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Carrier News

Humana Small Group Updates for Jan 2019

Updated Dental Plans and Enhancements for 2019

Humana overhauled their PPO dental plan designs for 2019 and enhanced the preventive service coverage. The new plan names have a plus sign. Features of Humana’s dental plans include:

  • 3 cleanings a year, standard. No limits on time of service and no health qualifier.
  • Periodontal cleanings now covered under preventive services. 4 per year. Separate from regular cleanings.
  • Starting on 10/1, all new groups will now receive dental ID cards.
  • Extended Annual Maximum included on all Traditional Preferred plans. Humana pays 30% coinsurance on expenses in excess of the member’s annual maximum, excluding orthodontia.
  • No waiting period on groups with 10 or more enrolled for preventive, basic, or major services.
  • Groups with 50% or greater participation receive employer-sponsored rates even if coverage is offered on a voluntary basis.
  • Unlimited Maximum benefit plans available.
  • 2 year rate guarantee available for a 3% load.
  • Periodontal services now every 2 years (was 3 years).
  • Fluoride/sealants covered to age 16 (was age 14).
  • Space maintainers covered to page 15 (was age 14).

Download their Dental Capabilities Brochure and their Producer Specialty Guide for more information.

Updated Producer Guides for 2019

Humana updated their Producer Sales Guide for the 2-99 segment. The document covers quoting, installation, group eligibility, underwriting processes and requirements, member maintenance, etc for all lines of coverage.

In October, Humana published their 2019 Small Group All Options Brochure, which details all community rated plan designs and networks along with dental, vision, and life benefit designs and guidelines.

Humana will Generate Forms 1094/95-B for Small Employers offering Level Funded Premium Plans for the 2018 Tax Year

For small employers who offered Level Funded Premium plans in 2018, Humana will automatically create and mail the employee statements (Form 1095-B) to employees and file the employer reporting including the statements and employer transmittal (Form 1094-B) to the IRS. The annual reporting is required under the ACA from all employers who offer self-funded plans. Humana’s Level Funded Premium plans are self-funded.

Employers can opt out of this service using the electronic opt out form. Large groups considered to be ‘Applicable Large Employers’ (generally groups with 50+ employees across all related companies) must opt out of the service because they are required under the ACA to combine the coverage reporting with their Employer Mandate compliance reporting using the C-series forms. Employers opting out can obtain membership data to facilitate the reporting from Humana directly.

View our article Employer Reporting Requirements under the ACA for more information.

New Spending Accounts Platform Launching Jan 1

Effective Jan 1, 2019, Humana Spending Accounts will transition to a new technology platform known as Humana Access. The transition will improve ease-of-use, increase convenience, and provide more online features. The following spending account options will now be available to groups of all sizes.

  • Health Savings Accounts
  • Health Reimbursement Arrangements
  • Healthcare Flexible Spending Accounts
  • Dependent Care Flexible Spending Accounts

For more information, view the Spending Accounts Sales Presentation and the Humana Access Rate Sheet.

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