLY
1
Senior Products
FOR AGENT USE ONLY
Medicare Advantage Plans
All the benefits of Original Medicare but even better with Humana’s variety of value-added
services
E Extra services – at no extra cost
•
Health Maintenance Organization (HMO)
–
–
•
•
Prescription home-delivery service for
90-day supplies
•
Humana Active Outlook- life
enrichment program offering health and
wellness information through
publications, website, local seminars,
plus many other programs
•
Fitness program - fitness center
membership in some areas
•
Personalized monthly update of your
medical and prescription drug expenses
and benefits
•
Online services, including personal
password-protected page on our
website and the online Rx Calculator to
help estimate monthly drug costs
Preferred Provider Organization (PPO)
–
–
–
•
Choice of a primary care doctor from our
network to coordinate care
Affordable monthly plan premium and
predictable copayments on most services
Freedom to choose provider – there may
be lower costs if in-network providers are
used
No referral required to see any provider
Affordable copayments for doctor’s visits
Private-Fee-for-Service (PFFS)
–
–
Network – Even though any doctor can be
chosen, most of our plans offer some form
of a network, which gives your clients
another way to save money on their care
Easy-to-use plan with full range of benefits
3
Medicare Prescription Drug Plan
(Part D)
Smart choice for easy-to-use drug coverage
• Help your clients with the prescription drug coverage that fits their needs
– Choose a stand-alone prescription drug plan – Humana offers 3 stand-alone
plans in most areas
– If your client is enrolled in both Part A and Part B of Medicare and chooses a
Humana Medicare Advantage plan with Prescription Drug coverage (MAPD),
they get prescription drug coverage automatically. That means no extra
decisions
• Get extra benefits with no extra costs
– Prescription home delivery by mail – Save money and reduce trips to the
pharmacy
– Monthly statement – SmartSummary Rx® is an easy-to-follow update of
prescription drug costs and benefits
– Rx Calculator – Provides estimates of monthly drug costs and how long it will
take to reach the various “stages” in the plan
Only approved private insurers like Humana provide prescription drug coverage
FOR AGENT USE ONLY
4
Med Supp
(A,B,C,F,G,K,L,N)
Plans
K, L & N
Help manage
expenses
Plan F & G
Protection against high
out-of pocket costs
Plan C
Predictable monthly expenses
Plans A & B
Basic Coverage
Medical Plans
 Individual Major Medical
 Short Term Medical
FOR AGENT USE ONLY
Individual Major Medical Plans
AL, AZ, CO, FL, GA, IL, KY, LA, MI, MS, TX, UT, WI
Enhanced Copay / 80%
Copay / 80%
Copay / 70%
Value / 100%
Enhanced HSA. / 100%
HSA. / 100%
80/60
80/60
70/50
100/75
100/70
100/70
Coinsurance options
Deductible options
Coinsurance
out-of-pocket limit
Lifetime maximum
benefit
Benefits
Individual:
$500
$1,000
$1,500
$2,000
$2,500
$3,500
$5,000
Family*:
$1,500
$3,000
$4,500
$6,000
$7,500
$10,500
$15,000
Individual:
Family*:
Individual:
Family*:
$3,500
$5,000
$10,500
$15,000
$1,500
$2,500
$5,000
$4,500
$7,500
$15,000
Individual:
Family*:
Individual:
Family*:
Individual:
$2,500
$5,000
$3,500
$7,000
$5,000
Individual:
Family*:
Individual:
Family*:
Individual:
Family*:
$5,000
$7,500
$15,000
$22,500
$1,500
$2,500
$3,500
$5,000
$5,950
$3,000
$5,000
$7,000
$10,000
$11,900
$1,500
$2,500
$3,500
$5,000
$5,950
$3,000
$5,000
$7,000
$10,000
$11,900
Family*:
Individual:
Family*:
Individual:
Family*:
Individual:
Family*:
$10,000
$0
$0
$0
$0
$0
$0
Unlimited
Unlimited
Unlimited
Unlimited
Unlimited
Unlimited
Preventive care
Diagnostic lab and xrays
100%
First $500 at 100% , then
80% after deductible
100%
100%
100% after deductible
100% after deductible
100% after deductible
Unlimited visits
$35 PCP, $60 Specialist
100%
First $300 at 100% , then
70% after deductible
3 visits-$35 PCP, $60
Specialist
then 70% after deductible
100%
Office visit copay
(injury/illness visits)
100%
First $400 at 100% , then
80% after deductible
6 visits-$35 PCP, $60
Specialist
then 80% after deductible
100% after deductible
100% after deductible
100% after deductible
80% after deductible
80% after deductible
70% after deductible
100% after deductible
100% after deductible
100% after deductible
$100 access fee then 80%
after deductible
Separate $500 deductible
then copay
$15/$35/$60/35%
$100 access fee then 80%
after deductible
Separate $700 deductible
then copay
$15/$35/$60/35%
$125 access fee then 70%
after deductible
Separate $1,000 deductible
then copay
$15/$40/$65/35%
$125 access fee then
100% after deductible
Separate $1,000
deductible then copay
$15/$40/$65/35%
100% after deductible
100% after deductible
Integrated with Medical
100% after deductible
Not covered. Member has
access to discount card
Inpatient/ Outpatient
services
Emergency room
services
Prescription drug
coverage
Plan snapshot only. Refer to your state-specific benefit summary for complete details and
non-network coverage.
FOR AGENT USE ONLY
7
Individual Major Medical Plans
IN, NM, NE, NV, OH, OK VA, NC, KS, MO, SC, TN
Portrait Share 80 Plus Rx Autograph Share 80 Plus Rx Autograph Total / HSA.
Coinsurance options
80/60
80/60
100/70
Individual:
Family*:
Individual:
Family*:
Deductible options
$1,000
$2,500
$2,000
$5,000
$3,500
$5,000
$6,000
$7,000
$10,000
$12,000
Coinsurance
out-of-pocket limit
Individual:
Family*:
Individual:
$2,000
$4,000
$2,000
Lifetime maximum
benefit
Benefits
Autograph Total Plus
Rx/ HSA.
100/70
Monogram Total Plus Rx
100/75
Individual:
$2,000
$3,000
$4,000
$5,200
Family*:
$4,000
$6,000
$8,000
$10,400
Individual:
$1,500
$2,500
$3,500
$5,000
Family*:
$3,000
$5,000
$7,000
$10,000
Individual:
Family*:
$7,500
$15,000
Family*:
Individual:
Family*:
Individual:
Family*:
Individual:
Family*:
$4,000
$0
$0
$0
$0
$0
$0
Unlimited
Unlimited
Unlimited
Unlimited
Unlimited
Preventive care
Diagnostic lab and xrays
100%
First $200 at 100% , then
80% after deductible
100%
First $200 at 100% , then 80%
after deductible
100%
100%
100%
100% after deductible
100% after deductible
100% after deductible
Office visit copay
(injury/illness visits)
Unlimited visits
$35 PCP, $50 Specialist
6 visits-$35 PCP, $50 Specialist
then 80% after deductible
100% after deductible
100% after deductible
100% after deductible
80% after deductible
80% after deductible
100% after deductible
100% after deductible
100% after deductible
80% after $75 copay per
visit and after deductible
Separate $500 deductible
then copay
$15/$35/$55/25%
80% after $75 copay per visit
and after deductible
100% after deductible
100% after deductible
Separate $1,000 deductible
then copay $15/$35/$55/25%
Not covered
Integrated with Medical
deductible
Inpatient/ Outpatient
services
Emergency room
services
Prescription drug
coverage
100% after $125 copay
per visit and after deductible
Separate $1,000
deductible then copay
$15/$40/$65/25%
Plan snapshot only. Refer toFOR
your
state-specific
AGENT
USE ONLY benefit summary for complete details and
non-network coverage.
8
Optional Benefits
(available with IMM plans in select states)
• Dental
– Traditional Plus includes coverage for preventive, basic, and major
services for network or non-network dentists
– Preventive Plus covers the most common preventive and basic services,
and discounts are available for major and basic services the plan doesn’t
cover
• Term Life – eligible for up to $150,000 in term life coverage
• Supplemental Accident – pays a set amount for treatment of
an accident
• Deductible credit to use next year – covered medical expenses
that apply to your deductible between Oct. 1-Dec. 31, can
apply to medical deductible for the next year
FOR AGENT USE ONLY
9
Short Term Medical Plans
Short Term Medical / 100%
Short Term Medical / 80%
100/75
80/60
Coinsurance options
Deductible options
Coinsurance
out-of-pocket limit
Lifetime maximum benefit
Individual:
Family*:
Individual:
$500
$1,000
$2,500
$5,000
Family*:
$1,000
$2,000
$5,000
$10,000
$1,000
$2,500
$5,000
$2,000
$5,000
$10,000
Individual:
Family*:
Individual:
Family*:
$0
$0
$2,000
$4,000
$2 million per covered person
$2 million per covered person
Preventive care
not covered
not covered
Diagnostic lab and x-rays
100% after deductible
80% after deductible
Office visit copay
(injury/illness visits)
100% after deductible
80% after deductible
Inpatient/ Outpatient
services
100% after deductible
80% after deductible
Emergency room services
100% after deductible
80% after deductible
Prescription drug
coverage
Integrated with medical 100% after deductible
Integrated with medical 80% after deductible
Benefits
Unless mandated by the state, preventive care, mental
health and hospice care are not covered.
Optional benefits like dental, life and the supplemental
accident benefit are not available with these plans.
Plan snapshot only. Refer to your state-specific benefit summary for complete details and
FOR AGENT USE ONLY
non-network coverage.
10
Dental and Vision
Plans
11
FOR AGENT USE ONLY
HumanaOne Dental Product Line
Sold with Medical Stand-alone
NEW
Dental Discount Bundle
NEW
(not named yet, scheduled to launch 4Q12)
HumanaOne Dental Simple ChoiceSM
NEW
(pilot: launching in PA 2/12; SC, NC, VA pending DOI approval)
HumanaOne Dental Loyalty PlusSM
(launched 12/11)
HumanaOne Dental Preventive Plus
HumanaOne Dental Value
(formerly C550 and HI215)
HumanaOne Dental Traditional Plus
Paper Applications
Apply on AWB
FOR AGENT USE ONLY
12
Life and
Supplemental Plans
13
FOR AGENT USE ONLY
Critical Illness Cash plan
 Pays lump-sum cash benefits for critical illnesses such as heart attack, stroke, and
cancer
 Issue ages 0 − 69 (may vary by state)
 Benefit amount from $5,000 to $50,000 with choice of plans:
- Vascular, cancer, and other illnesses
- Vascular and other illnesses
- Cancer only
 Benefits may reduce to 50% after age 70
 Covered cancer means first diagnosis (doesn’t include skin cancer except
malignant melanoma)
 Guaranteed renewable
 Optional Return of Premium rider and Cash Value rider offered in select states
FOR AGENT USE ONLY
14
Hospital Cash plan
 Provides lump-sum benefits directly to client for:
- Hospital confinement
- Outpatient surgery
- Emergency room care due to a covered illness or injury






Issue ages 0 − 69 (may vary by state)
Lump-sum hospital confinement from $250 − $2,000
Maximum coverage $2,000 for all in-force policies
$150 lump-sum accidental injury and sickness benefit per emergency room visit
$150 lump-sum outpatient surgery benefit
Optional hospital confinement daily benefit rider:
$50 ($200 ICU); $100 ($400 ICU; $200 ($800 ICU)
FOR AGENT USE ONLY
15
Memorial Fund
 A whole life plan to offset final expenses; available in benefit amounts




from $1,000 − $25,000
Offers a graded death benefit with level premiums for prospects with
health issues (becomes level after the third policy year)
Guaranteed cash value
Coverage for issue age is 45 − 80 (nearest age)
Premium options are life pay or 10-year pay
FOR AGENT USE ONLY
16
Junior Estate Builder
 Easy-to-obtain term life insurance for children from 14 days to 24 years;
converts to a whole life plan at age 25. Two plans with affordable premiums:
– $15,000 of coverage for JUST $35 per year
– $20,000 of coverage for JUST $45 per year
 At ages 25, 28 and 31, option of obtaining additional benefits with whole life
coverage regardless of health status
 If original choice is $20,000 of insurance, option to add $20,000 of coverage at
each option point (up to $80,000 total coverage)
 At each age interval, can increase the benefit:
– Age 25: double original face amount
– Age 28: triple original face amount
– Age 31: quadruple original face amount
FOR AGENT USE ONLY
17
Preventive Plus
Package for
Veterans
FOR AGENT USE ONLY
Preventive Plus Dental Plan Covered
Services
Covers 100 percent when your clients see an in-network dentist,
with no deductible or waiting period:
• Routine oral exams
• X-rays
• Sealants
• Periodontal exams
• Cleanings
• Topical fluoride treatment
For basic services such as fillings, the plan pays 50% after deductible
is met.
FOR AGENT USE ONLY
19
Discounts and Additional Savings
Savings on:
•
•
•
•
•
Prescriptions
Vision
Hearing care
Urgent & Convenient care centers
And more
We’ve worked with national retailers to
provide discount services for you and
your loved ones.
Humana brand dental coverage is insured or administered by Humana Dental Insurance Company, The Dental
Concern Inc., or Humana Insurance Company of New York. Limitations and exclusions apply. Discount services
offered are not insurance and are subject to geographical availability and may be discontinued at any time.
FOR AGENT USE ONLY
20
What will I get
Agent Compensation
21
FOR AGENT USE ONLY
Medicare Agent Commissions
2012 Commission Schedule
MEDICARE PRODUCTS
Plan Type - Medicare Advantage
All Medicare Advantage (MA Plans)
First Year - Initial Sale
Puerto Rico - $276 paid first month
California - $503 paid first month
All Other States - $352 paid first month
First Year - Replacement
Subsequent Years (2-6)
Puerto Rico -$11.50 pmpm ($138 annually)
California - $21.00 pmpm ($252 annually)
All Other States -$14.67 pmpm ($176 annually)
Subsequent Years (2-5)
MA Product Changes (HMO to PPO, PFFS to PPO, Puerto Rico - $138 paid first month
PPO to HMO, from other Carriers, etc)
California - $252 paid first month
All Other States - $176 paid first month
PlanType - Prescription Drug
First Year - Initial Sale
All PDP Plans
All States - $55 paid first month
PlanType - PDP Product Change
First Year - Replacement
PDP Product Changes (from other Carriers) All States - $28 paid first month
Puerto Rico -$11.50 pmpm ($138 annually)
California - $21.00 pmpm ($252 annually)
All Other States -$14.67 pmpm ($177 annually)
Subsequent Years (2-6)
All States- $28 paid at annual renewal
Subsequent Years (2-5)
All States -$28 paid at annual renewal
Plan Type - MA Product Change
Plan Type - MA & PDP Plan Option Change
Plan Changes (e.g. No change in Contract number,
PFFS A to PFFS B, HMO to HMO SNP, PDP Standard to
PDP Enhanced, etc.)
pmpm = per member per month
Original AOR remains - renewal commissions paid based on originating plan's effective date
Compensation = Commission +
Rewards Points
Line of Coverage
Critical Illness
($35K or more face
value)
Critical Illness
($15K-$30K face value)
Critical Illness
($10K or less face value)
Hospital Cash
Medical
Cash Cancer
Dental Traditional Plus
Term Life
Memorial Fund
Short Term Medical
Dental Preventive Plus,
Simple Choice, Value
(HI215/C550)
Vision
Junior Estate Builder
Rewards Points
Commission
Year 1
4.0
60%
2.5
60%
1.0
60%
1.0
1.0
1.0
1.0
1.0
0.5
0.5
45%
10%
55%
17-20%**
90%
78-110%*
5-15%**
0.5
10%
0.5
0.0
10%
51-70%*
Rewards Points
Commission
Year 1
1.0
15%
1.0
15%
Standardized Medicare
Supplement Plans - High
Deductible F, K, L, N
0.5
15%
Medicare Supplement
Waiver Plans - All Other
Plans
0.5
15%
Line of Coverage
Standardized Medicare
Supplement Plans - High
Deductible A,B,C,F,G3,
Select F
Medicare Supplement
Waiver Plans - All Basic
and Extended Basic
Plans, including Basic
Plans with Riders, Core
and Supplement Plans
*based on age
**depending on state
Compensation = Commission +
Rewards Points
Rewards Points program
Points turn into cash once 3 or more lines of coverage have been sold
15 points = $300
16-29 points = $20 per point
30-49 = $30 per point
50-74 = $40 per point
75-99 = $50 per point
100+ = $75 per point
FOR AGENT USE ONLY
24