Humana COVID-19 At-Home Testing Updates

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Beginning January 15, 2022, Humana will cover over-the-counter COVID-19 at-home test kits for members.

As announced by the U.S. Department of Health and Human Services group health plans will cover the cost of at-home, over-the-counter COVID-19 test kits beginning on January 15. This new policy will cover eight test kits per month, for all covered members, at no out-of-pocket cost.

Humana will offer commercial group members two options to get at-home, OTC COVID-19 test kits at no-cost:

  1. Pay the full amount for the test up-front and get reimbursed, and
  2. Have the pharmacy staff process the at-home OTC COVID-19 test kit as a claim and receive payment directly from Humana at no cost to them.

Please read the FAQ below for details and contact your Cornerstone representative with any questions.

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Humana Go365 Updates for January 2022

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Your resource for small group (2-99 eligible) Go365 questions and education:

  • Inside Engagement Professional: SBEngagament@humana.com
  • Go365 Healthy Life Coaching has arrived! A part of the whole-person approach Go365 takes to supporting well-being, Healthy Life Coaching is now available. This program is approved by the National Board for Health and Wellness Coaching and our coaches are highly trained professionals. They will help participants with weight management, stress, relationships, physical activity, career development and more. Members will be able to see their progress and achievements in the coaching section of the Go365 App. Check out this new offering today!
  • Daily Burn Sunset – Effective immediately, Daily Burn is no longer a compatible coaching app within the Go365 experience. Members can no longer see it in the Go365 experience to connect.  Member impact is low (~45 active users).
  • Go365 App Update – The Go365 App just went through an update and any member accessing the old version will be required to update the Go365 app before accessing.
  • Reminders when members submit proof for eligible activities
    • This year, we updated our verification process to determine eligibility for rewards based on proof submitted online or in the Go365 App. Since implementation, Humana has successfully denied numerous invalid self-submissions, standing up the integrity of the Go365 program. Any member that may have submitted an image they feel is valid, but it is denying, should call customer service.
    • To eliminate a potential call to customer service, Humana has a few pointers when members take a photo of a document to prove participation:
      • Keep it in focus
      • Remove as much background as possible and limit shadows
      • Avoid selfies with the documentation (i.e. member holding their bib – keep it to just the bib)
      • Capture the entire valid document that displays member name and date of the event
      • Stick to one form of proof, not all (i.e. one Bib, not a photo of both the bib and race results)
    • The following are available on the Go365 Community to help guide members:
  • Go365 Terms & Conditions Update – Updates to member agreements for Go365 typically occur at the beginning of a calendar year and 2022 is no exception. All Go365 members will be prompted to re-accept the Go365 Terms and Conditions (T&C) upon their first sign in to Go365.com and the Go365 App. The prompt takes place regardless of a member’s Go365 program effective date or how recently they may have accepted the program agreements previously. This is a reminder that the prompt occurs automatically and will begin as soon as December 29, 2021.  The primary update this year is the addition of Terms and Conditions for our coaching program, Healthy Life Coaching. The new language provides guidance on how the coaching program is administered; rules, confidentiality, access, and disclaimers regarding the parameters of coaching services. This is integrated with the Go365 T&C acceptance, regardless of whether members have access to Healthy Life
  • Home COVID Test Kit – Looking for a home COVID test kit?  Check out Humana + JPR Medical Website.
  • Go365 Webinars

Earn More with Humana’s Agent Bonus Programs!

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Earn a bonus when you sell Humana medical plans and new specialty lines of coverage with effective dates of January 1, 2022.

Click below for additional information regarding the bonuses:

Bundling Bonus

Subscriber Bonus

Contact your Cornerstone representative with any questions.

Humana Adds State Exhibit to Producer Contract

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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’s Dental Waiting Periods to Change November 1 for 5+ Enrolled

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Effective November 1, 2021, dental waiting periods are being eliminated on all new and existing employer-sponsored Humana groups with 5+ enrolled who meet certain criteria (below). This change in policy will position Humana more competitively and promote improved retention on existing business.

No waiting periods criteria:

  • Employer-sponsored
  • Group size is 5+ enrolled
  • Groups currently enrolled (still in their waiting periods) and new business (in the process of enrolling) in a 2019 generation dental plan
  • New business with an effective date of November 1, 2021, and beyond who are enrolling in a 2019 generation dental plan

This change does NOT apply to:

  • Late applicants waiting periods
  • Voluntary groups
  • Groups with 2 to 4 enrolled
  • Groups currently enrolled or enrolling in any dental plan except generation 2019

Benefit summaries, plan materials, marketing materials, and Mentor are in the process of being updated by the November 1, 2021, effective date. Due to the short timeframe of the change in waiting periods, some resources may not be ready in time.

Contact your Cornerstone representative with any questions.

Changes in Humana’s COVID-19 Testing Policy Effective October 1, 2021

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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.

Humana Offers New Business LFP Admin Credits

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Humana is bringing back the New Business LFP Admin Credits for December 1, 2021, and January 1, 2022, effective dates. The credit, at $200 per subscriber, is applicable to all markets and applies to new groups and first-time medical adds (i.e., existing ancillary adding medical).

Reminders:

  • Must enroll via LMG in order to qualify
  • Case needs to be submitted by fifth of the month deadline. If installation/underwriting approves to accept a case after the fifth and it goes through paper, it will not qualify for the admin credit.
  • December deadline is on a Sunday, so please be mindful of where the fifth falls
  • Credit will appear on or before the third billing statement.

Contact your Cornerstone representative with any questions.

Earn More with Humana’s New Fourth Quarter Agent Bonuses!

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Could you use a little extra incentive to sell? Below are the NEW bonus programs available through December 1 effective dates:

NEW Bonus Programs Just Released:

Current Bonus Programs Still Available:

Contact your Cornerstone representative with any questions.

IMPORTANT UPDATE: The Humana Dependent Audit Has Been Paused

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On August 9, 2021, we announced through the Monday Minute that Humana will be conducting eligibility verifications of spouse, common law spouse, or domestic partners in its commercial population. Groups were sent notices about this eligibility verification on July 22, 2021. Groups were asked to validate dependent information with 45 days following an inquiry from Humana.

There has recently been an update from Humana.

The dependent eligibility verification has been paused to thoroughly evaluate the program and make improvements before moving forward with the verification. Humana notified employers via email on August 17, 2021 that their impacted employees do not need to take action until further notice. We’ll be sure to share related communications with you, as they are developed.

Please reach out to your Cornerstone representative with any questions.

Humana Creditable Coverage Drug Lists

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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:

Contact your Cornerstone representative with any questions.

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