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Jason Powers: I’m Jason Powers, and I’m joined by my friend, Leah Daggett, our field sales executive and national sales council appointee with Humana. Welcome, Leah, to the set. Welcome to the show. We’re here for the fourth quarter carrier update, the Q4 kickoff summit. Glad to have you here.

Leah Daggett: Thanks, Jason. Happy to be here. Happy to talk about some of our updates for fourth quarter, moving forward.

Jason Powers: That’s awesome. Leah, you are not new to the show. You’ve been on the… This is a new studio for us, but you’ve been here before, and you did a great job of giving us an update last year. We’re looking forward to hearing what’s going on with 2023 and beyond with Humana.

Leah Daggett: Thank you. Happy to be here. The studio is beautiful, so.

Jason Powers: A lot of blood, sweat, and elbow grease.

Leah Daggett: I believe it.

Jason Powers: Well, let’s jump right into it. Humana, in the fourth quarter, what’s going on? What’s new?

Leah Daggett: Yeah. So we got a couple new things. The first one here is, we’ve done this in years past, our 15 month contract will be available to our level funded groups for 12/1 and 1/1 effective dates. The pricing will actually be the same as our 12 month contract. So the great thing about that is you can lock in at lower rate for a couple extra months. Just let us sales reps know at Humana that that’s what you want to do, and we’ll make sure that’s within the contract on your plan.

Jason Powers: And there’s no difference in rate, right?

Leah Daggett: Correct.

Jason Powers: It is the rate one way or the other way.

Leah Daggett: Yep. So 12 months or 15 months, it’s going to be the same rate across the board. So if you want to lock in, get those extra months, just let us know. We’d be happy to do it for you.

Jason Powers: I think the key for brokers that are considering that… It’s like, “Well, what’s the downside?” The key to remember is that communication with the members is that the open enrollment then pushes out another three months. So I think just, if you’re selling a 15 month contract, during that open enrollment meeting, make sure you’re communicating to those members that the open enrollment then pushes out to 15 months.

Leah Daggett: Exactly.

Jason Powers: It doesn’t come back around. So if you’re a January 1, it moves to an April 1 effective date. And that’s the next open enrollment.

Leah Daggett: Yep. So you’ll have a new calendar year plan, well plan year. But they will have that new open enrollment period pushed out. Exactly.

Jason Powers: That’s great. What about the plan designs and the product itself? I know we sell both community rated and level funded, any changes there in plan designs?

Leah Daggett: Yeah. So we are actually doing a portfolio refresh for both level funded and community rated. As you can see on the slides, we have a couple updates, so I’m just going to hit a few highlights. One of those being is we are simplifying our product portfolio. So we are going to be offering our simplicity plan designs, copay, savings HSA, which we renamed from high deductible health plan, and then our On Hand product, which is our virtual first product. And then, we are also updating just our deductibles and maximums to align with the new maximum limits, and we’ve expanded our pharmacy formulary. So you’ll see our RX5 as well as some copay and co-insurance cost shares. But I would say the biggest update that we have, just to get us a little bit more competitive in the marketplace, align with what some of the other carriers are doing, is doing what we call a triple hit on our emergency room and outpatient services.

So a member could see on one of their plan designs, a co-pay plus deductible co-insurance option for those types of services. And we’re hoping it kind of steers members towards lower cost services and access to care. And then, also, our On Hand product, which I said is our virtual first, it still has the same benefits as our other plan designs. You can still go in person for care and still have out of network benefits, but you get a couple other value added services, like a concierge team for your members, a kit that has a blood pressure cuff. We’ve expanded that to have some copays on some of the plan designs for in person care. And then, the last piece is just that our world class wellness program will be built into all of our products, level funded and community rated.

Jason Powers: That’s great. And then Go 365, right?

Leah Daggett: Yes.

Jason Powers: So that is the, I’d say you set the bar with wellness programs. I think most conversations we have with agents, when they’re looking at other carriers’ products, coming off of a Humana plan, are do they have something to replace Go 365 because there isn’t one. So it’s something that I think helps with stickiness with renewals. I think members enjoy all the benefits that come with it. And so, it does make retention and persistency a lot higher in that category.

Leah Daggett: Yeah, exactly. And I think, Humana, we just take that insurance piece a step further. We understand that in order to mitigate claims or help people, you need to start at both that mental and physical wellness. And so, our Go 365 kind of opens that window. Get your preventive screening, so you can get things caught early. Where are you mentally? We have a health assessment to kind of gauge what your current age is, what your actual age is based on your answers. And I think it’s kind of an eye opener to allow people to catch things or just be more mindful of getting up and maybe exercising for 10 minutes or going on a walk. So we like to take it just a step further and understand that it’s not just about insurance, at the end of the day, it’s about employees’ wellbeing. And the healthier you feel, the more engaged your employees will be, the happier, the more production that they will have at your company. And hopefully, the better your renewals are too because you’re catching things early. But yes, it’s definitely, I think a game changer in the marketplace, definitely our value that we add to health insurance.

Jason Powers: That’s great. Now, what about options? I know Humana’s been great about providing plan options on the grid that are lower cost options, like Canopy and Efficiency. Those are the two that provide the lower cost, particularly if we’re talking about renewals.

Leah Daggett: Yeah. So with our product portfolio, Canopy was one of probably our high selling product platforms. But just with simplifying the product or portfolio, we have rolled the Canopy plan name under kind of a copay because they were very similar. And then, Efficiency, we didn’t see a lot of membership on there. People would more so kind of elect either our On Hand product, which was very comparable. So with those two, we are no longer showing them on our plan grids. If you’re currently a community rated renewal, we’ll force roll you to either the copay or On Hand product. But if you’re currently level funded, we will not force roll you, but we’ll encourage you to either elect that copay or On Hand product. Sorry.

Jason Powers: Stick and the carrot.

Leah Daggett: Yes. Yes.

Jason Powers: That’s great. So then, what else is going on with the plans? And do we have some deadlines that we need to be looking at?

Leah Daggett: Yeah. So I guess, the last little piece of the refresh would be when can you quote it? So community rated, those new plans are going to be available for 1/1/23 effective groups. You can start quoting it on 10/1. That is probably state by state basis, depending if we can get some early quoting filed or not for 1/1. And then, for level funded, you can quote that now today for 10/1 effective groups.

Jason Powers: Those quotes are all available right now?

Leah Daggett: Yes. For the level funded. And the great thing is you should see some cost savings. So we’re seeing the average between 3 to 10% saving on those plan designs to help get us a little bit more competitive.

Jason Powers: Got it. And I know we won’t take a deep dive into networks, but I know we still have the KC PPOX available, here in the KC market. But otherwise the choice care network is really the broad network that we would normally quote.

Leah Daggett: Correct. Yep. So we have two networks, like you said, the PPOX, which is St. Luke’s based. You’ll typically see roughly 13 to 15% savings just on that network. So if you have a population that’s already using St. Luke’s, you could pair that with a CHC broad network for maybe someone that might travel more often, but both are available. CHC is our nationwide network. Both have out of network benefits. It’s just that, in network, PPOX is limited to the Kansas City metro counties.

Jason Powers: Got it. Now, something new that I’ve seen is the Copay Maximizer, what is that?

Leah Daggett: Yeah, so we are actually partnering with a company called PillarRx. And what they will do is reach out to members that see are using a high cost specialty med, and they will work with a manufactured skits and copay assistance. And so, this Copay Maximizer program should help both employer savings as well as member savings. We’re thinking at least up to, or seeing, predicting up to 20% savings for employers. So this is a way to kind of help keep more consistent renewals, as special team meds are pretty costly, can be some of the biggest chunk of claims for our employer groups. So we’re just trying to do something to help both the members mitigate that cost as well as employers, so that you can see those more stable renewals along the line.

Jason Powers: And we see a lot of similar programs when we start looking at larger groups, self-funded plans where we’re targeting those specialty drugs. It’s really interesting to see Humana kind of jump out front and introduce a program like that to small group. Is this in the community rated and level funded, or is this isolated to level funded?

Leah Daggett: Yeah, so great question. We will have this available on the new product generations that we just talked about earlier for both community rated and level funded and then in our 100+ space as well. The only area that you won’t see this is our 51 to 99 fully insured and then on the high deductible health plans.

Jason Powers: Wow. So there it is, right there. So all the way up to 100+. And then, what’s our, so you mentioned PillarRx, so are they a separate company? Is that a Humana owned company? What is PillarRx?

Leah Daggett: So they’re a separate vendor that we will partner with, and what they do is they take reporting. They’ll get information to see if a member may qualify for some savings through manufacture copay assistance. And what they’ll do is they’ll do an outbound, outreach to the member, either via email or a phone call, explain the program to the member. And if the member is interested, they will then proceed to enroll the member in the PillarRx Copay Maximizer program. From there, they will work with the pharmacy on processing the claims and also work with the manufacturer to get that copay assistance. Just really great way, but the member won’t have to pay more than what they’re currently paying today. They might actually see that they’re saving costs through getting this copay assistance.

Jason Powers: And I tell you, that’s quickly becoming one of the largest line items that we see in claims data is to specialty Rx.

Leah Daggett: Yeah. It counts, I think, there’s like 1% utilization, but it counts like 40% of the claims. So to be able to find something that can help both the member and the employer group steady their claims, so they’re not as much. I think it’s really game changer there and will help us get more aggressive, moving forward.

Jason Powers: And that’s across the grid. I want to make it clear. That’s across the grid. It’s not like you have to choose the On Hand, or you got to choose the Simplicity. This is across the board, across the grid.

Leah Daggett: Yeah. Across the grid, except our, I guess, our savings HSA. So if you’re on that… But yeah, everything, community rated, level funded, or 100+, ASO, you will be having some sort of outreach to them, if you think they qualify.

Jason Powers: That’s great.

Leah Daggett: And be enrolled in that program, hopefully.

Jason Powers: That’s great. And I one part there, it’s not something that the broker has to introduce. This is something automatic that happens in the background. When a member gets prescribed that medication, PillarRx is making that outreach call to the member and engaging with them, at that point.

Leah Daggett: Correct. Yep. So the broker, you guys wouldn’t have to worry about anything. I think the only thing that you need to be aware of is member might call like, “Hey, I got this call from PillarRx. Is this-”

Jason Powers: Who are they?

Leah Daggett: Yeah. Right. Is this real? And so, yeah, all you guys have to do is be aware of it, and we’ll take care of the rest.

Jason Powers: That’s great. That’s great. So what about incentive programs? Brokers love incentive programs. And I know Humana’s got, at least I saw some announcements on it. So walk us through what’s going on here with bonuses.

Leah Daggett: Yeah. So we have a couple great bonus programs going on, right now, our August through December. We do see sometimes those are extended into January. But right now, August through December, we have continued our $25 per enrolled subscriber, one time payments. And that would be for non-community rated groups, as well as our bundling bonus. This is for dental and vision and life cases bundled together that have five enrolled employees or up to 99. And you get 500 bucks for selling dental and vision and 1000 for dental, vision, and life. So with that, I feel like there’s no reason we shouldn’t see some of those dental and vision sales, dental, vision, and life sales, just because it’s pretty big bonus dollars there with Humana. And we have a great product as well on all those lines, so.

Jason Powers: You really do. And we don’t really go into it because we’re talking about the medical products. We’ll do an ancillary tomorrow, but you do have a great dental product with an unlimited max.

Leah Daggett: Yes.

Jason Powers: You’ve got all the standard, what I would call at least here Johnson County, the Johnson county plan, the 100, 80, 50,000 thousand dollars max, but really great pricing, really broad network. Your vision plans are sound and then life insurance as well, so.

Leah Daggett: Yeah. And if you guys, if you ever need any discretion on that, we have some wiggle room on the dental and life. Our vision rates are canned. But yeah, as you said, our products, I think our dental plan is one of the richest dental plans that you’ll see in the industry. We have a built in extended annual maximum, and that provides 30% coverage for our members after they exhaust their annual max. When you incorporate that with our normal discounts, which is about 20% nationwide, a member is seeing about 50% coverage after their annual max has already been met.

Jason Powers: Wow. So the incentive programs for the producers, and reminder to our agents, as a general agency, our relationship with Humana is more of a producer. So a lot of that stuff, we do in coordination with whatever arrangement we have with you on the compensation side. So we do share in those. They tie back to actual case credits, and I want to make sure that we extend those bonuses onto you as well. But not just broker bonuses, you’ve got incentives now for the employers, is that… And I just kind of briefly glanced at it as I was preparing for today, but that is for both products? Or is that just the level funded side?

Leah Daggett: Yeah, so we have two different employer type credits, we would say. The first one is a premium holiday, and that would be our 51 to 99 fully insured groups can get a premium holiday up to a $15,000 credit, admin credit. And that would be for 12/1 and 1/1 effective dates. And this will be for select groups. So when I’m working with you guys, I’ll let you know, “Hey, this case qualifies. They will get this premium credit, if they were to move to Humana.” That’s a new business side only for the 51 to 99 premium holiday. For level funded, this will be for both new business groups and then our current renewal groups, moving from either community rated to our level funded product. The group will get a $200, per rolled subscriber, admin credit. And that’s, again, for 12/1 and 1/1 effective dates on select cases. But we’ll keep you posted on which groups qualify. And then, the employer can share in those savings and credits.

Jason Powers: Those are great. I think that’s a great way to really incentivize groups to take a harder look at Humana, in particular, in some of the areas where you’re really strong. Your network’s really strong. Your product fits really well in that small group segment. And one of the things that makes that product even more attractive is your robust wellness program. I know we touched on it, in the beginning, but I feel like it’s important to finish off with how robust it really is. So talk to us a little bit more. Is there something new going on with Go 365? I know there’s been some enhancements along the way, but the overall theme is what?

Leah Daggett: Yeah. The overall theme, I think the great part of it, I know we kind of touched on this, is we believe in our wellness program so much that not only do we provide a premium credit back to the employers, but also members can earn gift cards, fitness devices. They can get fitness apparel. So I think the great thing about that wellness program is we also have Go 365, we call them client engagement professionals. They’re someone that will outreach to the group and kind of tackle any of the necessary things that need to be done to how do we get your employees engaged? Where do we begin? What do you feel your company is lacking in, where Humana can come in and help? So we’ll have those client engagement professionals that will set up maybe group challenges. I know, Humana, we have a hundred day step challenge. So that kind of gets me moving.

But when clients are engaged, we do find that, not only are saving on your claims cost, but we also provide a premium credit up to 15%. Think about that. At the end of the day, that’s some big premium savings, and that would be based on your tier. So if you have someone that’s covered in family coverage with Humana, and they get to gold status or above, we’re getting a 15% premium credit back to that group. The group can choose what to do with that premium credit. We’ve seen multiple ways that’s done. They’ve given part of it back to the employees to help kickstart them in getting engaged in the program. We’ve seen them keep it and maybe funnel it to different things that they need within their company. And Humana actually penalizes us. If we don’t get our health assessment or biometric screening done, they start pulling some money out of our checks. So different things that you can do with that. But each year I get 300 bucks and gift cards. I them for around Christmas time. And so, it’s just really nice and really fun. Keeps me aware of my health and when I need to get up and get moving.

Jason Powers: Well and you hit it right on the head. So it’s gift cards. It’s that and the premium credits. I think that’s the key for people to remember. And you mentioned family premiums are going through the roof everywhere. It’s not one carrier or another. People out there that have family coverage are paying on level with mortgage payment for a really nice house. And a 15% discount off of that premium can be substantial to that family. So not only that, but then I always enjoyed being able to convert the Go 365 bucks to Amazon gift cards, right around Christmas time. It’s always nice to get $350 worth of Amazon gift cards, so.

Leah Daggett: It’s perfect. I love it. I mean, it makes me feel like Christmas time is not as stressful, when I can have that option to use my Go 365 points, which correlate to bucks for that, so.

Jason Powers: The most stressful part about Christmas is January 1 renewals.

Leah Daggett: That’s true.

Jason Powers: Well, any parting thoughts for brokers as they enter the busy season in Q4 here, in January renewals?

Leah Daggett: I just think I’m always open to any questions you may have. I know we have a great partnership with Legacy. So if there are any questions that you have, be happy to help on that. Any program updates you may need, just let us know, and we’ll work with Jason to make sure you get all the information you need. And hopefully. Just everyone can breathe here in the next couple of months. I know busy season’s right around the corner, if not here already.

Jason Powers: Oh my goodness. It’s already here. It’s already here. Well, you heard it from Leah. You need anything with Humana, or with your Humana quotes, or Humana support, you can reach out to our team here at Legacy Brokers, and Leah’s happy to support on their side as well. Until next time, we bid you a successful and prosperous Q4. Thanks for joining us. We’ll see you next time.

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