nefits mandated by Congress, as well as plans providing improved coverage with varying degrees of out-of-pocket costs for premiums, deductibles, and co-insurance. The company’s revenues from CMS and the beneficiary are determined from its PDP bids submitted annually to CMS. The company’s PDP contracts with CMS are renewed generally for a calendar year term unless CMS notifies the company of its decision not to renew by May 1 of the calendar year in which the contract would end, or the company notifies CMS of its decision not to renew by the first Monday in June of the calendar year in which the contract would end. All material contracts between the company and CMS relating to its Medicare stand-alone PDP products have been renewed for 2016, and all of its product offerings filed with CMS for 2016 have been approved. The company administers CMS’ Limited Income Newly Eligible Transition (LI-NET) PDP program. This program allows individuals who receive Medicare’s low-income subsidy to also receive immediate prescription drug coverage at the point of sale if they are not already enrolled in a Medicare Part D plan. CMS temporarily enrolls newly identified individuals with both Medicare and Medicaid into the LI-NET PDP program, and subsequently transitions each member into a Medicare Part D plan that might or might not be a Humana Medicare plan. Group Medicare Advantage and Medicare PDP The company offers products that enable employers that provide post-retirement health care benefits to replace Medicare wrap or Medicare supplement products with Medicare Advantage or PDPs from the company. These products offer the same types of benefits and services available to members in the company’s individual Medicare plans and could be tailored to match an employer’s post-retirement benefit structure. State-based Medicaid Contracts The company’s state-based contracts allow it to serve members enrolled in state-based Medicaid programs, including Temporary Assistance to Needy Families (TANF), Long-Term Support Services (LTSS), and dual eligible demonstration programs. TANF is a state and federally funded program that provides cash assistance and supportive services to assist families with children under age 18. LTSS is a state and federally funded program that offers states a set of program design options and refers to the delivery of long-term support services for the company’s members who receive home and community or institution-based services for long-term care. The company’s American Eldercare Inc. (American Eldercare) acquisition in 2013 expanded the company’s LTSS footprint in Florida. The company’s contracts are generally for three to five year terms. Medicare beneficiaries who also qualify for Medicaid due to low income or special needs are known as dual eligible beneficiaries, or dual eligibles. The dual eligible population represents a disproportionate share of Medicaid and Medicare costs. There were approximately 10.2 million dual eligible individuals in the United States in 2015, trending upward due to Medicaid eligibility expansions and individuals aging into the Medicare program. The company has contracts to serve Medicaid eligible members in Florida under the TANF and LTSS programs. The company’s contracts in Virginia and Illinois serve members under each state’s dual eligible demonstration program. In addition, in Illinois, the company has an Integrated Care Program Medicaid contract. The company’s Kentucky Medicaid contract is subject to a 100% coinsurance contract with CareSource Management Group Company, ceding all the risk to CareSource. In addition to the dual eligible members that the company serves under the Virginia and Illinois demonstration program, it serves other dual eligible members enrolled in its Medicare Advantage and PDPs. As of December 31, 2015, the company served approximately 440,000 dual eligible members in its Medicare Advantage plans and approximately 1,070,000 dual eligible members in its PDPs. Individual Commercial Coverage The company’s individual health plans are marketed under the HumanaOne brand. The company offers products both on and off of the public exchang
humana inc (HUM:New York Consolidated)
500 West Main Street
Louisville, KY 40202
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