Jeffrey Wade
Humana Inc. is an American for-profit health insurance company that was founded in 1961 as a nursing home company. In 2023, Humana announced that it would be exiting the Employer Group Commercial Medical Products business, which includes all fully insured, self-funded, and Federal Employee Health Benefit medical plans. This decision was made after a strategic review that determined that the commercial business was no longer aligned with the company's long-term goals and positioned to meet the needs of commercial members. Instead, Humana will focus on government-funded programs and specialty businesses, such as Medicare Advantage, Group Medicare, and Medicaid. This shift in focus is expected to occur over the next 18 to 24 months.
| Characteristics | Values |
|---|---|
| Type of company | For-profit health insurance company |
| Location | Louisville, Kentucky, US |
| Year founded | 1961 |
| Founders | Lawyers David A. Jones Sr. and Wendell Cherry |
| Current focus | Government-funded programs and specialty businesses |
| Commercial plans | Exiting over the next 18 to 24 months |
| Commercial plans include | All fully insured, self-funded, and Federal Employees Health Benefits medical plans |
| Other services | Group dental and vision plans, Group life insurance plans, Medicare Advantage, Group Medicare, Medicare Supplement, Medicare Prescription Drug Plans, Medicaid, Military and Specialty (Dental, Vision, Life, etc.) |
Explore related products
What You'll Learn
- Humana is exiting the commercial health insurance business
- The company will focus on government-funded programs
- Humana's commercial insurance includes fully insured, self-funded, and Federal Employee Health Benefit plans
- Commercial insurance also covers group dental and vision plans
- Humana is the fourth-largest health insurance provider in the US
Humana is exiting the commercial health insurance business
Humana Inc. has announced that it will be exiting the Employer Group Commercial Medical Products business, which includes all fully insured, self-funded, and Federal Employee Health Benefit medical plans, as well as associated wellness and rewards programs. The company has stated that this decision is the result of a strategic review that determined the Employer Group Commercial Medical Products business was no longer positioned to sustainably meet the needs of commercial members in the long term.
This exit from the commercial health insurance business will take place over the next 18 to 24 months, with Humana shifting its focus to government-funded programs and specialty businesses. The company's core insurance lines of business will remain committed to long-term growth, including Medicare Advantage, Group Medicare, Medicare Supplement, Medicare Prescription Drug Plans, Medicaid, Military, and Specialty (Dental, Vision, Life, etc.). Humana group vision and life insurance plans are currently insured or offered by Humana Insurance Company or its subsidiaries across various states.
In a statement, Humana's president and CEO, Bruce D. Broussard, said, "This decision enables Humana to focus resources on our greatest opportunities for growth and where we can deliver industry-leading value for our members and customers." The move is expected to have minimal impact on the company's full-year 2023 forecast, with Humana raising its forecast for the Medicare Advantage program.
The exit from the commercial group business is a strategic decision that will allow Humana to concentrate its resources on its Medicare Advantage business and other government-backed programs. This shift in focus is expected to benefit a large number of Americans, with potential cross-market implications on healthcare plans administered through commercial insurers, Medicare Advantage, and Medicaid.
While Humana exits the commercial health insurance business, the company emphasizes that no other Humana health plan offerings will be materially affected. This transition aligns with Humana's long-term strategy to primarily focus on government-funded programs and advance its leadership position in specialty businesses.
Gravie Insurance: Making Money by Simplifying Healthcare
You may want to see also
Explore related products
The company will focus on government-funded programs
Humana has announced that it will be exiting the Employer Group Commercial Medical Products business, which includes all fully insured, self-funded, and Federal Employee Health Benefit medical plans, as well as associated wellness and rewards programs. The company will instead focus on government-funded programs and specialty businesses. This decision was made after a strategic review found that the commercial business was no longer meeting the needs of its members or supporting the company's long-term strategic plans.
The transition is expected to take place over the next 18 to 24 months. During this time, Humana will shift its resources towards government-funded programs like Medicare Advantage, Medicare, Medicaid, and Military plans. As of September 30, 2022, Humana had 8.7 million Medicare members across all 50 states, Washington, DC, and Puerto Rico. More than half of these members (5.1 million) were enrolled in a Medicare Advantage plan, which offers extra benefits like dental, vision, and fitness memberships.
Humana's decision to focus on government-funded programs is in line with its strategy to advance its leadership position in integrated value-based care and expand its CenterWell healthcare services capabilities. CenterWell offers payer-agnostic, senior-focused primary care services, and Humana has plans to open new centers in several states, including Indiana, Kentucky, Louisiana, Mississippi, and Texas.
In addition to its focus on government-funded programs, Humana will also continue to develop its specialty businesses, such as dental, vision, and life insurance plans. The company remains committed to the long-term growth of its core insurance lines and to removing unnecessary barriers in healthcare, particularly for seniors, veterans, and school-aged children.
Usage-Based Insurance: Money-Saving or Money Pit?
You may want to see also
Explore related products
Humana's commercial insurance includes fully insured, self-funded, and Federal Employee Health Benefit plans
Humana Inc. has recently announced that it will be exiting the Employer Group Commercial Medical Products business. This includes all fully insured, self-funded, and Federal Employee Health Benefit medical plans, as well as associated wellness and rewards programs. The decision to exit this sector of the market was made after a strategic review found that the company was no longer in a position to sustainably meet the needs of commercial members or support the company's long-term strategic plans.
Humana's commercial insurance business encompasses a range of health benefit plans, including fully insured, self-funded, and Federal Employee Health Benefit options. Fully insured plans, such as the Level-funded premium (LFP) funding solution, are designed to provide predictable costs and financial protection for individuals and businesses. Self-funded plans, on the other hand, offer more flexibility for businesses to control costs by leveraging employees' overall health and wellness through programs like Administrative Services Only (ASO) funding arrangements.
Federal Employee Health Benefit plans are also a significant component of Humana's commercial insurance offerings, providing medical coverage for federal employees. These plans are tailored to meet the unique needs of government employees and their families. In addition to these core insurance offerings, Humana also provides specialty businesses, including dental, vision, and life insurance plans.
While Humana transitions away from commercial plans, the company remains committed to the long-term growth of its core insurance lines of business. This includes a continued focus on government-funded programs, such as Medicare Advantage, Group Medicare, Medicare Supplement, and Medicare Prescription Drug Plans. By shifting its focus, Humana aims to better serve its members and customers, delivering industry-leading value and advancing its leadership position in the healthcare industry.
Child Accident Settlements: The Preferred Path for Insurance Adjusters
You may want to see also
Explore related products
Commercial insurance also covers group dental and vision plans
Commercial insurance covers a wide range of health and medical services, and this includes group dental and vision plans. These plans are typically offered as part of an employee's health benefits package, with the employer purchasing the insurance.
In the case of Humana, the company has recently announced its exit from the commercial health plan business, including the Employer Group Commercial Medical Products business. This means that Humana will no longer offer fully insured, self-funded, or Federal Employee Health Benefit medical plans, as well as associated wellness and rewards programs. However, Humana's individual dental and vision plans are still insured or offered by Humana Insurance Company and its subsidiaries, depending on the state. For example, in New Mexico, group dental plans are insured by Humana Insurance Company, while in Texas, they are offered by Humana Insurance Company, Humana Dental Insurance Company, or DentiCare, Inc. Humana group vision plans also vary by state, with insurance or offers provided by Humana Insurance Company, Humana Health Benefit Plan of Louisiana, Inc., or other subsidiaries.
Other companies, such as Cigna Healthcare, also offer group dental and vision insurance plans for employers. These plans can vary by location and plan type, with exclusions and limitations outlined in the applicable plan documents. Cigna Healthcare provides access to a wide range of dentists and eye care professionals, with options for both in-network and out-of-network coverage.
Additionally, dental and vision insurance can be added to health plans established by the Affordable Care Act (ACA). While these are not considered essential health benefits for adults, they are classified as essential for children, and so pediatric dental and vision coverage may be included in certain ACA health plans.
The Life of an Insurance Adjuster: A Day in the Shoes of Dad
You may want to see also
Explore related products
$0.99
Humana is the fourth-largest health insurance provider in the US
Humana Inc. is a for-profit health insurance company headquartered in Louisville, Kentucky. It is the fourth-largest health insurance provider in the United States. The company was founded in 1961 as a nursing home company called Extendicare Inc. by lawyers David A. Jones Sr. and Wendell Cherry. By 1968, it had become the largest nursing home company in the country. In 1972, Jones and Cherry sold the nursing home chain to purchase hospitals. In 1974, they changed the company's name to Humana Inc., reflecting their goal of providing more humane care.
Humana has a long history in the healthcare industry, dating back to its creation of its own health insurance plan in the 1980s. By 1993, Humana had become the largest hospital operator in the country, owning 77 hospitals. The company has since undergone various strategic shifts, including the sale of its hospitals in 1994 and a focus on health insurance operations. In 2005, Humana partnered with Virgin Group to offer incentives for healthy behaviours. The company has also expanded through acquisitions, such as its purchase of Concentra Inc. in 2010, and has explored mergers with other insurers, including Aetna in 2015.
In recent years, Humana has announced its exit from the Employer Group Commercial Medical Products business, which includes fully insured, self-funded, and Federal Employee Health Benefit medical plans. This decision is part of a strategic shift to focus on government-funded programs and specialty businesses, such as Medicare Advantage, Group Medicare, Medicare Supplement, and Medicaid. Humana's pivot towards government-sponsored health programs is driven by the changing landscape of the healthcare industry, particularly the growth of Medicare and Medicaid as significant profit sources for insurers.
As Humana transitions away from commercial health insurance, it remains committed to the long-term growth of its core insurance lines, including Medicare Advantage, Group Medicare, Medicare Supplement, Medicare Prescription Drug Plans, Medicaid, Military, and Specialty businesses. The company's ranking as the fourth-largest health insurance provider in the US underscores its significant presence and impact in the healthcare industry. Humana's strategic decisions aim to align with evolving market demands and position the company for sustainable growth in the healthcare sector.
Unraveling Career Paths: Life After Being an Insurance Adjuster
You may want to see also
Frequently asked questions
Humana Inc. is an American for-profit health insurance company based in Louisville, Kentucky.
Humana has announced that it will be exiting the Employer Group Commercial Medical Products business, including all fully insured, self-funded, and Federal Employee Health Benefit medical plans. Instead, the company will focus on government-funded programs like Medicare Advantage and specialty businesses.
Some of the specialty businesses Humana will focus on include Group Medicare, Medicare Supplement, Medicare Prescription Drug Plans, Medicaid, Military, and Specialty (Dental, Vision, Life, etc.).
Humana has stated that it will wind down its commercial business over the next 18 to 24 months.
Humana's strategic review determined that the Employer Group Commercial Medical Products business was no longer positioned to sustainably meet the needs of commercial members over the long term or align with the company's long-term strategic plans.
