Humana 2014 Annual Report Download - page 16

8
Individual Commercial Coverage
Our individual health plans are marketed under the HumanaOne® brand. We offer products both on and off of the
public exchange, including exchange offerings in certain metropolitan areas in 15 states. We offer products on exchanges
where we can achieve an affordable cost of care, including HMO offerings and select networks in most markets. Our
off-exchange products offered in 22 states are primarily PPO and POS offerings, including plans issued prior to 2014
that were previously underwritten. Policies issued prior to the enactment of the Health Care Reform Law on March 23,
2010 are grandfathered policies. Grandfathered policies are exempt from most of the requirements of the Health Care
Reform Law, including mandated benefits. However, our grandfathered plans include provisions that guarantee renewal
of coverage for as long as the individual chooses. Policies issued between March 23, 2010 and December 31, 2013 are
required to conform to the Health Care Reform Law, including mandated benefits, upon renewal in 2014, 2015 or 2016,
depending on the state.
Prior to 2014, our HumanaOne® plans primarily were offered as PPO plans in 27 states where we could generally
underwrite risk and utilize our existing networks and distribution channels. As indicated above, this individual product
included provisions mandated by law to guarantee renewal of coverage for as long as the individual chooses.
Rewards-based wellness programs are included with many individual products. We also offer optional benefits
such as dental, vision, life, and a portfolio of financial protection products.
Employer Group Segment Products
This segment is comprised of products sold to employer groups including medical and supplemental benefit plans
as well as health and wellness products as described in the discussion that follows. The following table presents our
premiums and services revenue for the Employer Group segment by product for the year ended December 31, 2014:
Employer Group
Segment
Premiums and
Services Revenue
Percent of
Consolidated
Premiums and
Services Revenue
(dollars in millions)
External Revenue:
Premiums:
Group Medicare Advantage $ 5,490 11.4%
Group Medicare stand-alone PDP 8 —%
Total group Medicare 5,498 11.4%
Fully-insured commercial group 5,339 11.1%
Group specialty 1,098 2.3%
Total premiums 11,935 24.8%
Services 362 0.8%
Total premiums and services revenue $ 12,297 25.6%
Intersegment services revenue:
Wellness $ 78 n/a
Total intersegment services revenue $ 78
n/a – not applicable
Employer Group Commercial Coverage
Our commercial products sold to employer groups include a broad spectrum of major medical benefits with multiple
in-network coinsurance levels and annual deductible choices that employers of all sizes can offer to their employees
on either a fully-insured, through HMO, PPO, or POS plans, or self-funded basis. Our plans integrate clinical programs,
plan designs, communication tools, and spending accounts. We participate in the Federal Employee Health Benefits