Humana 2006 Annual Report Download - page 16

Our Products
As more fully described in the products discussion that follows, we provide health insurance benefits under
health maintenance organization, or HMO, Private Fee-For-Service, or PFFS, and preferred provider
organization, or PPO, plans. The following table presents our segment membership at December 31, 2006, and
premiums and administrative services only, or ASO, fees by product for the year ended December 31, 2006:
Medical
Membership
Specialty
Membership Premiums ASO Fees
Total
Premiums and
ASO Fees
Percent of
Total
Premiums
and ASO
Fees
(dollars in thousands)
Government:
Medicare Advantage:
HMO....................... 457,900 — $ 4,869,044 $ — $ 4,869,044 23.1%
PFFS ....................... 473,000 — 3,136,200 — 3,136,200 14.9%
PPO........................ 71,700 — 493,820 — 493,820 2.3%
Total Medicare Advantage .... 1,002,600 — 8,499,064 — 8,499,064 40.3%
Medicare stand-alone PDP ...... 3,536,600 — 3,050,304 — 3,050,304 14.5%
Total Medicare ............. 4,539,200 — 11,549,368 — 11,549,368 54.8%
Medicaid .................... 390,700 — 520,520 — 520,520 2.5%
Medicaid ASO ............... 178,400 — — 1,423 1,423 — %
Total Medicaid ............. 569,100 — 520,520 1,423 521,943 2.5%
TRICARE ................... 1,716,400 — 2,543,930 — 2,543,930 12.1%
TRICARE ASO .............. 1,163,600 — — 48,019 48,019 0.2%
Total TRICARE ............ 2,880,000 — 2,543,930 48,019 2,591,949 12.3%
Total Government ........... 7,988,300 — 14,613,818 49,442 14,663,260 69.6%
Commercial:
Fully insured:
PPO........................ 1,246,500 — 3,684,442 — 3,684,442 17.4%
HMO....................... 507,700 — 2,019,936 — 2,019,936 9.6%
Total fully insured .......... 1,754,200 — 5,704,378 — 5,704,378 27.0%
ASO ......................... 1,529,600 — — 291,769 291,769 1.4%
Specialty ...................... — 1,902,800 410,986 — 410,986 2.0%
Total Commercial ........... 3,283,800 1,902,800 6,115,364 291,769 6,407,133 30.4%
Total ..................... 11,272,100 1,902,800 $20,729,182 $341,211 $21,070,393 100.0%
Our Products Marketed to Government Segment Members and Beneficiaries
Medicare Advantage Products
Medicare is a federal program that provides persons age 65 and over and some disabled persons under the
age of 65 certain hospital and medical insurance benefits. Hospitalization benefits are provided under Part A,
without the payment of any premium, for up to 90 days per incident of illness plus a lifetime reserve aggregating
60 days. Eligible beneficiaries are required to pay an annually adjusted premium to the federal government to be
eligible for physician care and other services under Part B. Beneficiaries eligible for Part A and Part B coverage
under traditional Medicare are still required to pay out-of-pocket deductibles and coinsurance. Prescription drug
benefits are provided under Part D. CMS, an agency of the United States Department of Health and Human
Services, administers the Medicare program.
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