Humana Medical Plans

[Charise Scrivner]

LOUISVILLEKy.--(BUSINESS WIRE)-- Humana Inc. (NYSE: HUM) today 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. No other Humana health plan offerings are materially affected. The company remains committed to the long-term growth of its core Insurance lines of business, including Medicare Advantage, Group Medicare, Medicare Supplement, Medicare Prescription Drug Plans, Medicaid, Military and Specialty (Dental, Vision, Life, etc.), as well as its CenterWell healthcare services business.

Based on the seasonality of Employer Group Commercial Medical Products earnings, the company now expects first-quarter 2023 earnings to represent approximately 33 percent of full-year 2023 Adjusted EPS, after considering the non-GAAP treatment of the Employer Group Commercial Medical business. This compares to the approximately 35 percent estimate previously disclosed, which did not take into account the non-GAAP treatment of Employer Group Commercial Medical earnings.

Further, due to this seasonality dynamic, the non-GAAP treatment of Employer Group Commercial Medical results is also anticipated to increase the first-quarter 2023 Insurance segment benefit ratio by approximately 30 basis points, with no impact expected on the full-year 2023 Insurance segment benefit ratio.

Humana Inc. (NYSE: HUM) is committed to helping our millions of medical and specialty members achieve their best health. Our successful history in care delivery and health plan administration is helping us create a new kind of integrated care with the power to improve health and well-being and lower costs. Our efforts are leading to a better quality of life for people with Medicare, families, individuals, military service personnel, and communities at large.

Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our full accessibility rights information and language options.

Humana group medical plans are offered by Humana Medical Plan, Inc., Humana Employers Health Plan of Georgia, Inc., Humana Health Plan, Inc., Humana Health Benefit Plan of Louisiana, Inc., Humana Health Plan of Ohio, Inc., Humana Health Plans of Puerto Rico, Inc. License # 00235-0008, Humana Wisconsin Health Organization Insurance Corporation, or Humana Health Plan of Texas, Inc., or insured by Humana Health Insurance Company of Florida, Inc., Humana Health Plan, Inc., Humana Health Benefit Plan of Louisiana, Inc., Humana Insurance Company, Humana Insurance Company of Kentucky, or Humana Insurance of Puerto Rico, Inc. License # 00187-0009, or administered by Humana Insurance Company or Humana Health Plan, Inc. For Arizona residents, plans are offered by Humana Health Plan, Inc. or insured by Humana Insurance Company. Administered by Humana Insurance Company.

Humana individual dental plans are insured or offered by Humana Insurance Company, HumanaDental Insurance Company, Humana Insurance Company of New York, The Dental Concern, Inc., CompBenefits Insurance Company, CompBenefits Company, CompBenefits Dental, Inc., Humana Employers Health Plan of Georgia, Inc., Humana Health Benefit Plan of Louisiana, Inc., or DentiCare, Inc. (DBA CompBenefits). Discount plans are offered by HumanaDental Insurance Company, Humana Insurance Company, or Texas Dental Plans, Inc. Arizona residents insured by Humana Insurance Company. Texas residents insured or offered by Humana Insurance Company, HumanaDental Insurance Company, or DentiCare, Inc. (DBA CompBenefits).

In states, and for products where applicable, the premium may include a $1 administrative fee. If you have purchased an association plan, an association fee may also apply. Some plans may also charge a one-time, non-refundable enrollment fee. (This fee is non-refundable as allowed by state).

Humana group dental plans are offered by Humana Insurance Company, HumanaDental Insurance Company, Humana Insurance Company of New York, Humana Health Benefit Plan of Louisiana, The Dental Concern, Inc., Humana Medical Plan of Utah, CompBenefits Company, CompBenefits Insurance Company, CompBenefits Dental, Inc., Humana Employers Health Plan of Georgia, Inc., or DentiCare, Inc. (DBA CompBenefits).

Humana individual vision plans are insured by Humana Insurance Company, The Dental Concern, Inc., or Humana Insurance Company of New York, or Humana Health Benefit Plan of Louisiana, Inc. Arizona residents insured by Humana Insurance Company. Texas residents insured by Humana Insurance Company.

Humana group vision plans are offered by Humana Insurance Company, HumanaDental Insurance Company, Humana Health Benefit Plan of Louisiana, Humana Insurance Company of Kentucky, Humana Insurance Company of New York, CompBenefits Insurance Company, CompBenefits Company, or The Dental Concern, Inc.

Our health benefit plans, dental plans, vision plans, and life insurance plans have exclusions, limitations and terms under which the coverage may be continued in force or discontinued. Our dental plans, vision plans, and life insurance plans may also have waiting periods. For costs and complete details of coverage, call or write Humana or your Humana insurance agent or broker.

Before applying for group coverage, please refer to the pre-enrollment disclosures for a description of plan provisions which may exclude, limit, reduce, modify or terminate your coverage. View plan provisions or check with your sales representative.

For group plans, please refer to your Benefit Plan Document (Certificate of Coverage/Insurance or Summary Plan Description/Administrative Services Only) for more information on the company providing your benefits.

Statements in languages other than English contained in the advertisement do not necessarily reflect the exact contents of the policy written in English, because of possible linguistic differences. In the event of a dispute, the policy as written in English is considered the controlling authority.

WakeMed has been working diligently for an extended period of time to reach a reasonable new contract with Humana regarding their Medicare Advantage plans. Unfortunately, an agreement has not been reached and the contract terminated as of 12:01 am, October 31, 2023.

When Humana denies claims for care that has already been provided, our patients may have significantly higher out-of-pocket costs. We believe your need for medical care should be determined by you and your doctor, not an insurance company. The decisions our physicians make about your care are based on best practices and evidenced-based medicine. Humana has a demonstrated history of making decisions that are often in conflict with these best practices.

WakeMed is committed to caring for our community and we recognize how difficult this situation is for the patients we serve. We are committed to communicating with our existing Humana MAP patients to ensure they understand the impact that this contract termination will have on them and their financial responsibility for care received.

Humana Medicare Advantage members (HMO and PPO) who are currently in an ongoing treatment program at WakeMed may qualify for a Continuity of Care exception. These individuals should contact Humana to initiate this process. Our WakeMed providers and staff are available to assist with completion of any required documents. Humana is required to offer Continuity of Care coverage when appropriate to ensure their patients have uninterrupted access to the care they need. Members should contact Humana with any questions or concerns about navigating this process.

We recognize how difficult this situation is for the patients we serve. Patients are the heart of everything we do, and we continue working to come to a fair and equitable agreement with Humana. Should we reach an agreement, we will let our patients know as soon as possible.

* Please verify with your supplemental plan that your coverage applies to any Medicare provider. There are rare instances when a supplemental plan restricts your benefit coverage to a limited provider network.

UC San Diego Health has been recognized as a 4.5-star provider of care to Medicare Advantage patients by the Integrated Healthcare Association, a statewide nonprofit group.

If you have any questions on which Medicare Advantage HMO plans are accepted at UC San Diego Health, please call 619-471-9123. For assistance in enrolling in a Medicare Advantage plan, please call My Senior Health Plan, 855-923-3034.

If you need more information after reviewing the list above, call 858-249-3560. Patients who receive medical benefits through another employer group retirement plan should contact their employer group to determine what plans are being offered.

This is not a comprehensive listing of private or public insurance we accept. We strongly encourage you to call your insurance company directly and provide them with tax ID numbers for UC San Diego Medical Group (tax ID 23-7064656) and UC San Diego Health / UCSD Medical Center (tax ID 33-0599494) to verify their participation as in-network providers for your specific insurance plan.

**Johns Hopkins physicians and physician groups are not participating with the MDONEX or VAONEX plans, which are offered on the Maryland and Virginia health exchanges. Johns Hopkins physicians and physician groups are also not participating with the Core, Compass, Navigate, Value or Balance plans, which are also offered on state health exchanges.

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