Effective starting August 18, 2021, all licensed producers will receive a new exhibit to their contract, Exhibit 4: Product Authorization. This exhibit will list the states where the producer is considered to be contracted to sell with Humana.

As stated above, Exhibit 4 will list the states where a producer is considered contracted, including any non-appointment state and any state for which an active appointment exists. Renewal commissions are not impacted, they will continue to pay in accordance with applicable laws.

A new exhibit will be triggered when a producer:

• No longer has any active appointments in a state (the state will be removed)
• Has a state license that term (the state will be removed)
• Has a new non-appointment state that is added to their record (the state will be added)
• Is first appointed in a state (Note – subsequent appointments in a specific state do not generate a new exhibit)

This exhibit does not impact a producer’s ability to sell in any state where they are properly licensed. As long as they are properly licensed in the state where they are selling and maintain an active producer contract, Humana will automatically re-appoint the producer for the specific legal entity that is necessary.

Contact your Cornerstone representative with any questions.

Humana has updated their current COVID testing policy effective October 1, 2021. They have released a comprehensive FAQ document for your reference.

Humana continues to cover COVID-19 testing at $0 member cost-share for all members as required by the Public Health Emergency (PHE) regulations established by the federal government. This means that Humana members may be eligible for COVID-19 viral (antigen or molecular) testing when:

• The test has been ordered by a physician or other licensed healthcare professional and is FDA-approved or authorized under the EUA, which includes any of the following:
• The member has symptoms of COVID-19 (cough, difficulty breathing, fatigue, fever, headache, nasal congestion, new loss of sense of taste or smell, sore throat); or
• The member is asymptomatic with a known exposure to someone with suspected or confirmed COVID-19 and has not tested positive within the past three months; or
• The member requires pre-admission or pre-procedural testing in an asymptomatic individual.

Humana members may not be eligible for COVID-19 viral (antigen or molecular) testing to be covered for any indications other than those listed above including, but not limited to, the following:

• Employment (e.g. pre-employment, return to work) or school purposes (e.g. return to school); or
• Entertainment purposes (e.g. prior to a concert or sporting event); or
• General population or public health screening; or
• Physicals (executive or routine); or
• Screening in a congregate setting; or
• Sports participation; or
• Travel purposes

Contact your Cornerstone broker advisor with any questions.

If your customers’ health plans include prescription drug coverage and also cover members who are eligible for Medicare Part D benefits, those customers are required to notify such members by October 15 of each year and advise them as to whether their current prescription drug plan is “Creditable” or “Non-Creditable”.

• Creditable coverage means the employer health plan’s prescription drug coverage is expected to pay out, on average for all plan participants, as much as the standard Medicare Part D prescription drug coverage.
• Non-creditable coverage means the employer health plan’s prescription drug coverage is, on average for all plan participants, not expected to pay out as much as standard Medicare prescription drug coverage pays.

Humana will also include an article in the employer newsletter, Humana Focus, to remind your customers of the creditable coverage notice requirement, which will include links to Humana’s prescription plans tested for creditable coverage.

Click these links to view Humana plans tested for creditable coverage:

• Small Group Pharmacy Plans
• Large Group Pharmacy Plans
• Puerto Rico Pharmacy Plans
• LFP Pharmacy Plans
• ASO Pharmacy Plans

Contact your Cornerstone representative with any questions.

Starting August 4, 2021, Humana will begin conducting eligibility verifications of spouse, common law spouse, or domestic partner dependents in its commercial population through an independent vendor. Please be aware that employees of one or more of your groups may be asked to validate dependent information. On average, approximately 8.1 percent of spousal and domestic partner dependents are found to be ineligible for coverage, according to the vendor’s research.

Self-funded and federal employer groups will be exempt from this process. If a dependent is determined to be ineligible, coverage will terminate in compliance with applicable state regulations. Humana will not seek to recover paid claims, so there is no financial impact to the ineligible dependent.

Notification of this process will be sent to employer groups starting July 22, 2021. You can view a sample of the group communication by clicking here. Outreach to employees will begin on August 4, 2021. Dependents will be able to verify eligibility through a variety of methods. They will have a 45-day time period to respond to the verification inquiry.

Contact your Cornerstone representative with any questions!