icn you ucco ,c `" ~ ~~ `~~ ,.1 Torn Slllima~ ,_ ~nt;ve ~- !P i,ar~~ ~~ ~.~uat~n ~._ _. ~~~,~ Hum~"~a -nc. ~ ~;d ~c,G~q ~~ air a~,. e Proposal Prepared for Kerr County January 2008 Gary Looney, REBC A~ N A ~~ U H (~ ~~~~- ~ ~$~~-~ when you need it most September 7, 2007 Kerr County Commissioner's Court C/O County Judge Pat Tinley County Courthouse 700 Main Kerrville, Texas 78028 Dear Judge Tinley: Humana Inc. 8431 Fredericksburg Road Suite 570 San Antonio, TX 78229 vwvw.humana.com HUMANA when you aced it most Thank you for the opportunity to reply to Kerr County's request for proposal. This proposal includes self -funded benefit options submitted on behalf of: Don Wallace -Wallace and Associates As one of the nation's largest publicly traded health benefits companies, Humana offers comprehensive health coverage through a variety of consumer-based and traditional plans. Humana's products and services are designed. to help employers better manage their costs while providing employees increased choice and participation. Rapidly rising health care costs coupled with employee's desire for choice are the principal issues facing employers choosing health benefits coverage today. As a result, Humana is engaging consumers in the cost of their health care, offering choices and providing information to make sound decisions as a means of lowering expenses for themselves and their employers. The company's role is to help members become active health care consumers by providing them with knowledge, navigation, and guidance. ~"` This strategy is supported with innovative products and accomplishments, which include: • Progressive pharmacy programs that allow members to receive prescription drugs while encouraging them to seek effective, lower cost options with extensive information about costs, drug interactions, and efficacy • One of the largest provider networks with hospitals and providers on a regional and nationwide basis • The Personal Nurse° service for care management services in which a registered nurse serves as a personal concierge who guides members through Humana's award winning clinical programs and assists them to navigate the health care system • Service centers that are staffed with service representatives who are highly trained in Humana plans and networks • Our Website, www.humana.com, which earned the prestigious eHealthcare Leadership Gold award for "Best Site Design" and an award of distinction in the "Best Health Content Site" category Humana's goal is to create aconsumer-centric health plan experience that uses products, processes, and technology to provide innovation and enables consumers to take charge of their own health while executing the basics flawlessly. Sincerely, F-- i!r' Thomas Silliman Sales Executive Humana Inc. ~ Enclosure Official Health Benefits Provider of the PGA TOUR HUMANA.~. ~ ; _ >.'; s ~ E when you need it most J, , , .. ,. err ~.r TABLE OF CONTENTS I. Executive Summary II. Benefit Summary III. Proposed Plans and Rates A. 15/12 Contract with 125% Aggregate Attachment B. 15/12 Contract with 120% Aggregate Attachment C. 24/12 Contract with 125% Aggregate Attachment D. 24/12 Contract with 120% Aggregate Attachment IV. Additional Information E. Forms F. Notice to Proposer Form G. Questionnaire H. Directors and Officers Report I. Group Stop-Loss Policy Sample Contract J. Network Facility Listing K. Certificate of Liability Insurance V. Standard Reporting Package Kerr County ABOUT HUMANA Guidance when you need it most Humana is a national health benefits company headquartered in Louisville, Kentucky. To combat rising health care costs, we developed and documented proven health benefit solutions that are working for many employers. The Humana Guidance Solution tells consumers they can look to Humana for assistance in choosing and using their health benefits. We can help employers develop viable, cost-saving employee benefits strategies. Essential components of our approach include: o Leadership in self-funded administration o Experience over three decades in providing group health benefits o Extensive provider networks o Clinical programs with proven results o Excellent customer service o Education and guidance o Reporting capabilities o Award-winning Internet services ~y .~ ~' :~ ~; 4 T ~- "` 3 ~r Humana has been in the health care industry for more than 40 years and has 20 years of experience providing health benefits for groups and individuals. We have historically embraced change and opportunities to reshape our company and the health care industry. In the past five years, Humana has developed collaborative relationships with other innovative organizations to become the nation's leading Internet-enabled, customer-focused health insurance company. We launched our consumer-driven health plans in 2001, and two years later Forrester Research named Humana a market leader in both product offerings and market strategy among companies providing new kinds of health plans. Humana -recognized for industry-leading innovation: o A finalist in three categories of the 2004 American Business Awards for our new approaches to health plans, customer service, and technology leadership o Best example of using technology to facilitate aconsumer-directed health plan at the 2004 Consumer-Directed Health Care Conference (CDHCC) o One of 100 Technology Leaders by Computerworld in 2004 o A leader in the use ofself-service technology by Forrester Research CDHP Survey We use Internet technology to simplify the health care process for employers, members, brokers, and physicians. 2 H//UMANA ~~t1 /t1t777CP when you need it most °tll.r® THE HUMANA GUIDANCE SOLUTION ~~~ ; ~t'~ _ ~ ~~ , ~`'~~ I `'~.r The Humana Guidance Solution integrates health resources, financial forecasting, consumer engagement, and innovative product design. This unique solution blends technology, science, and creative thinking to bring flexibility to health care management. Product Design -Facilitating member involvement Our product innovations lead the consumerism movement in health care: o Plans are designed to allow both employers and individual members to take control of costs and use the health care system effectively o Plan features include up-front allowances, spending accounts, and unique pharmacy plans, which encourage consumers to consider each health care decision carefully o Education helps members improve drug compliance rates and manage chronic illnesses o Tools and resources help guide members toward better utilization Health Resources -Fostering informed decisions and better outcomes Humana provides a comprehensive suite of clinical programs and services -from member-accessed information on MyHumana, to in-depth care coordination for all of our members. We partner with members by meeting them where they are in the health care spectrum, encouraging them to stay well when they are healthy and helping them to navigate the health care system when they are ill. Ultimately, we achieve cost savings for employers by creating informed consumers and reducing utilization, while providing a better experience for members. Our advanced predictive modeling methods transform medical, pharmacy, demographic, behavioral, and hospital claims data into actionable information we can use to identify members who can benefit most from our services. Combining this predictive modeling with our clinical expertise, Humana quickly engages those members to offer personal guidance and education about their health status, care options, and effective benefits usage. 3 HUMANA., ~~ui~~itt7CC when you need it most Financial Forecasting -Turning numbers into answers Humana gives employers an overview of their health benefits by using sophisticated analysis techniques to show: o How their past experience will impact future decisions o How various plan designs and contribution scenarios will affect future expenses Humana helps eliminate one of the most difficult aspects of benefits administration for employers - unexpected costs. With our guidance and consultation, we help employers predict their health benefit expenses accurately, budget effectively, and develop along-term approach to reducing their claims trend. Humana's proven methods let employers essentially "pick their trend." Consumer Engagement -Empowering members Even the most confident person can become completely frustrated when immersed in the health care system. Consumers are expected to buy services without knowing all of the costs, follow instructions without understanding the reasons, and accept decisions without giving any input. Humana encourages members to assume more control over their health. When people are given clear information and guidance, they have the resources to make the right decisions for themselves. When they understand their options and the financial impact of their decisions, they do a better job of managing their spending. It's individuals who improve health care trends over ~`~' the long term -not the government, or employers, insurers, or health care providers Integration drives the solution The integration of Health Resources, Financial Forecasting, Consumer Engagement, and Product Design to create the Humana Guidance Solution uniquely enables consumers to lower costs, change their actions, and improve outcomes. 4 H)UMANA C~l[IC~U 17Cc~ w6cn you aced it iu~ist ~ RESULTS A three-year study shows that the integration of the four key areas in the Humana Guidance Solution has dramatic results. Huntana's experience: a savings of $207 per employee and a claims trend of 5.6 percent. Study results prove the Humana Guidance Solution works Humana conducted a maj or study of its SmartSuite health plans that validates the effectiveness of its guidance solution. The three-year study, ending in 2004, demonstrated that 143,000 members in 155 companies realized a 5.6 percent claims trend -compared to a national cost inflation rate of 12 to 14 percent. This approach is not cost-shifting. The share of contribution from both the employee and the employer remained constant over the life of the study. Study participants: o Used more preventive services with fewer inpatient hospital stays o Had 76.8 percent prescription drug compliance versus 62.7 percent in traditional plans o Utilized Humana's online resources 50 percent more frequently than other members As employers continue to implement the Humana Guidance Solution, they realize the long-term impact of proactive and engaged employees. At the same time, Humana continues to bring more innovative and customized programs and services to meet our customers' needs -achieving the new experience employers and employees seek: o Enabling consumers and employers to lower costs, change behaviors, and improve outcomes o Providing quantifiable results -regardless of the company's size, industry, or demographics o Holding employers' premium increases to single digits o Improving the employer's and employee's experience with health care Ultimately, we achieve cost savings for employers by changing behavior while creating a better experience for both employees and employers. `t.r 5 HUMANA~ ~~ui~~unc~e when you need it mole ~`"' CUSTOMER-FOCUSED SERVICE Customer Service is an integral part of Humana's consumer engagement efforts. We recognize that our members expect and deserve excellent service when it comes to their health benefits -including the prompt payment of their claims and guidance through the complex health care system. From our operational procedures to the recruitment and training of our Customer Service representatives, we are organized around acustomer-focused approach. Humana is dedicated to hiring and retaining a highly professional and qualified Customer Service staff. We require each Customer Service specialist to have a college degree, one year of inbound call center experience, and excellent communication skills. To further enhance associates' skills, Humana provides an intensive eight-week training session. The training includes classroom instruction on claims, benefits and eligibility, interpersonal skills, medical terminology, and systems. Once Customer Service specialists complete training, they are responsible for handling telephone calls from members, providers, agents brokers, and benefits managers. Member Customer Service Prompt claims payment Humana manages more than 75 percent of claims electronically and processes more than 70 percent of all claims automatically -allowing them to be paid quickly and accurately. Our performance goals are: 0 85 percent of claims paid within 14 calendar days 0 95 percent of claims paid within 30 calendar days Prompt Customer Service call response Humana's Customer Service performance includes an average of 20 seconds to answer a customer's call and a 1.3 percent call abandonment rate. Our dedicated Customer Service units serve specific employer groups. These dedicated units allow customer calls, claims, benefits administration, and key accounts to be treated with equally high standards of service. The service centers provide customer-friendly service from 8 a.m. to 6 p.m. (member's time zone), Monday through Friday. After normal business hours, members can call our interactive voice response system, which is available 24 hours a day, seven days a week. In addition, members can log on to our Website, www.humana.com, to obtain personalized Customer Service via the Internet. 6 HUMANA_ ~~uic~iani c> when you need it mast ~""` Employer Customer Service From a quick implementation of your group to online administrative functions, Humana supports employers in every way. Humana assigns an account relationship management team to serve as a single point of contact with employers, providing installations that are efficient, timely, and accurate. An account services director works with the sales executive to implement the employer's plan. They follow awell-defined process to make sure all the necessary steps are completed, thus ensuring a seamless transition. This teamwork allows Humana to provide ID cards, contracts, invoices, and Summary Plan Descriptions on or ahead of schedule. ~- s.-a A collaborative electronic workplace provides a project management approach to the employer's account installation. This process includes ease of installation, a smooth transition, a standardized and simplified process, and increased speed. 'r.r H/jUMANA ~~t/7lT [777 (~C when you need it mist '~.r INNOVATIVE PRODUCT DESIGN We work with employers to help them take control of costs and provide employees with tools and resources to use their health plan effectively. Humana offers traditional plans - PPO, HMO, POS -but our plan design team also works with employers to develop innovative plans that meet employers' different needs. Consumer-Driven Health Plans Our portfolio ofconsumer-driven plans consists of CoverageFirst® PPO, a High Deductible Health Plan, SmartSuite®, Personal Care Account (PCA) PPO, and Humana Preferred PPO. Humana's funding options include Health Savings Accounts (HSAs), Flexible Spending Accounts (FBAs), and Personal Care Accounts (PCAs) -also known as Health Reimbursement Arrangements (HRAs). SmartSuite SmartSuite is a unique health insurance concept from Humana that offers a solution to employers' concerns over the rising cost of providing medical benefits. Employers can choose a wide range of consumer-driven plans and pharmacy benefits. Because this consumer strategy is such a departure from traditional health benefit offerings, ,, employees are prepared through a series of communications that educate them and help them understand what drives increased health care costs. Before, during, and after enrollment: Employees are prepared for the selection of benefits before and during open enrollment through P1anProfessorsM, Humana's turn-key employee communication program. Being an informed consumer starts as early as enrolling in a plan. Enrollment occurs via an online "Wizard" that guides employees to the best plan for them to meet their individual health and financial goals. The Wizard allows employees to make decisions knowing the full financial impact of their choices. The Wizard matches each employee's personal preferences and financial "risk tolerance" and helps the enrollee narrow down his or her choices. It then shows cost variations if the employee chooses a high payroll deduction and richer benefits, or chooses to "pay as you go." The Wizard matches plans based on cost preferences for coinsurance, office visit (copayments and deductibles), Rx, and hospital benefits. The Wizard also asks which services the employee thinks he or she will need in the upcoming year and then factors in national average costs for the services. It drives through each available benefit plan to calculate the anticipated out-of-pocket costs for the employee. Then the wizard adds the payroll deduction to come up with a total and shows the plans with the lowest anticipated cost - or all available plans, according to the employee's preference. a H77UMANA~ (~t~i~Yd77CC~ when you need it mnst ~...r For renewing members, the information in the Wizard is also based on the members' last year's utilization, including how much they spent on health care and what portion was spent on medical or prescriptions. The Wizard shows employees the financial responsibility and risk they take with each plan. Studies indicate that -because of this helpful guidance -many employees choose alower-cost plan and then select an FSA to pay for additional expenses. CoverageFirst CoverageFirst offers catastrophic coverage plus a $500-per-member benefit allowance that is used before the deductible is satisfied. Approved services -with the exception of prescription drugs, medical copayments, and behavioral health services -are covered 100 percent up to the maximum benefit allowance amount when care is received from participating providers. After the benefit allowance is exceeded, a deductible applies. This plan is ideal for the nearly half (45 percent) of health plan members who are expected to have claims at or below $500 in 2006 (Source: Reden & Anders, Ltd.). Personal Care Account (PCA) PPO Humana's PCA plans are based on the IRS' approved Health Reimbursement Arrangement (HRA) guidelines. These consumer-driven health plans can be offered on a standalone basis or as part of SmartSuite. In addition to the PCA funds, employees receive astored-value Visa° card called the HumanaAccesss"' card, which allows them convenient access to their PCA funds and engages them in the purchase process. The HumanaAccess card also coordinates with their FSA if the employer offers this option. i Group N~me:EMVLOVEP '~ GrouO ED.: rT3456 -~ ~I~ _ ~ ~~~ ~_~ i ~,° 06/06 t SKYLAR M NANSFf~f High Deductible Health Plan A High Deductible Health Plan gives employees solid health care coverage plus incentives to manage their benefits wisely. It also allows employers flexibility in cost-sharing. The plan features low premiums and an integrated deductible for both medical and pharmacy costs. Members pay toward the deductible every time they see a doctor or fill a prescription. An out-of-pocket maximum provides a built-in cap on annual health expenses. Once the deductible is met, standard coinsurance rates apply. The High Deductible Health Plan also offers the opportunity to contribute tax-free dollars to a Health Savings Account (HSA), since a High Deductible Health Plan is a prerequisite for opening an HSA. Humana offers seamless administration of both the plan and the HSA, which is managed by Humana's banking partner, UMB Financial Corporation, amulti-bank holding company. 9 H/UMANA (itriiTU~7~u when you need it most ~ Funding options for consumer-driven plans and traditional plans Financial products round out the consumer-driven plans. Regardless of the plans selected, groups have several options when it comes to funding the plans, for the benefit of the company and the employees. Humana offers and administers Health Savings Accounts and Flexible Spending Accounts. Health Savings Accounts (HSA) An HSA is a funding option that helps employers and employees budget and pay for health care. It allows members to cover health care expenses tax- free and save for future needs, since funds continue to accumulate and can earn interest tax- free. The HSA is only available with a High Deductible Health Plan. .4 ~' '`~ Flexible Spending Account (FSA) - for health care and dependent care A health care Flexible Spending Account (FSA) is ~` ~ pre-tax money members set aside, through payroll deductions, to use for certain expenses not covered by their health benefits. An FSA can help employees manage their health care expenses -'.. __,.._ ~~~ _..,, ~ , , „ ~ ,t , ~~ ~ ... ~~. while reducing taxes on their earned income. Employees can open a health care FSA whether or not they enroll in a Humana medical plan. They access their funds through the HumanaAccess card, which is used at the time of service to deduct eligible expenses from their health care FSA automatically. They can use the card to pay for medical copayments and other FSA-eligible expenses wherever Visa debit cards are accepted, which typically eliminates the need to file a claim and wait for reimbursement. Along with a health care FSA, employees have the option of opening a dependent care FSA to set aside pre-tax funds to pay for childcare and similar services -such as daycare or adult care. With a dependent care FSA, the employee files a claim for reimbursement rather than use the HumanaAccess card. With either FSA, unused funds do not carry over at the end of the plan year. 1 o H/UMANA ('ruii7unCC~ when you need it mist . Provider Networks Humana's extensive networks of physicians, hospitals, and other health care providers support our consumer-choice benefit strategy as well as our HMO, POS, PPO, and EPO plans. The network includes 420,000 providers in a1150 states, the District of Columbia, and Puerto Rico. Humana performs extensive, in-depth research to match the appropriate network with the employer group -whether it is a traditional or high-performance network. Network advantages The advantages of the national provider network are: o Efficiency -Competitive discounts to help employers control medical costs. The average nationwide discounts off billed charges are: • Hospital inpatient - 35.5 percent • Hospital outpatient - 31.5 percent • Physician - 41.8 percent o Scope - An extensive network of physicians, hospitals and other providers in a1150 states o Access - A national network with convenient access to participating providers coast to coast o Network stability -Abroad range of providers with a low turnover rate o Responsiveness -Highly-trained professionals who selectively target and contract providers to become part of our network Our average regional network discounts are up to 20 percentage points higher than those offered by many rental networks -and are equal to, or better than, other national carriers' network discounts. In fact, employers who use leading national rental networks in Humana's primary areas will likely improve their discounts by switching to Humana. And they should experience minimal network disruption, since most providers in competing rental networks are also part of Humana's network. Network innovation Humana is a leader in developing efficient network structures that give our clients the broadest range of options while supporting our consumer-focused strategy. Our networks include tiered and structured designs. v Humana 's network includes providers across the country. The highest concentration of providers is in the regions shaded yellow above. 11 HUMANA ~~uii~unce when you need it mrsC ~rr+ Humana Preferred (high-performance network) In an effort to identify providers who are committed to both efficiency and effectiveness, Humana has developed a nationwide network ofhigh-performance providers. These doctors and hospitals join employers and insurers in their concern about health care costs and are willing to play their part in managing those costs. Humana Preferred (also referred to as HPN for high-performance network) customizes its selection criteria to each market, resulting in a network of approximately 70 to 75 percent of Humana's total participating providers and hospitals. Compared to traditional health plans, Humana Preferred is designed to offer significantly lower health plan costs while recognizing provider efficiency and effectiveness. It was developed in response to the demand for transparency in the health care industry. Providers participating in Humana Preferred provide health care to patients while making efficient use of treatment resources. Humana Preferred gives employees the option to use in-network and out-of-network providers. Members will receive higher in-network benefits only when they visit doctors or hospitals in Humana Preferred. The plan pays more of the costs when the chosen providers are in Humana Preferred. National Transplant Network Humana's National Transplant Network serves adult and pediatric patients in more than 92 facilities with more than 550 programs in 26 states and 44 metropolitan areas. Transplant patients and their physicians can choose the most appropriate facility for their unique situation. Studies show that our transplant network reduces costs by more than 45 percent. Humana chooses only those facilities that meet certain standards and established guidelines. Our selection criteria include, but are not limited to: o History of continuous operation o Transplant volume o Outcomes o Technology o Stability of the team o Provider reputation o Clinical expertise o Location o Employer and member requests '' ~h.,r.r ~ ~~~ ~.. FNdhma7 • ~IChkaOe,. ... DYIOfaM ... Hbn4M CRY!. •Indhsrwpmlf! «N.m'xerM. SL LmuI iClndY!mrtll ~ ~ ' + B/tlRmmra ym~ ~ Laxb 1( I,DtilHlila ~ Rltllnmmmel -' Chyp~lHm ,~ 17rsmga COUrRt ~.MamIryBM mu tlrann .~ puaNs ~ SoaAhEtlls ~ N ~am(VPmaA1 Lble i • LLm Am®~In Tamama ®'IminbAmslm.. Bam~bpo • Oblbs. Houatlmn - aJrrcMaonMRb San FMRenHa TamiPa f Humana's national transplant network has more than 92 facilities with more than 550 programs in 26 states and 44 metropolitan areas. 12 HUMANA (it.tii~uncc~ when you neat it mast ~'"' Prescription Drug Coverage Employees generally use their prescription drug benefit more than any other feature of their health insurance coverage. In 1994, Americans spent four cents of every health care dollar on prescription drugs. By 2008, prescription drug costs may take as much as 30 cents from each dollar of health care spending. As the cost of generic and brand drugs continue to rise, these increases reduce the effectiveness of traditional benefit designs. Employers need a reasonable way to reduce their costs. Humana's solution To help employers manage their pharmacy benefit needs, Humana offers: o A network of more than 51,000 pharmacies o Flexible, innovative benefit designs o Access to most pharmacies, as well as mail order and specialty drug service o Dedicated customer service, account management, and client-specific reporting o Consumer programs designed to engage and educate plan members o Information and technology to help members learn about choices and health care costs Flexible, innovative benefits design Humana's pharmacy guidance solution addresses transparency (understanding real costs), choice, and independence. With more people taking more medicine than ever before, Humana is educating consumers about the true costs of prescription drugs. As a result, members are changing their perceptions and spending behaviors. Humana's benefits designs include Rx4 and RxImpactsM to help employers manage their costs. Rx4 The Rx4 prescription drug benefits reduces pharmacy costs while giving consumers greater flexibility and choice. By having members assume more financial responsibility for the choices they make, our Rx4 benefits helps employers control costs. RxImpact RxImpact groups drugs according to their ability to prevent a serious medical episode and according to the time frame in which they impact medical expenses. By linking drug costs with their potential medical use, RxImpact encourages employees to follow their treatment plans and talk to their doctor about lower-priced medications. Drugs that have the highest likelihood of preventing illness are in the first tier, regardless of their cost. With RxImpact, employees see the direct correlation between their medications and their future health. Depending on the drug's category or tier (A, B, C, or D), employees pay a set copayment or coinsurance amount, or they receive an allowance toward the medication's cost. When paying their portion of the charges, employees have the security of an out-of-pocket maximum per prescription, per year. Retail pharmacy network Humana has negotiated some of the lowest discounts in the industry with more than 51,000 pharmacies nationwide -including all national chains, most major regional chains, and more than 13,000 independent pharmacies. Our discounts typically have a significant advantage over competitors, including some of the largest pharmacy benefits managers. rrr 13 HUMANA ~iuii~antc when ~~ou need i[ most Mail order pharmacy service Humana offers amail-order pharmacy service as a convenient, reliable option for members on maintenance medications. Specialty drugs Consumers spend $5 to $10 billion a year on specialty drugs, and spending could double within the next five years. Employees who take specialty drugs (including self-injectables and other high- tech drugs) are often faced with high costs and limited access to these medications - a situation that can jeopardize their health and ability to work. Humana's SpecialtyRx program provides self-injectable and high-tech drugs, allowing employers to save on claims costs and employees to save through our significant discounts. Through SpecialtylZx, members can obtain medications for many chronic conditions, with significant savings over traditional providers. ~: ,., [~ ~ A~ ~;,~ ~,. .x~~..~ Pharmacy service and account management Clients who enroll with Humana have the support of an Rx account team that monitors and manages the pharmacy benefit. The team includes an account executive, account service representative, medical director, clinical pharmacist, benefit analyst, and Customer Service manager. The team members work together to recommend options and help the employer keep the group's health care costs under control. A dedicated pharmacy team in each Customer Service center is available to answer members' questions about their prescription benefits. The pharmacy service representatives have extensive training and participate in learning opportunities throughout the year. Pharmacy reporting Humana provides employers with key financial and utilization statistics about their pharmacy benefits. Also, a dedicated account team works closely with the employer during implementation and throughout the plan year on pharmacy benefits. Pharmacy information available on MyHumana At MyHumana, members can find the following pharmacy-related information: o An 18-month history of medical and pharmacy claims, copayments, and out-of-pocket costs o Information about drug costs, levels, and alternatives o A drug library o A pharmacy locator 14 H)UMANA: ~ILUCY lI77('O tihen you need it most ~'"'' Maximize Your Benefit The Maximize Your Benefit pharmacy education program offers guidance to members in controlling their prescription drug spending, understanding their drug benefits, and finding lower-cost prescription drug options. Many members do not know that lower-cost alternatives can save them as much as $22 per prescription. Maximize Your Benefit identifies members who have filled a more expensive prescription when a less expensive option is available. Humana contacts these members to let them know about their options and encourages them to discuss the lower-cost alternatives with their doctor. Approximately 22 percent of contacted members have converted to lower-cost alternatives, reducing their costs by an average of $240 per year. We deliver Maximize Your Benefit messages in a variety of ways -including voice response phone calls, letters, and secured a-mail messages. Approximately 22 percent of contacted members converted to lower-cost Rx alternatives - reducing their costs by an average of $240 per year 15 HUMANA ~,tne~ct~7ce~ when you need it most Additional Services Humana's specialty products, combined with Humana's health plans, give employers single-source coverage and the ability to build a comprehensive benefits plan that fits their needs. Humana's selection of ancillary services includes: o Dental PPO, HMO, traditional, and voluntary plans o Aggregate and Specific Stop Loss o Life insurance o Accidental death and dismemberment (AD&D) coverage o The Savings Center, a specialized area providing discounts on health and wellness products, programs, and services to Humana members HumanaDental plans HumanaDental is ranked among the top dental insurance companies in the nation. HumanaDental is available as a stand-alone plan or in conjunction with medical plans. The plan can be designed to meet the needs of the employer and employees, providing incentives for regular and preventive dental care. Some plans pay up to 100 percent for basic dental care. Dental networks Our status as a "Top 10" dental insurance company with more than two million satisfied members encourages dentists to -` participate in our network. Since more than 76,000 dentists participate in the HumanaDental network nationwide, we are able to negotiate attractive dental fee schedules. Humana members throughout the country can use the Dentist Finder on www.humanadental.com to find an in-network dentist. vt... ~~ ~ ~ I 8~q ' ~Toals~ 1 ~s ~ 1 Atlrrr~Mlan 18~ This list contains dentists that match your specnc~ations.Click on the map halloo (or a detailed map to the dentist's office, including drilling directions. Ytmen choosing a dentist office, please make sure the dentist you choose is in the HumanaDental network. 1. Lee Bialkowski, DDS • Dentistry • General 844 Willard Dr Ste E Green Eay, WI 54304 19201497-1302 Specific and aggregate stop-loss protection Employers gain an important advantage when Humana serves as both an administrative services provider and the reinsurer. With most of our funding options, employers are immediately reimbursed for all amounts over their specific deductible. Once an employer reaches the maximum deductible for an employee, Humana reimburses the employer so the employer's cash flow is not impacted. Employers experience no delays due to claims eligibility issues -large claims are audited before the provider is reimbursed, ensuring accurate payment. Banking options Humana offers a variety of funding and banking arrangements to meet the individual needs of each employer. Options include funding either from aHumana-owned account or from the employer's account. Funding can take place daily or weekly on a paid or issued basis. Life insurance and accidental death and dismemberment coverage 16 H))UMANA CfLlllYti J1C0 when von need it roost Humana makes life insurance coverage easy with basic and optional life programs. Basic Life provides a core level ofemployer-sponsored protection, while Optional Life offers employees coverage at affordable group rates without additional cost to the employer. Both plans are simple, easy to use, and include these standard features: o Guaranteed acceptance (no medical underwriting questions for pre-specified coverage levels) o Accidental death and dismemberment (AD&D) coverage automatically included o Option to convert to a whole life policy o Ability to waive the premium in the event of a qualifying disability o A living benefit, which pays up to 50 percent of the total benefits available if life expectancy is less than 12 months Services included in our fees Humana takes an inclusive approach to self-funded account services. Our fees typically include a full range of services, such as: o Actuarial and underwriting services o Claims payment o Utilization and case management o Internet access for employers and members o Banking and financial reports o Monthly and annual reports o Flexible Spending Accounts o HSA Administration and coordination o Prescription Drug Administration '`r•- o PlanProfessorsMrnember communications o Provider networks o Subrogation and claims recovery o Summary plan description (SPD) preparation o Tax reporting (Form 1099, Schedule A and W-2) o New York City and Massachusetts Surcharge reports Also available: o Clinical programs • Disease Management • HumanaBeginnings ~ helping women make the best choices to achieve a healthy, full- term pregnancy • HumanaFirst, a 24-hour nurse line o COBRA and HIPAA administration o Installation and maintenance of leased networks o Interfaces with third parties (e.g., reinsurers, pharmacy benefits managers) o "Shared savings" for out-of-network services 17 HUMANA t ~ui~~t7»e~ when ynu need it ninst `~.. HEALTH RESOURCES Humana provides a comprehensive suite of clinical programs and services to educate members and address their needs at all levels of health. Our experience has proven that education and guidance convert passive health care users into active health care consumers -who work better with their doctors, make smart choices, improve their health, and save health care dollars. Consumers' health care needs change depending on their health: o Members who are acutely ill need specialized, focused support. o Members who have a chronic condition need education about their condition and support of a nurse educator. o Healthy members will generally work to maintain their health using education and other wellness support. Understanding Informational Needs Acutely ill '~ !^~ ~; Low risk, generally healthy '~1ri+ While most members are generally healthy and have routine health care needs, the acutely ill - a small percentage of members -account for the majority of health care costs. Needs differ depending on use, and Humana provides targeted programs and services to meet individual needs. 18 HUMANA ~iuii~ani c when you need it mnst ~"'' Member identification and evaluation for clinical care We are able to identify members who could benefit from health guidance by using an array of tools and methods to find those at risk for future health problems. These tools allow for quicker, more accurate identification and engagement, ultimately resulting in better outcomes, a better experience, and reduced costs, through: Health assessments: As part of our identification process, we offer health assessments. Members take a confidential lifestyle questionnaire, which allows Humana to identify health risks. They then receive a customized health report so they can begin making lifestyle adjustments. When indicated, Humana uses the responses to the questionnaire to refer a member to the appropriate level of care. Predictive modeling: Our award-winning predictive modeling method takes the information we know about members -individually and collectively -and transforms all this data into actionable information. We find the members who can benefit most from our services and offer personal guidance and education about their health, effective benefits usage, and care options. The award-winning technology we use to understand health care consumers draws from information such as: o Demographic data -exploring the frequency of disease states among homogeneous people o Medical claims -looking at members' medicines, doctors, hospitals, lab work, clinical information, and more o Pharmacy claims -integrating medical and pharmacy claims o Data mining -pinpointing members in need based on valuable knowledge from our electronic data o Health assessment lifestyle questionnaire -using confidential data to identify family history and personal issues that affect health care decisions By integrating this information, Humana provides a detailed picture of members as individuals and as an aggregate group to identify who is at risk for major health events, predict risks for future health care needs, and provide new targeted programs and services. Humana uses several avenues to reach the member and provide the appropriate level of care. Health agents: Members can call Humana's Health Agents when they need guidance about health situations but are unsure of which Health Resources program is right for them. The Agents are knowledgeable about all Humana programs and place members in guidance programs that will provide the most appropriate fit. Clinical review: As physicians interact with Humana through the authorization and referral process, the unique situation of each member becomes more apparent. This serves as an opportunity to identify which Health Resources best meet the individual's needs. Transition of care: Humana understands that medical treatment should not be interrupted. If we identify members in the process of changing health plan carriers, we make sure they have no disruption of their medical treatment or interference with the doctor-patient relationships. err 19 HUMANA. ~~ui~~uncp when yoia need it most ~"' Guidance and support Predictive modeling and our other assessment tools are only as good as the available clinical programs and guidance they provide. o Our case management program has shown a 10 percent reduction in readmission rates o Participants in HumanaBeginnings have a 9 percent lower premature birth rate, which amounts to $46,000 savings per avoided occurrence o Our Health Resources programs show a per-member per-month savings of $10.50 to $14 r°:.~~ .; .,. ~:, -~~_._. :,'. o Disease management -These programs help members and their families manage specific chronic medical conditions -such as asthma, cancer, congestive heart failure, coronary artery disease, diabetes, kidney disease, neonatal intensive care, and rare diseases including cystic fibrosis, Parkinson's disease, and more than 10 other conditions. o Transplant services -Since 1987, Humana has maintained a dedicated staff of physicians and nurses in Louisville, Kentucky, whose sole focus is organ transplant cases. Our transplant staff is available 24 hours a day to work with the member, family, and medical team before and during hospitalization and for one year postoperatively. These professionals help members and their families manage the complex and emotional process of organ and tissue transplants. They also review coverage, coordinate benefits, facilitate services, and follow the transplant recipient from initial referral through treatment and recovery. o Complex case management -Those facing major medical procedures and traumatic events are often overwhelmed with complex information and decisions. Case Managers are there to help navigate the health care system, coordinate necessary services, explain health benefits, and simply make things easier during a difficult time. o HumanaBeginnings: This added-cost program offers prenatal education and guidance from the early stages of pregnancy through the baby's first months. A HumanaBeginnings nurse works with the expectant mother to help her make the best choices to achieve a healthy, full-term pregnancy, thereby avoiding a premature birth and the associated costs. 20 HUMANA. Cuei~~uucx~ when cou need it most '' 'r.+ o Personal Nurse :The Personal Nurse seeks to help members understand their conditions, find resources, and most effectively use plan benefits -all in an effort to help them realize their health goals. From service coordination to health education to benefits guidance, the Personal Nurse is there as a partner. Three out of four participants report that they manage their condition more effectively while working with a Personal Nurse. o HumanaFirst®: Registered nurses are available around the clock to answer '~"'`"~'`~~ ` ~' -~'''"""" health-related questions and to guide uncertain members to the appropriate level of care. These nurses assess what is going on with the member, based on symptoms, and can help them decide if a reaction to a new medication is normal or then direct them to an urgent care center or a emergency room. Additionally, they can help with "how-to" questions - such as properly changing a bandage at home or preparing for lab tests. Studies show that 35 percent of callers to HumanaFirst® decide to pursue an alternative, lower-cost care option. Quality improvement and accreditation Humana is accredited by the American Accreditation Healthcare Commission. In addition, many of our programs -such as Pharmacy Management, Transplant Management, Case Management, Green Bay Medical Management, Personal Nurse, Disease Management and Product Innovation -are registered under ISO 9001:2000, an international quality management standard published by the International Organization for Standardization (ISO). At Humana, we focus our quality improvement program on care that is: o Medically appropriate o Delivered in the most cost-effective setting o Consistent with quality standards set forth by the local health plans and the corporate quality management team \..~ 21 HUMANA. ~~ui~~Uncc when you need it most ~.r, FINANCIAL FORECASTING Humana helps eliminate unexpected costs -one of the most difficult aspects of benefits administration for employers. We help employers predict their health benefits expenses, budget effectively, and develop along-term approach to reducing their medical trend. Data technology Humana has invested heavily in developing a sophisticated data system that provides group-specific plan information to our customers. One component of the robust data system is the Electronic Data Warehouse, which is a totally integrated computer mainframe system that houses massive amounts of critical data on medical costs, pharmacy costs, demographic information, provider utilization patterns, and detailed claims stratification information. Client reporting Humana firmly believes that data analysis and reporting are critical in successfully managing a health benefits plan. Our capability involves more than a set of standard reports. It comprises a strategic Customer Guidance Plan, consultative services from our team of experts, and user-friendly, meaningful reports to assist our customers in controlling their health care costs, through: vy„r o Regular monthly reports on member activity, and key financial and utilization statistics that allow employers to monitor trend. To ensure the reports include important and relevant information, a dedicated account team works closely with the employer during implementation and throughout the plan year. o Clinical analysis and cost trend detection, using ongoing environmental analysis of emerging treatments, technologies, service delivery methods, pharmaceuticals, and more. Quicker identification of new influences on costs allows Humana to project future cost implications and establish new Health Resources services for members. Clinical analysis Through daily data feeds, the Verisight® tool stores information in Humana's data system on the employer group's medical claims, pharmacy claims, utilization patterns, employee demographics, severity scores (stratification variables), and clinical program participation. With this advanced technology, Humana is able to run queries on the employer's data, compare population subsets to identify differences in clinical data and disease burden across the company's locations, or examine the influence of interventions over time. To help employers in understand what drives their costs, Verisight provides advanced reporting on historic vs. fixture costs and gives the employer an interactive, multi-color visual of current and historic trends. Verisight also benchmarks utilization trends against national, regional, and even industry standards. 22 H)JUMANA C/L(liTlI71eY~ when V~xi need it twist Some of the client-specific reports Verisight can generate include: o Utilization versus costs (hospital inpatient, physician office visits, hospital outpatient) o Type of medical service o Medical comparison (types of claims per member per month) o Contributing factors to medical costs versus trend o Mental health and substance abuse -inpatient and outpatient o Impacts of catastrophic events o Participation in clinical programs o Catastrophic events within major clinical categories o High utilizers of clinical programs o Pharmacy costs by disease category (per member per month) o Contributing factors to pharmacy cost versus trend o Pharmacy network savings (retail and mail order) The Versight report also includes a summary report with observations on medical and pharmacy trends, details on the contributing factors to the trends, and recommendations on how to reduce the employer's costs. It is recommended that the report be generated yearly, with updates made on a quarterly basis. By analyzing the report from Verisight, Humana is able to: o Detect current and emerging medical trends o Identify participants early for clinical programs or intervention o Target employee communications and consumer education to specific audiences Medical director consultation Our regionally-based medical directors are available to employers to provide consultation, creating a true strategic approach in managing health care trends. Using Verisight reporting and other tools, the medical director examines the underlying conditions and cost drivers specific to the employee base that may differ from industry norms. Serving as a partner and consultant, the medical director works with companies to craft a strategy to address issues of concern. Making informed decisions SmartSuite includes a proprietary modeling tool called SmartStart,s"' which can be used to: o Preview various contribution strategies o Recommend optimal benefits bundles and/or contribution strategies to help employers achieve their goals o Predict how contribution levels can affect Humana provides a standard reporting package that offers valuable information to customers to assist them in controlling health care costs. Our medical directors then work with the customer to develop a strategy to contain costs. employee behavior for up to three years o Determine which combination of plans to offer by annualizing costs or savings o Instantly generate rates for plan selection alternatives 23 HUMANA: ~ ~tti<~unco when ~•ou need it most '~..% ,; G„ ,F. : : F ~' `r CONSUMER ENGAGEMENT Humana believes that consumer engagement is one of the most important elements to control medical spending rates and that long-term solutions to increasing trends must start with the consumer. Humana's total solution includes advancing new roles: employers as facilitators, employees as consumers, and Humana as the guide. Humana helps consumers and employers manage costs and make confident decisions. We engage members in the process of understanding the health care system by knowing what they are buying and the costs associated with it, just as they do in making other purchase decisions. We help members appreciate that taking time to understand and compare options helps them save money and receive appropriate health care services by: o Learning about what care is needed o Looking at choices available o Evaluating providers' results, credentials, and fees o Talking with others who have received care from the providers they are considering SmartSummarysM - a member's personal quarterly financial and benefits statement Humana is proud to be the first company in the health benefits industry to develop a personalized, quarterly finance and benefits summary that helps members make health care decisions with confidence by: O Putting medical, prescription drug, and financial information all in one place O Giving personalized guidance and cost- saving opportunities O Speaking in plain language so members can understand their health care and benefits O Providing relevant, actionable information O Using personal examples and specific numbers to illustrate how members' plans work O Helping members review patterns of past health activity O Containing personalized savings opportunities iii >~ ~•,, Smart'~t~~~~~~~.~r~ _ 11ctr.,nrr t:~ prsur J+n.,!w,r;` hr,il;h ~~ a , ~~.~ , t~~...iur ~rtt f Hin~~~i! "atrm;~!~t ,;,. ... 24 HUMANA (itti~~~tttrc> when you need it most '`''~' Humana engages the consumer Humana is in the top 10 of all companies for the use and application of technology and has received several awards for its leadership in e-Health capabilities. Whether it is traditional print methods or advanced technology, Humana provides the tools to help members get the information they need to make wise health decisions. P1anProfessors'" When people are given resources and guidance, they have the right information to make decisions. And when they understand the financial impact of their decisions, they do a better job of managing their spending. In all our communications, Humana encourages members to take responsibility for their health and health care. P1anProfessor is a year-round communications program that delivers tips and tools to help members understand their options, manage their health benefits, and make educated decisions about their health care spending, through: O Print educational materials to guide members from pre-enrollment, through enrollment, and through the remainder of ,,, the plan year O PlanProfessors"' magazine, with Humana program updates and guidance for members ' th ' h fhb f i~uvi~>N:a ~ _o I PL ' NProfessor MAGAZINE e.~ro~~., ~.,~ reran e..~e for being a smart ~°~~^~~ health care consumer o~o«K"~..~ M., f~. R.o+nv w: vww :.w.~Mrn, ~nz~v.:n.,~ r.. ~ ~. w w ~,.~s~n°,~d,~rt~~ ~~~~„n~~r~n~r~~, ae..r~n ~,..i.~e ~na~~.M. m rth w~: '; ~ ~~ ~. ~~ gen ~b M brosrtN y iw k ~W+a'A '. Iresbl rcn don~in ,; musing eir eat ene rts most effectively, mailed to members' homes O Pre-formatted articles for use as handouts and on employer's intranets Consumer engagement technologies Technologies used to engage consumers include: o E-Plan Professor, a monthly e-mail newsletter with articles on using plan benefits, saving money on health care, and on staying well o Targeted messaging, with outbound telephone calls using voice-activated technology (VAT) to provide wellness reminders to get a mammogram or to consider alower-cost drug, for example o E-messages, using a-mail and a monthly electronic newsletter to send member wellness reminders, health information, and tips on how to use their health plans more effectively or achieve a desired behavior change o MyHumana, a member's personal home page i.r Zs H/UMANA. ~t~it>lunec when vuu need it nurxt '~" MyHumana MyHumana is apassword-protected, personal home page on www.humana.com that provides a wealth of information and resources to help members make informed decisions. By visiting MyHumana, members can: Humana '~'`°"'" MY~. MIMtW~r Taoh ~..,A.res . i.en MyCOmmunfcatians `a. _ ~ ~ ProvlOer TOO15 ,• F~k MyBerretlts - nr~... w„..=~ ~.-~:.-- Memarw c.arow i:rocm. oaie ~ - y%'~ R••eeren i..i ~., rt .1 ~ .~ t ~ .: t~ .[~.u. t.- ~. r~,.r o- kzns ~f, ,_ .. ~ • ~ . IC~~v .na PhsemeiY iooh ~ -.. i. ~e... ..,... . ~. ~ ,.. >~~.., ..~.q ~ r,. , sF.r~~.~ ~. MyClalms MMical ~::. ~ . ~:...,,~ __ s. _.__ t .,... ~ MyPreseription Claims neanneesourees ~ Pka.•~wse•reur mo.veuM Pna.~nacr c~a~mx ..,r :.+, u.aun. r p;;. ,H i ® MyFinancial Toots °.. ~ ~T, ,.~ .~ .e, ~.~ :. ~_~.. . . <~ ~ ,-,~o .r.., ,.. MyFleaftfi Recortl - ~ - .nai w ,.. , o~, ~ ~, ..r . ,:.. ~ Wi45ot. , ~.. .~, ~. View medical and pharmacy plan information o Current benefits, claims history, amounts paid toward deductible, current total out-of-pocket costs, and copayment history o Replacement ID cards o Lower-cost drug equivalents, pharmacy finder, and drug interactions o How much a member will pay out-of- pocket for specific prescription drugs o Humana's mail order prescription program o Clinical Drug Library for information about drugs, possible food interactions, immunizations, and more Look up participating doctors and hospitals o Doctors' disciplinary records o Comparison of hospitals and outcomes by service chosen Access general heath information o Condition Centers for education and health management tools o Health guidelines for immunization and preventive care o Alternative health libraries for holistic medicines and complementary and alternative medical treatments o Print and audio libraries for general health information o Health programs o Personal Health Record o Discounts and other cost-saving programs negotiated by Humana on fitness equipment, fitness center memberships, skin care products, organic food packages, weight loss and smoking cessation programs, and more. Use financial decision tools o Tools to help with estimate health expenses o Rx Calculator to determine past and future Rx expenses based on current benefits o Flexible Spending Account and Personal Care Account balances and transaction history z6 HUMANA. ~Tui~~uncv when vent need it Hurst Employer Engagement Online administrative functions w Employers can access information about their plan and its performance at www.humana.com whenever it is convenient for them. To meet the employer's needs, the Website is customizable to create ease of use and quick access to the information needed. To simplify navigation, the employer home page uses customizable tabs that reflect the tasks administrators typically need to perform. Administ,ative Wrb Sile Produets Enrollment Fintlars Additional Wplralne Maintenanca Billing Guides and and Relp Reporting Socudty and Snvinga Tools Administration Sorvicos Se•rarvl tasl.=. listed belcvv require '; ou tc have gene through "i;r~wC `setup" ~.f'~nu have tier alreatlq~ rnmpletetl Greuo ~etun please do so rcz,'_ 1s ne,a~ Wncti,~^~IaU~' bea,nes a': citable. vau can pet dela,led + Read M11v Rdessaoes JI t ~~I~.o~ts he(E F'e zure lu . ~=et K har'4 pr•r• to P,~-'u•- you are + amend a kIESSade FnI r;t ul~ to Ale :'1'e?rP ~ l~'t,.: -,,`, t q t ' . e...,e_ a ~ Terninale an enblovee hon bill + VrorovE ID Cartls • vler,' amour pill + TEnnmale an Enulo'ree troll Bi)1 r + Viet: a SIIb SCfibEr Sunnar; ~ • + View: a subscnber sunnar'; a Fnd a PM•slrian nr Iiosmtal + Subnit :hanaes b': e-nail + Find a dentist + T¢, sheets + Fintl a Pharnar: + Add a subscnber ~ `•hea' olossarr of dental ferns + ~d a subs[ribEr + I~o~x to reach HunanaDental + TErninate a subscriber + REm,entb: Asked Guestions + Ternlnate a subscriber ~ Access NEIo + F.Indif:'subsaiber'deoendent infarn,auon + health plan v,'izards ^ t: r. , ~., . _ ~ „ ~ ~..~ ^ I, •'~ ~~ a + Enable DEledatlon • ,I, .- I ,.., ,,, + Ghanae:Deledate L4'ork + Plodrfv subscriber deuentlenl,rbrr!aUUn ^ „,„ ,,.,_ ,~. + Assmn ~:eb a:.ess riohts ^ ~ I I ,. ~ 1.,.~1. ,,,... + FdanaoE user security staves + Geate'edlta sell-set: icE even) + I'Aaintain user security Infornauon ~ Vlea• a subscribers stir' + Fdainlain nraanizauon se: uri4, Into >• Grouo ne1I51EnanCe + irle:ti Ui'e, 311 SECUI11't otofllE ^ ,, ~ „ . , , , ,,,, + PAonitor se:unP~ {hanaes + Prlnt P.r,/OIII'IEItI ~ ChallUe fortis + AccESS and Dflnl ee{4fIC: {hanbe torus C • ~ + Enrolment Genler :en ,e r: ' ~,r~erd C.erAer Loam ntrart l"Jmanas nen~ Cnr:~l + Enrollnerd GEnler Slnu!auon + Gonolenentarr antl Alternative PAetli:ine P89ti UCe uslnq f`UP,4nq'S tie J'Enro'JnEnt Genler + V15iUn Ds{aunt bf091an + ~i ievEnrollnent Status By logging on to www.humana.com, employers can perform many administrative functions, including Web-based enrollment. Features of the employer home page o Enrollment maintenance o Billing o Administrative guides and tools o Reporting o Website Security Administration o Products and services o Communication Center o "What's New" link to an overview of new online features and services 27 HUMANA ~yuyt~u7tCB when you need it moat E-administration functions o Web-based enrollment o Add a new hire o Change coverage o Terminate an employee's coverage o Update employee demographic information o Add a dependent and update insurance information o Security administration features allow designation of Web functions while protecting privacy of information o Send and receive secure messages o Print and download standard reports from an employer-specific menu Benefits management functions o Access eligibility (type of product, coverage dates, copayment amounts) o Access claims status and details o Print temporary proof of coverage o Order replacement ID cards to enable quick access to care o View and print Summary Plan Description o Print and download the most current Network directories Online bill presentment and payment o View monthly bill for efficient reconciliation o Issue electronic payment to manage financial transactions on your schedule 4rrr 2g HUMANA ~ iuii~uiu'o when you need it mast With its unique Guidance Solution, Humana steps far beyond the traditional role of an administrator and provides a comprehensive, integrated package of: o Unique product design o Excellent service o Consumer engagement efforts o Cutting-edge technology o Extensive health resources o Industry-leading financial forecasting o Extraordinary, caring people Humana's commitment is to provide excellent service to employers. Whether the employer need the advantages that technology provides, or a high-touch personal approach, we join with employers in a unique partnership to keep their health care costs from skyrocketing. We use data gained from technology to reduce administrative costs and improve the information and choices available to members, employers, and providers. Behind these tools are caring people who have both the knowledge and understanding needed to provide the highest level of service and guidance. ~wr .. i_ »°1 t ~ ~ i- a ~S;.~Y `` rx ~~, +t a~~ r ~ Y , ~. ~ --rt x3~a:-- .~~ ~ M_ ~ ~'~} ,' ~y ..r, ~! 29 ~: ~~ HUMANA. ~~uii~eit7cc~ when ti~ou need it most TEXAS HumanaPPO 08 90/70 Plan • Routine immunizations tbirth to age 6} • Routine imrr~unizatior~s (age 6 to 18) • Routine Pap smear • Annual routine mammogram • Routine lab test and X-ray • Routine adult physical exam (18 years and above) • Routine child exams (to age 18) • Preventive endoscopy (includes colonoscopy, proctosigmoidoscopy and sigmoidoscopy) Preventive Care (1) Physician Services '. ~~) bird Facility Services Plan pays for services at Plan pays for services PARTICIPATING providers at NONPARTICIPATING 100% 100% 100% 70% after deductible 100% after office visit copayment 70% after deductible 100% 70% after deductible • Office visits • Diagnostic, lab and X-rays (copayment does not apply) • Allergy testing (copayment does not apply) • Inpatient services • Outpatient services • Office surgery • Emergency room physician visits (2} • Allergy injections and nonroutine injections other than allergy 100% after $30 primary care 70% after deductible physician/$30 specialist 90% after deductible 70% after deductible 100% 100% 100% after $5 copayment 70% after deductible per visit • Inpatient hospital care • Outpatient surgery • Outpatient nonsurgical care • Outpatient advanced imaging (PET, MR(, MRA, CAT, SPECTJ • t-lospital emergency services (emergency room copayment waived if admitted) (2j 90% after deductible 70% after deductible 90% after deductible 90% after deductible 100% after $50 copayment per visit 70% after deductible 70% after deductible 100% after $50 copayment per visit Prescription • Please see attached pharmacy benefit information, if applicable Drugs (includes oral contraceptives} '~.r HumanaPPO combines the cost-saving incentives of a modern health plan with freedom of choice. When you see participating providers, you receive the highest level of benefits available under your plan. At the same time, you retain the flexibility to see any physician. TX-25308-TE 6/07 HumanaPPO 08 90170 Plan Plan pays for services at Plan pays for services PARTICIPATING providers at NONPARTICIPATING providers Other Medical • Skilled nursing facility (up to 60 90% after deductible 70% after deductible Services (3) per calendar year) • Horne health (up to 60 visits per calendar year) • Physical and occupational therapy (up to combined limit for all therapy services up to 60 visits per calendar year) • Speech cognitive and audiology therapy • Durable medical equipment (up to $2, 500 per calendar year) "~Ilrrr • Urgent care facility Same as specialist copayment per 70% after deductible visit • Chiropractic services (up to 12 100% after specialist office visit 70% after deductible visits per calendar year) copayment per visit • Arnbulance (2) 90% after deductible 90% after participating deductible • Transplant services Sarre as any other covered Sarre as any other covered condition ~nrhen services are condition (covered expenses are received frorn a Humana limited to a maximum benefit of ~iransplant Network provider $.35;000 per transplant) Deductible and • Deductible and out-of-pocket limits for participating and nonparticipating providers calculate separately Out-of-Pocket Maximum Accumulation Methods Deductible • Individual $1,000 Two times individual (per calendar year,' participating deductible copayments do not .Family (4) Two times individual Two times family apply) participating deductible participating deductible Out-of-Packet • Individual $2,000 Two,times individual Maximum participating out-of-pocket (per calendar year, maximum deductibles and copayments do not .Family Two times individual participating out-of-pocket Two times family participating out-of-pocket apply) maximum maximum Lifetime Maximum $1,000, 000 Benefit (participating and nonpartidpating combined} Basic Mental • Inpatient services (up to 10 90% after deductible 70% after deductible Disorders days per calendar year) • Outpatient therapy sessions (up to Same as specialist copayment 70% after deductible 15 visits per calendar year) Chemical • Inpatient services Covered the same as any other Covered the same as any other and Alcohol • Outpatient therapy and office illness illness Dependence therapy sessions (lifetime maximum of three separate series of treatments for each insured person) Serious Mentat • Inpatient services (up to 4.5 days Covered the same as any other Covered the same as any other Illness per calendar year) illness illness • Outpatient therapy and office therapy sessions (up to 60 visits per calendar year) Prior authorization - 1-imana sometimes requires preauthorization for some services and procedures your physician or other ,:,ravider may recommend for you. Humana does this solely to determine whether the service or procedure qualifies for payment under your benefit plan. You and your health care provider decide whether you should have such services or procedures. Humana's preauthorization determination relates solely to payment by Humana. To find a fist of services and supplies that require preauthorization for coverage, please visit our Website at Humana.com/membersJtools/ or call Customer Service. Failure to obtain necessary preauthorization when required may result in a reduction of otherwise payable benefits. Your health care practitioner should call Customer Service to obtain preauthorization. Payments -Participating providers agree to accept amounts negotiated with Humana as payment in full. The member is responsible for any required deductible, coinsurance, or other copayments. Plan benefits paid to nonparticipating providers are based on maximum allowable fees, as defined in your Certificate of Insurance. Nonparticipating providers may balance bill you for charges in excess of the maximum allowable fee. You will be responsible far charges in excess of the maximum allowable fee in addition to any applicable deductible, coinsurance, or copayment. Additionally, any amount you pay the provider in excess of the maximum allowable fee will not apply to your nut-of-pocket limit or deductible. Participating primary care and specialist physicians and other providers in Humana's networks are not the agents, employees or partners of Humana or any of its affiliates or subsidiaries. They are independent contractors. Humana is not a provider of medical services. Humana does not endorse or control the clinical judgement or treatment recommendations made by the physicians or other providers listed in network directories or otherwise selected by you. To be covered, expenses must be medically necessary and specified as covered. Please see your Certificate for more information on medical necessity and other specific plan benefits. (1) The following are generally defined as primary care physicians under your plan; general practitioner, family practitioner, pediatrician or internist. (2) Ambulance transportation and/or services received in an emergency room are not covered unless required because of emergency care, as defined in your Certificate. (3) Visit and day limits are corrtbined for participating and nonparticipating providers. (4) You are not required to meet individual deductibles once the family deductible has been met. Before applying for coverage, please refer to the Regulatory Pre-enrollment Disclosure Guide for a description of plan provisions which may exclude, limit, reduce, modify or terminate your coverage. This guide is available at Numana.com/members/enrollment center/pre-enrollment disclosures or through your sales representative. The ~zutoufat of bevrefiGS hrovi~led rlepentis upots tlae plafr selerte~z`. Premiums wi31 vm•y arorclinn to the selection nz~de. Forgenetnl questions aboarr t6u ytart, mfttart ynur betarfits ndmiru>tratm: Limitations and Exclusions This is a partial list of limitations and exclusions. Your group may have specific limitations and exclusions not included on this list. Please check your Certificate for this complete listing. The Certificate is the document upon which benefit payment will be determined. The plan imposes apre-existing condition. exclusion.This means that if you have a medical. condition before coming to our plan, you might have to wait a certain period of tithe before the plan ~v~.ll pros~de coverage for that condition_This exclusion applies only to conditions for which medical advice, diagnosis, care, or a-eannent was recomn?en:~led or received within a Ei-month period. Genera}ly, this 6-month period ends the day before your coverage becomes effective. F-lowever, it you were in. a waiting period for ccnrerage, the 6-month period ends on the. day before the waiting period begins.Tlu• pre-existing condition exclusion does not apply to pre~*nancy; genetic information in the absence of a diagnosis of the condition related to the information; or to a child who is enrolled in This exclusion may last up to 1? months (13 anonths if you are a late enrollee} front your first day of covcragc, or if you tvcrc in a waiting period, from the first d.ay of your waiting period. 1-lowever, you can reduce the length of this exchasion period by the number of days of your prior "'creditable coverage". Most prior health covcragc is creditable coverage and can be used to reduce the pre-existing condition exclusion if you have not experienced a break in coverage o£at least o3 days.'to reduce the 12-month (or 13-naontlil exclusion period by your c..redi.table coverage, you should give us a copy of any Certificates of creditable coverage you have. If yon do not have a Certifxca~e, but you da have prior health coverage, we will help you obtain one frown your prior plan or issuer.There are also other ways that you can show you have. creditable. coverage. Please contact us if you. need help demonstrating creditable. coverage. All questions about the pre-existing condition exclusion and creditable coverage should. be directed to I-lumana Enrollment at ?43? hortune L7rive, Lexington, KY 405019 or1-300-372-7207. Unless specitically stated othenvisc, no benelits will be provided for ot• on account of the following items: 1. 'Ireannents, services, supplies or surgeries that are not medically necessary, except for the specified rotative preventive sernices as outlined in the "Schedule of Benefits" and described in the "Covered Expenses" section of the Certificate. 2. A sickness or bodily injury arising out of or in the course of, any ernployrnc°nt for ~~-age, gain or profit. 3. A sickness or bodily injury, which is covered under any Workers' Compensation or sinular law."Phis limitation also applies to a covered person who is not covered lzy Workers' Cc,mpeusation a.nd lawfully chose not to be. 4. lyny drug, biological product, device, na.ediaal treatment, or procedure which is experimental, or investigational or fi>r research purposes. 5. 'T'reatment of nicotine habit or addiction, including, but not linuted to. nicotine patches, h}~}in.osis, smoking cessation classes or tapes. j~,;te plan within :r1 days after birth, adoption, or placement for adoption. fi. Prescription drugs, including vitanuns, and self'-acirninistered injectable drugs, unless administered to you: r a. while an inpatient in a hospital, or skilled nursing facility, or health care treatment facility, or psychiatric clay treatment facility; or. crisis stabilizatian. unit, or residential treatment center far children or adolescents, or cherrrical dependency- treatment center; b. by a health care practitioner during an office visit: or c. by a home health care agency as part of a covered home health care plan when approved by us. 7. In-vitro fertihr.,ation; any medical or surgical treatment of infertility; infertility evaluatians; infertility sen%ices; sex change services; or reversal of elective sterilization. 8. Cosmetic surgery and casmetic services or devices, unless fi>r reconstructive surgery: a. resulting from. a bodily injury infection or other disease of the involved part, when functional impairment is present; or b. resulting from congenital disease or anor:naly of a covered dependent child, which resulted in a functional iulpau•rnent; or °ri> c. resulting from craniofacial abnormalities of a covered dependent child to improve the function of or attempt to create a normal appeararzce. A lunctional impairment is defined as a direct measurable reduction of physical performance of an organ or body part. Expense incurred fbr reconstructive surgery pcrf'arrned due to the presence of a psychological condition are not covered, unless the condition{s) described. above are also met. 9. Dental services, appliances or supplies for treatment of the teeth, gums, jaws or alveolar processes, including but not limited ta, any oral surgery or periodontic surgery and preoperative and postoperative. care, implants and related procedures, orthodontic pri>cedures, and any dental services related to a bodily injury or sickness unless otherwise stated in the Certifcate. 10. <;us[odial care and maintenance care. 11. Any treatment, including but not limited to surgical procedures: a. for obesity. vvhich includes morbid obesity. `_~H]UMANA~. VLlTGlgl1GB When VOU need it n10St b, fir obesity, which includes morbid obc°sity, for the purpose ar: treating a sickness or bodily injury caused by, a~rnplicated bv, or. exacerbated by the ol7esity. 12. f~lternative medicine. 1 5. C'hiropraetic services or spinal manipulations (unless specifically listed on this benefit surnnrary). 1 i. Vision examinations or testing for the purposes of prescribing corn ctive lenses; orthoptic [raining (eye exercisesj: radial keratc3torny, refractive kea•atoplasry or any other surgery or procedure to correct myopia, hyperopia or stigmatic error; or, the purchase ar- fitting of-eyeglasses or contact lenses (except as the result of an accident or following cataract surgery as stated in the Certificate). l5. Expenses for treatment of complicrations of noncovered procedtues or services. These limitations and exclusians apply even ifa health card practitioner has per-fornu:d ar prescribed a medically appropriate procedure, treatment or supply'I'his does not prevent your health care. practitioner from providing or performing the procedure, treatment or supply; however, t}te procedure, e~-eatanent ar ,apply will not be a covered expense. TX-25308-TE 6/07 Insured by Hurr~ar~a Insurarue Company Large Group H u m a n a P P~ R x 3 Prescription Drug Coverage Level One - $10 Levef Two = $20,,Cevel Three - $35 ~~ How the Rx3 When you present your rneu3bership card at a participating pharmacy, you. will be required to make structure works a copaymcnt for your prescriptions based on the type of medication. you purchase: • Level One: Lowest copaynrent for low-cost generic drugs. • Level Two: Higher copaytnent for higher-cost brand-name drugs.* • Level Three: Highest copaynrent for higher-cost drugs, both generic and brand-names.These drugs may }rave generic or brand-name alternatives in Levels One orTwo.* * If you. request abrand-name drug when a generic equivalent. is available, you pay rh.e ap}?]icable generic copaytnent, plus the cost difference between the brand-name and generic drugs. If your doctor indicates• that a. generic clrtzg cannot. be substituted by svr.i.ting "1.)ispense as Written"' on your prescription, you can only receive. chat specific drug, even if a generic equivalent is available. As a result. you ~vi11 be charged the applicable brand-nam.e copayn~sent. In this case, you ~-vill not be responsible for the cost diti~erence between the brand and generic. If you discover at the pharmacy that your doctor gave you a "I~)ispense as Written° prescription, you can ask the pharmacist to contact your doctor for approval of a generic equivalent. Prescription drug products, or classes of certain prescription drug products, are generally reviewed. on an ongoing basis by a Humana Pharmacy and Therapeutics committee, which is composed of physicians and pharnucists. Drugs are reviewed for safety, effectiveness and. cost-effectiveness prior to assignment or a change in. assignment. to one of the levels. Coverage of a prescription. drug as• placement. of the drug svitlrin a level are subject to change throughout the year. If drugs are moved to categories with higher member cost, advance notice is provided based on past usage. Always discuss prescription drugs with your doc:ror to determine appropriateness or clinical effectiveness. Some dnsgs in all levels may be subject to dispensing limitations, based on age, gender, duration or quantity>. Additionally, Borne ds-trgs rrray need. prior authorization in order to be covered. hi these cases, your plxysiciarr should contact Humana Clinical Pharmacy Review at 1-500-555-<.;LIN (254b). Members can. visit Htunana'sZX/ebsite, Humana.eonz, to obtain information about their prescription drug and corresponding benefits and. for possible lower cost alternatives, or they can call Htunana's Customer Service with questions or to request a partial Humana Rx3 Drug List by mail. Coverage at When you present your membesship card at a participating pharnac.}; yotz are required co make a copaynrent participating for each prescription based on the current assigned level of the drug. pharmacies Drugs assigned to: Copaynient per prescription or refill Level One $10 Level Two $20 L,c?vel Ths-e.e $35 • Your copayntents for covered prescription drugs are made on a per. presca-iption or refill basis and will not change if I-hunana receives any retrospective volume discounts or prescription drug rebates. There are no claim forms to file if you use a participating pharmacy and present your membership card a=itlr each prescription. Nonparticipating You may also purchase prescribed medications from a nonparticipating plrarnxacycYou ~vi.ll be required to pay pharmacy for your prescriptions according to the following rule: COVerage* • Yuu pay lUU percent of the actual charges -You file a claim form with Humana (address is on the back of III card) - Claim is paid at 70 percent of the actual charges, after they are first reduced by the sum of the applicable copaynrent and any required clifference between the amount paid by I-Iuman.a to the dispensing pharmacy for the brand-name drug and the amount Humana would have paid the dispensing pharmacy ti,r a generic medication • Your capayments for covered prescription drugs are made on a per prescription or refill basis and will not clxange if Humana receives arty retrospective volume discou.rzts or prescription drug rebates * In Georgia, the nonparticipating benefits are paid the same as th.e participating benefits, per state. regulation. GN-12894-TF 5.'il7 Coverage Ycfur coverage includes the following: S~3eCIfICS • A 30-day supply or the amount prescribed, whichever is less, for each prescription or refill • Contraceptives • For Arizona, coverage also includes FDA approved contraceptive dcvicrs • Certain self-adnunistered injectable drugs approved by Humana will be paid at the applicable copaymrnt. Certain drugs. medicines or medications that under federal or state law may be dispensed only by prescription from :a physician. Some drugs may be subject to prior authorization requirements for coverage under the plan.Additionallc, Borne drugs rrtay have dispensing limitations, whit}z tirnit coverage based on duration, age, gender or dosage criteria.To determine whether a drug prescribed tizr you may be afl~cted by these coverage limitations, please contact Customer Service or visit our Website. For a conrplcte listi.n.g of participating pharrnarics, please refer to your participating I?rovicicr direi tczrv, or visit our Website at Humana.com. Mali-Order and For your convenience, you can receive a maximum 90-day supply per prescription or re-fill (maximum 90-day Retail aft-drty supply for self-adanirristereil injectabl<° or specialty drugs) for certain maintenance dru`;s. In these cases, multiple copaymcuts will usually apply"1'he same requirements apply ~vhcth.cr purchasing rnedicatious through a participating mail-order pharmacy or purchasing in person at a retai} pharmacy. Some retail pharmacies may rot dispense on a 9i)-day basis. Members can. till Customer Service or visit our Website for more information, including nrail-order forms. Definition • Brand-name medication (drug;: a medication that is manufactured and distributer by only one Of terms pharmaceutical manufacturer or as defined by the aacional pricing standv-d used by I-Iusnana. • Copayment: the: unount to be paid by the member toward the cost of each separate prescription or refill of a covered drug when. dispensed by a phannac~y~. • Generic medication (drug): a nzeclication that is manufactured, distributed, and available from several pharmaceutical marrrrfacturers and identified by the clzenrical name or as cletined by t}ze national pricing standard used by 1-Iumana. • Participating pharmacy: a pharmacy that has signer a direct agreement with us or has been desiTmated by us to provide covca:ed pharmacy services, covered specialty pharmacy services; or c:ovcred mail order pharmacy services, as defined by us, to covered. persons, including covered prescriptions or refills delivered through the mail. ~~ • Nonparticipating pharmacy: a pharmacy that has nat been designated by us to provide services to covered persons. LlmltatlOnS and Unless specifically stated otherwise, rra benefits will be provided for or on account of the eXC~US10nS follass-ing items: • Any drug prescribed for a sickness or bodily injury not covered under the policy: • Any drug, medicine or medication labeled "Caution-lunited by federal law to investigational use" or any c~xpcrimenta) or investigational. drug, nu•dc•ine or medication, erven though a charge is rrtacle to you. { WI - .C'his does not apply to those investigational drugs which arc approved by th.c United States Food and Drug Adnunistratian for treatment of HTV infection or a medical condition arising from or related to, and that has completed a T?hase III cluzical investigation.} • Anorectic or any drug used. for the purpose of ~--veight control. • Any drug used for cosmetic purposes, {NC - ,unless prescribed for a congenital defect of a dependent child,} including but not linuted to {TN -remove but not linuted to}: - Tretinoin, e.g. Retin A, except if ycu are• under the age of 45 or are chagnosed as having adult acne; -Dcnnatologi.cals or hair growth stimulants; or -Pigmenting or de-pigmenting agents, e.g. Solaquin. • Arry drug ar meric:irrc: that is: - I.,awfirlly obtainable; without a prescription (over the. counter drugs), except insulin {LA -insulin covered under diabetes benefit}; or -Available in prescription. strex}gth without a prescription.. • Abortifacients (dnzgs used to induce abortions}. • Infertility services including medications. {.IL - IVIc°. dications far the treanncnt of infertility: unless specifically referenced in the certificate. } { CA -Infertility services including medications, except as otherwise specified elsewhere in the policy: } • Any drug prescribed for impotence and/or sexual dysfunction, e.g.Viagra. • Any drug for which prior autltorizatiozz is required, as determined by us, and aot obtaine°d. {TX -You map choose to purchase the prescription., obtain prior authorisation, and file a elaim with. us for reimbursement. However, if prior authorization is not obtained., you will not receive reimbursement for the prescription ~' purchased. } Limitations and • Any service, supply or therapy to eliminate or reduce a dependency on, ar addiction. to tobacco and exclusions (eont'd) tobacco products, including but not limited to nicotine withdrawal therapies, pral;rams, services ar nzedicati.ons. { IN - reanove but not limited to } ~r+ • Treatment for c7nychomycasis (nail fungus). • Any portion of a prescription ar refill that exceeds a 90-day suppl}-, received tiorrz a mail. order pharmacy or a retail pharmacy that participates in our program which allows you to receive a 9i)-day supply of a prescription ar refill. • Anv portion. of a prescription or refill that exceeds a 30-day supply, received front a retail pharmacy that does not participate in our program lvhich allows you to receive a 9U-clay supply ofa prescription or refill. • Any portion. of a specialty drug or self'-administered injectable drug received from. a retail pharmacy or a specialty pharmacy that exceeds a 30-day supply; unless otherwise determined by us. • hegerrd drugs which arc not deemed medically necessary by us. • Nlore than one prescription ar refill for the same drug or therapeutic equivalent medication prescribed by one or more ]zealth care practitioners and dispensed by orte or more pharmacies until you have used, or shotild have used, at least 75;4, of the previous prescription or refill, unless the drug or therapeutic equivalent medication is purchased through a mail order pharrriacy, or a retail pharrna.cy that pa.rticipaxes ixr our program. which allows you to receive a 90-day supply of a prescription i.~r re#ilt, ira lvhich case you have used, or should have used Ff;°/n of the previous prescription. (Based on the dosage schedule prescribed. by the health care practitioner.) These. limitations and exclusions apply even. if a health care practitioner has perfi>rnted or prescribed a medically appropriate procedure, service, treatment, supply or prescription, "I:his does not prevent your health care practitioner or pharrrracist from providing or perfarnting the proced.uxe, service, treatment, supply ar prescription; however, the procedure, service, treatment, supply or prescription u7ll not be a covered expense;. 'T'his is only a partial list of limitations and exclusions. Please refer to the Benefit Plan Document for complete details regarding prescription drag coverage. "~rr/ HUMANA~ ~iuie;TanGe when you aced it most I-fun~ma Plans are otiered by the Family of Insurance and Health Plan Companies incluiiing Humana ~ledicctl Plan, Inc., Huntana hmptayers I-Iealth Plan of Georgia, Inc.,1-Iumana I-Iealth Plan, Inc.. I-Iumana I-Iealth Benelit Plan of Louisiana, Inc., Humana Health. Plans of Nlichisan, Inc.; Humana Health Plan of Ohio, Inc., Humana Health Plans of Puerto Rico; Inc. Licence #i O!235-0008, Humana V(7isconsin Health Organization Insurance Corporation, or Htunana Health Plan ofTexas, Inc. - A Health Maintenance Organization or insured by Humana Health Insurance Company of Florida, Inc;., I-lumana Flealth Plan. Inc., F-Iumarta I Iealth Benefit Plan of T ouisiana, Inc., Humana Insurance Company, Humana Insurance Company of Kentuckyc Enzphesys Insurance Company; or hlumana Insurance of Puerto Rico, Inc. License # 00187-0009 Far Arizona Residents: OlTered by Humana Health Plan, Inc:. or insured by Humana Insurance Corrapan}; Emphesys Insurance Company Please refer to your Benefit Plan. Document (Certificate of Coverage/Insurance) for more inti>rmation on the company providing your benefits. Our health henefrt plans have limitations and exclusions I-~umanal'I?O ~' GN-12594-TF.. 5/07 Proposed Plans: Table of Contents A. 15/12 Contract with 125% Aggregate Attachment B. 15/12 Contract with 120% Aggregate Attachment C. 24/12 Contract with 125% Aggregate Attachment D. 24/12 Contract with 120% Aggregate Attachment ~•. ~tlrw' Covered Benefits PPO 9070, $1000/2000 ded (3x fam), 2000/4000 pop (3x Number of Emolovees fam), $50 er, $30 o.v., $10/20/35 rx (2.5x mo) Single 165 Single + Spouse 21 Maximum Allowable Run-in °/ 16% Single + Child(ren) 31 Stoploss Commission 10% Family 26 Total 243 Total Number of Members 395 f11 Charge for Humana Admin Services ~ ® ~1^ _~- Worksheet tab name PPO PPO-alt 1 Single Rate $33.42 $37.01 $37.01 Single + Spouse Rate $33.42 $37.01 $37.01 Single + Child(ren) Rate $33.42 $37.01 $37.01 Family Rate $33.42 $37.01 $37.01 Composite $33.42 537.01 $37.01 Total 597,453 5107,921 5107,921 Contract Basis 15/12 15/12 SPECIFIC STOP LOSS ~ ®- __~ Specific Lifetime Maximum $1,000,000 $1,000,000 Specific Deductible (per Covered Person) $50,000 $60,000 Maximum Specific Benefit $950,000 $940,000 Coinsurance Level 100% 100% Specific Premium Single Rate $52.77 $43.89 $41.26 Single + Spouse Rate $129.65 $83.91 $78.90 ~' Single + Child(ren) Rate $129.65 $65.46 $61.55 Family Rate $129.65 $114.07 $107.25 Composite 577.45 $57.61 $54.16 Estimated Annual Specific Premium 5225,837 5167,977 5157,938 Aaare9ate Premium Single Rate $14.00 $4.63 $5.63 Single + Spouse Rate $14.00 $8.85 $10.77 Single + Child(ren) Rate $14.00 $6.90 $8.40 Family Rate $14.00 $12.03 $14.64 Composite $14.00 $6.08 $7.39 Estimated Annual Aggregate Premium 540,824 S17,715 521,583 TOTAL ANNUAL PREMIUM AND ADMIN $364,114 $293,613 $287,423 AGGREGATE STOP LOSS Projected Claims 100% 100% Single $355.30 $315.80 $318.31 Single + Spouse $679.35 $603.84 $608.62 Single + Child(ren) $529.95 $471.04 $474.77 Family $923.48 $820.83 $827.33 Composite $466.37 $414.54 $417.82 Estimated Annual Claims 51,359,947 51,208,785 57,218,360 Aggregate Attachment Point 125% 125% Single $408.59 $394.75 $397.88 Single + Spouse $781.25 $754.80 $760.77 Single + Child(ren) $609.44 $588.80 $593.47 Family $1,062.00 $1,026.04 $1,034.17 Composite $536.33 $518.17 $522.27 Estimated Annual Attachment Point' 51,563,939 57,510,982 51,522,950 ~r Estimated Annual Minimum Attachment Point (90%)' $1,359,883 $1,370,655 Total Combined Est. Max. Liability $1,928,053 $1,804,595 $1,810,373 'Final calculation will be based on actual enrollment by plan. PLEASE REFER TO PROPOSAL FOR CONTINGENCIES AND EXCLUSIONS 3:54 PM 9/612007 Kerr County Proposal 1512-125 corridor(1).xls Version 3.1.2 Page 1 Effective Period: January 01, 2008 Through December 31, 2008 f ive Period: January 01, 2008 Through December 31, 2008 `rr Humana is pleased to provide the following detailed description of the services included in our Medical Administration Fee, as well as other optional services that may be provided by Humana. The information below is confidential and to be used by Kerr County for the sole purpose of this bid. Please note all fees are quoted on a per employee per month (PEPM) basis unless specified otherwise. Medical Claims Administration Utilization, Case Management, Radiology and Transplant Management, Personal Nurse Predictive Modeling Eligibility Management Pharmacy Administration Core Wellness Programs -Access to MyHumana web site for employer and employees - Humana Health Assessment - Wellness Calendar Program - Preventative Reminders Toll free access to customer service via phone, IVR and Internet Ongoing ID Card Administration State Surcharge Reporting Annual Plan Sponsor Summary for 5500 filing Bank and funding arrangements, additional fee for custom accounts Employee and Enrollment Communication Materials Standard Monthly Reporting Package Summary Plan Description Preparation Internet Access to Summary Plan Description Options 1) Integrated CM/DM/UM (Medical Behavioral Health Care Advantage) $2.45 2) Managed Medical Behavioral Health Care Basic $1.47 Network Access Network Administration Provider Directories via the Internet All Fees quoted on a PEPM basis unless noted Included Custom Fee for Service Vision $0.35 No COBRA (2% of premium retained by Ceridian) $0.50 Yes $0.50 HIPAA Certificates $0.25 Yes $0.25 HumanaFirst 24/7 Nurse Line, Health Planning, and Audio Library $0.37 Yes $0.37 Claims Fiduciary $1.63 No Third Party Interface Fee -Outside Reinsurance* $1.25 No Third Party Interface Fee - (per vendor)* $0.55 No Outbound Feeds** $0.10 per feed No SmartSummary Print Buyup Option $0.50 No Health Help RadConsult $0.46 No EAP Telephonic $0.73 No EAP Assess and Refer $1.06 No EAP Short-term Counseling $2.36 No "h/ *Based on monthly feed in a standard or agreed upon format 3:54 PM 9/6/2007 Kerr County Proposal 1512-125 corridor(1).xls Version 3.1.2 Page 2 "Assumes $0.10 per feed as requested by the client, and assumes Humana's standard file format for all feeds. ~r '~Urr+ 3:54 PM 9/6/2007 Kerr County Proposal 1512-125 corridor(1).xls Version 3.1.2 Page 3 ~r,Kive Period: January 01, 2008 Through December 31, 2008 Coordination of Benefits Subrogation, Humana retains 30% of recoveries Overpayment Recovery Claims Diagnostic Software, Unbundling and Upcoding Shared Savings, Humana retains 30% of savings All fees are billed on a Per Participant Per Month basis and a $200 monthly minimum applies 5-300 300-3000 Over 3000 (PPPM) (PPPM) (PPPM) Flexible Spending Accounts $7.00 $5.50 $5.25 Personal Care Account (HRA) $7.00 $5.50 $5.25 Combined Spending Accounts $9.00 $7.50 $7.25 One-Time Set-Up for any above $1,000 $2,000 $4,000 HSA (Health Savings Account) $3.75 PPPM All fees are quoted per participant unless noted Program Level PPPM Fee Coronary Artery Disease, CAD Telephonic $69 Congestive Heart Failure, CHF Telephonic $196 Diabetes Telephonic $150 Fwd Stage Renal Disease, ESRD Onsite $431 .Stage Renal Disease, ESRD Telephonic $173 ~onic Kidney Disease, CKD Onsite $173 Neonatal Intensive Care Unit, NICU Telephonic $2,073 per case Neonatal Intensive Care Unit, NICU Onsite $2,742 per case Rare Diseases -High Intensity Disease* Interactive $115 Rare Diseases -Low Intensity Disease" Interactive $81 Rare Diseases -Low Intensity Disease* Self-directed $35 Cancer Telephonic $315 Asthma -Low to Moderate Acuity Telephonic $143 per case Asthma -High Acuity Home Visit $828 per case Asthma -High Acuity Telephonic $489 per case Asthma -High Acuity Ongoing $91 HumanaBeginnings $247 per case Bariatric Management Program $900 per surgery. _ Telephonic Health Coaching and Tailored Web Program $190 per participant per year Ad Hoc Reporting $150 per hour 'Please obtain a list of the diseases included in the High and Low categories from your Humana Representative. " Wellness programs will be billed directly by the vendor. See attached page for conditions and caveats to the above quoted programs and services ~-` 3:54 PM 9/6/2007 Kerr County Proposal 1512-125 corridor(1).xls Version 3.1.2 Page 4 This quote assumes Humana will retain 100 percent of pharmacy rebates and apply a PEPM credit against the administrative fee equal to the rebate per script. The client can elect to have the pharmacy rebates paid directly to them on behalf of the self-funded plan. If this option is selected, the ASO fee will be increased by the value of the rebate credit. Net rebates due the customer will be calculated and settled every 6 months. Actual utilization data is used when available to calculate the PEPM credit. Absent of client specific data, 1.0 scripts per member per month should be used for non-retiree populations. Unless actual mail order utilization data is available, Humana assumes 5.5% of prescriptions PMPM are mail and the rest are retail. In the case where 1.0 scripts PMPM is used, this equates to 0.95 retail scripts per member per month and 0.05 mail scripts per member per month. The pharmacy rebates are guaranteed payments based on the pharmacy benefit design; the pharmacy rebate will differ for "highly managed", "limited managed" and "unmanaged" pharmacy benefit designs and "plans not eligible for rebates" according to the below schedule. The schedule is subject to change without notice. Humana will honor this schedule and benefit design changes for 45 days from the quote dates. The quoted administrative fees, discounts and rebates are provided assuming that Humana's standard drug list, Prior Authorization list, and Medical Dispensing Limits are utilized. Level of Plan T e of Rx Plans Rebate Per Scri t Highly Managed Plan Rx3 or Rx4 Tier Plans w/copays $3.15 per retail script Delta between tier 1 and 2 is $10 or more Delta between tier 2 and 3 is $20 or more Limited Managed Plan Rx3 or Rx4 Tier Plans w/copays or tiered coinsurance $2.00 per retail script Delta between tier 1 and 2 is less than $10 (copay plans only) Delta between tier 2 and 3 is less than $20 co a lans onl Unmanaged Plan Flat and two-tiered copay plans $1.25 per retail script Rx4 Choice* Plans excludin allowance laps Plans NOT Eligible for Rebates All flat coinsurance plans NO Rebates All Rxlmpact and allowance plans and RxValue* plans All HDHP tans Humana calculates each mail order script as 3 scripts for rebate purposes. * Please see your Humana sales representatives for details associated with these benefit designs. The administrative fee in this Rating Exhibit includes a $0.40 per pharmacy claim transaction fee assuming Medical and Rx are included. 3:54 PM 9/6/2007 Kerr County Proposal 1512-125 corridor(1).xls Version 3.1.2 Page 5 ' 'ive Period: January 01, 2008 Through December 31, 2008 ~': `rMrf'~ffective Period: January 01, 2008 Through December 31, 2008 This proposal expires in 90 days or on the effective date of the proposal, whichever date is earnest. This proposal was developed with the information provided and is subject to change based on updated claim experience, corresponding enrollment, and large claimant information to within 30 days of the proposed effective date. Humana reserves the right to change the quoted coverage terms, rates/fees/factors or withdraw the quote if: - employer contribution for all full-time employees is less than 50% of the conventional equivalent single rate. - both Administration and Stop Loss coverages) are not awarded to Humana. - less than 75% of all eligible employees are enrolled, excluding employees who have waived coverage for another group plan. (will accept down to 50%, assuming the difference between 50% and 75% is due to spousal waivers) - a signed Disclosure Statement and Application are not received within 30 days prior to the effective date. - the disclosure statement reveals large or potential large claimants not identified prior to the release of this quote. - updated claim experience with corresponding enrollment is materially different than used to develop the quoted rates/fee/factors. - the number of employees enrolled changes by +/-10% or more, if there is a change in effective or renewal dates, or if there is a material change in the plan of benefits. - the underlying plan does not include pre-certification, utilization review, or large case management programs, including a benefit penalty for non-compliance. - the underlying plan does not include Humana's recommended transplant benefits in addition to the quoted administration fee rate, Humana may assess the following fees: - for printing/mailing SPDs, if requested, as follows: -print & batch mail to client at $3.00 per SPD, or -print & mail to employees' home at $5.00 per SPD - for Shared Savings at 30% of discounts obtained for out-of-network claims - for Subrogation, at 30% of savings obtained - for additional interfacing fees - for administrative services associated with run out claims after termination. - for the costs of audits beyond the audits provided by Humana, as described in our audit policy - Capitation, if applicable, may be billed separately than fee-for-service expenses. In addition, the following conditions apply to these quotes: - Humana should be notified of the sale at least 60 days prior to the effective date for timely 8 accurate implementation. tom'' - Should a higher individual stop-loss deductible be required on any individual (laser), the amount in excess of the group's individual stop-loss deductible will be excluded from coverage under the aggregate stop loss. - Aggregate coverage is available only when purchased with specific coverage. - The aggregate maximum benefit is $1,000,000. - Quote is based on offering comparable benefits, but does not necessarily provide for an exact duplication, if applicable. - Quote assumes that the National Transplant Network is utilized; otherwise, rates, fees and factors are subject to change. - Quote assumes Humana will retain 100% of Rx rebates and has applied rebate equivalent credit against the PEPM admin. fee. - If purchased, the price quoted for Humana to be the claims fiduciary assumes one level appeals. - Humana's administration fees do not include the administration of claims incurred prior to the effective date of this quote. 6rcluded from the quoted stop loss coverage are any expenses which are: - caused or contributed to by war or an act of war. - for any injury or illness which is eligible for reimbursement under a workers' compensation or occupational disease coverage. - for a covered person who is legally confined for any reason in a jail, prison, correctional institution, or in the covered person's home. - caused or contributed to by a covered person committing or attempting to commit an illegal act. - incurred by a covered person who is disabled on the effective date unless disclosed to us prior to the effective date. - for drugs, procedures, services, supplies or treatments which are -experimental or investigational. -not medically necessary and appropriate. -rendered or received outside the United States, except as defined by the underlying plan for emergency treatments. (Such emergency treatments are limited to $ 250,000 (U.S.) per individual under the stop loss coverage.) - covered under any other plan. - for litigation, extra-contractual damages, compensatory damages, or punitive damages. - for claim exceptions paid by the underlying health plan at the direction of the client. Coverage will be subject to lasered deductibles as follows: leductible Name or id# Deductible Name or id# 0 $0 $0 $0 $0 $0 This information is provided for the purpose of illustrating the projection of claim costs, premium rates, and administration fees. The underlying factors are proprietary to Humana and not for public release. 3:54 PM 9/6/2007 Kerr County Proposal 1512-125 corridor(1).xls Version 3.1.2 Page 6 Number of Emolovees Single Single + Spouse Single + Child(ren) Family Total Total Number of Members Covered Benefits PPO 9070, $1000/2000 ded (3x fam), 2000/4000 oop (3x fam), $50 er, $30 o.v., $10120/35 rx (2.5x mo) 165 21 Maximum Allowable Run-in % 16% 31 Stoploss Commission 10% ?¢ 243 395 ~ f11 Charae for Humana Admin Services ~- ®- ~ Worksheet tab name PPO PPO-alt 1 Single Rate $33.42 $37.01 $37.01 Single + Spouse Rate $33.42 $37.01 $37.01 Single + Child(ren) Rate $33.42 $37.01 $37.01 Family Rate $33.42 $37.01 $37.01 Composite $33.42 $37.01 $37.01 Total $97,453 $107,921 $107,921 Contract Basis 15/12 15/12 SPECIFIC STOP LOSS ®® ® ®~ Specific Lifetime Maximum $1,000,000 $1,000,000 Specific Deductible (per Covered Person) $50,000 $60,000 Maximum Specific Benefit $950,000 $940,000 Coinsurance Level 100% 100% Specific Premium Single Rate $52.77 $43.99 $41.24 Single + Spouse Rate $129.65 $84.10 $78.85 *1I~ Single + Child(ren) Rate $129.65 $65.61 $61.51 Family Rate $129.65 $114.33 $107.18 Composite $77.45 $57.74 $54.13 Estimated Annual Specific Premium $225,837 $168,363 $157,837 Aaareaate Premium Single Rate $14.00 $8.83 $10.24 Single + Spouse Rate $14.00 $16.89 $19.57 Single + Child(ren) Rate $14.00 $13.17 $15.27 Family Rate $14.00 $22.95 $26.61 Composite $14.00 $11.59 $13.44 Estimated Annual Aggregate Premium $40,824 533,803 $39,180 TOTAL ANNUAL PREMIUM AND ADMIN $364,114 $310,087 $304,938 AGGREGATE STOP LOSS _® -~ ® _® Projected Claims 100°/ 100% Single $355.30 $315.78 $318.31 Single + Spouse $679.35 $603.78 $608.63 Single + Child(ren) $529.95 $471.00 $474.79 Family $923.48 $820.76 $827.35 Composite $466.37 $414.50 $417.83 Estimated Annual Claims $1,359,947 $1,208,676 S1,218,389 Aaareaate Attachment Point 120% 120% Single $408.59 $378.93 $381.98 Single + Spouse $781.25 $724.54 $730.36 Single + Child(ren) $609.44 $565.20 $569.74 Family $1,062.00 $984.91 $992.82 Composite $536.33 $497.40 $501.39 Estimated Annual Attachment Point` $1,563,939 $1,450,412 $1,462,066 ~/ Estimated Annual Minimum Attachment Point (90%)` $1,305,370 $1,315,860 Total Combined Est. Max. Liability $1,928,053 $1,760,498 $1,767,004 'Final calculation will be based on actual enrollment by plan. PLEASE REFER TO PROPOSAL FOR CONTINGEN CIES AND EXCLUSIONS 3:56 PM 916!2007 KerrCounty Proposal 1512-120 corcidor(1).xls Version 3.1.2 Page 1 Effective Period: January 01, 2008 Through December 31, 2008 Vl~ll~l~l when you need it most:; `ive Period: January 01, 2008 Through December 31, 2008 ~r Humana is pleased to provide the following detailed description of the services included in our Medical Administration Fee, as well as other optional services that may be provided by Humana. The information below is confidential and to be used by Kerc County for the sole purpose of this bid. Please note all fees are quoted on a per employee per month (PEPM) basis unless specified otherwise. Medical Claims Administration Utilization, Case Management, Radiology and Transplant Management, Personal Nurse Predictive Modeling Eligibility Management Pharmacy Administration Core Wellness Programs -Access to My Humana web site for employer and employees - Humana Health Assessment -Wellness Calendar Program - Preventative Reminders Toll free access to customer service via phone, IVR and Internet Ongoing ID Card Administration State Surcharge Reporting Annual Plan Sponsor Summary for 5500 filing Bank and funding arrangements, additional fee for custom accounts Employee and Enrollment Communication Materials Standard Monthly Reporting Package Summary Plan Description Preparation Internet Access to Summary Plan Description Options 1) Integrated CM/DM/UM (Medical Behavioral Health Care Advantage) $2.45 2) Managed Medical Behavioral Health Care Basic $1.47 Network Access Network Administration Provider Directories via the Internet All Fees quoted on a PEPM basis unless noted Included Custom Fee for Service Vision $0.35 No COBRA (2% of premium retained by Ceridian) $0.50 Yes $0.50 HIPAA Certificates $0.25 Yes $0.25 HumanaFirst 2417 Nurse Line, Health Planning, and Audio Library $0.37 Yes $0.37 Claims Fiduciary $1.63 No Third Party Interface Fee -Outside Reinsurance* $1.25 No Third Party Interface Fee - (per vendor)* $0.55 No Outbound Feeds** $0.10 per feed No SmartSummary Print Buyup Option $0.50 No Health Help RadConsult $0.46 No EAP Telephonic $0.73 No EAP Assess and Refer $1.06 No EAP Short-term Counseling $2.36 No *Based on monthly feed in a standard or agreed upon format 3:56 PM 9/6/2007 KerrCounty Proposal 1512-120 corridor(1).xls Version 3.1.2 Page 2 "Assumes $0.10 per feed as requested by the client, and assumes Humana's standard file format for all feeds. ~r-' Wry 3:56 PM 9/6!2007 KerrCounty Proposal 1512-120 corridor(1).xls Version 3.1.2 Page 3 ~,ntive Period: January 01, 2008 Through December 31, 2008 Coordination of Benefits Subrogation, Humana retains 30% of recoveries Overpayment Recovery Claims Diagnostic Software, Unbundling and Upcoding Shared Savings, Humana retains 30% of savings All fees are billed on a Per Participant Per Month basis and a $200 monthly minimum applies 5-300 300-3000 Over 3000 (PPPM) (PPPM) (PPPM) Flexible Spending Accounts $7.00 $5.50 $5.25 Personal Care Account (HRA) $7.00 $5.50 $5.25 Combined Spending Accounts $9.00 $7.50 $7.25 One-Time Set-Up for any above $1,000 $2,000 $4,000 HSA (Health Savings Account) $3.75 PPPM All fees are quoted per participant unless noted Program Level PPPM Fee Coronary Artery Disease, CAD Telephonic $69 Congestive Heart Failure, CHF Telephonic $196 Diabetes Telephonic $150 End Stage Renal Disease, ESRD Onsite $431 Stage Renal Disease, ESRD Telephonic $173 ~IMV'bnic Kidney Disease, CKD Onsite $173 Neonatal Intensive Care Unit, NICU Telephonic $2,073 per case Neonatal Intensive Care Unit, NICU Onsite $2,742 per case Rare Diseases -High Intensity Disease' Interactive $115 Rare Diseases -Low Intensity Disease' Interactive $81 Rare Diseases -Low Intensity Disease' Self-directed $35 Cancer Telephonic $315 Asthma - Low to Moderate Acuity Telephonic $143 per case Asthma -High Acuity Home Visit $828 per case Asthma -High Acuity Telephonic $489 per case Asthma -High Acuity Ongoing $91 Humanai3eginnings $247 per case Bariatric Management Program $900 per surge Telephonic Health Coaching and Tailored Web Program $190 per participant per year Ad Hoc Reporting $150 per hour 'Please obtain a list of the diseases included in the High and Low categories from your Humana Representative. " Wellness programs will be billed directly by the vendor. See attached page for conditions and caveats to the above quoted programs and services 3:56 PM 9/6/2007 KerrCounty Proposal 1512-120 corridor(1).xls Version 3.1.2 Page 4 This quote assumes Humana will retain 100 percent of pharmacy rebates and apply a PEPM credit against the administrative fee equal to the rebate per script. The client can elect to have the pharmacy rebates paid directly to them on behalf of the self-funded plan. If this option is selected, the ASO fee will be increased by the value of the rebate credit. Net rebates due the customer will be calculated and settled every 6 months. Actual utilization data is used when available to calculate the PEPM credit. Absent of client specific data, 1.0 scripts per member per month should be used for non-retired populations. Unless actual mail order utilization data is available, Humana assumes 5.5% of prescriptions PMPM are mail and the rest are retail. In the case where 1.0 scripts PMPM is used, this equates to 0.95 retail scripts per member per month and 0.05 mail scripts per member per month. The pharmacy rebates are guaranteed payments based on the pharmacy benefit design; the pharmacy rebate will differ for "highly managed", "limited managed" and "unmanaged" pharmacy benefit designs and "plans not eligible for rebates" according to the below schedule. The schedule is subject to change without notice. Humana will honor this schedule and benefit design changes for 45 days from the quote dates. The quoted administrative fees, discounts and rebates are provided assuming that Humana's standard drug list, Prior Authorization list, and Medical Dispensing Limits are utilized. Level of Plan T e of Rx Plans Rebate Per Scri t Highly Managed Plan Rx3 or Rx4 Tier Plans w/copays $3.15 per retail script Delta between tier 1 and 2 is $10 or more Delta between tier 2 and 3 is $20 or more Limited Managed Plan Rx3 or Rx4 Tier Plans w/copays or tiered coinsurance $2.00 per retail script Delta between tier 1 and 2 is less than $10 (copay plans only) Delta between tier 2 and 3 is less than $20 co a lans onl Unmanaged Plan Flat and two-tiered copay plans $1.25 per retail script Rx4 Choice* Plans excludin allowance tans Plans NOT Eligible for Rebates All flat coinsurance plans NO Rebates All Rxlmpact and allowance plans and RxValue* plans All HDHP laps Humana calculates each mail order script as 3 scripts for rebate purposes. * Please see your Humana sales representatives for details associated with these benefit designs. The administrative fee in this Rating Exhibit includes a $0.40 per pharmacy claim transaction fee assuming Medical and Rx are included. 3:56 PM 9/6/2007 KerrCounty Proposal 1512-120 corridor(1).xls Version 3.1.2 Page 5 five Period: January 01, 2008 Through December 31, 2008 ~d p'Effective Period: January 01, 2008 Through December 31, 2008 This proposal expires in 90 days or on the effective date of the proposal, whichever date is earliest. This proposal was developed with the information provided and is subject to change based on updated claim experience, corresponding enrollment, and large claimant information to within 30 days of the proposed effective date. Humana reserves the right to change the quoted coverage terms, rateslfees/factors or withdraw the quote if: - employer contribution for all full-time employees is less than 50% of the conventional equivalent single rate. - both Administration and Stop Loss coverages) are not awarded to Humana. - less than 75% of all eligible employees are enrolled, excluding employees who have waived coverage for another group plan. (will accept down to 50%, assuming the difference between 50% and 75% is due to spousal waivers) - a signed Disclosure Statement and Application are not received within 30 days prior to the effective date. - the disclosure statement reveals large or potential large claimants not identified prior to the release of this quote. - updated claim experience with corresponding enrollment is materially different than used to develop the quoted rates/fee/factors. - the number of employees enrolled changes by +1-10% or more, if there is a change in effective or renewal dates, or if there is a material change in the plan of benefits. - the underlying plan does not include pre-certification, utilization review, or large case management programs, including a benefit penalty for non-compliance. - the underlying plan does not include Humana's recommended transplant benefits In addition to the quoted administration fee rate, Humana may assess the following fees: - for printing/mailing SPDs, if requested, as follows: -print 8 batch mail to client at $3.00 per SPD, or -print & mail to employees' home at $5.00 per SPD - for Shared Savings at 30% of discounts obtained for out-of-network claims - for Subrogation, at 30% of savings obtained - for additional interfacing fees - for administrative services associated with run out claims after termination. - for the costs of audits beyond the audits provided by Humana, as described in our audit policy - Capitation, if applicable, may be billed separately than fee-for-service expenses. In addition, the following conditions apply to these quotes: - Humana should be notified of the sale at least 60 days prior to the effective date for timely & accurate implementation. °`IYr/' - Should a higher individual stop-loss deductible be required on any individual (laser), the amount in excess of the group's individual stop-loss deductible will be excluded from coverage under the aggregate stop loss. - Aggregate coverage is available only when purchased with specific coverage. - The aggregate maximum benefit is $1,000,000. - Quote is based on offering comparable benefits, but does not necessarily provide for an exact duplication, if applicable. - Quote assumes that the National Transplant Network is utilized; otherwise, rates, fees and factors are subject to change. - Quote assumes Humana will retain 100% of Rx rebates and has applied rebate equivalent credit against the PEPM admin. fee. - If purchased, the price quoted for Humana to be the claims fiduciary assumes one level appeals. - Humana's administration fees do not include the administration of claims incurred prior to the effective date of this quote. Excluded from the quoted stop loss coverage are any expenses which are: - caused or contributed to by war or an act of war. - for any injury or illness which is eligible for reimbursement under a workers' compensation or occupational disease coverage. - for a covered person who is legally confined for any reason in a jail, prison, correctional institution, or in the covered person's home. - caused or contributed to by a covered person committing or attempting to commit an illegal act. - incurred by a covered person who is disabled on the effective date unless disclosed to us prior to the effective date. - for drugs, procedures, services, supplies or treatments which are -experimental or investigational. -not medically necessary and appropriate. -rendered or received outside the United States, except as defined by the underlying plan for emergency treatments. (Such emergency treatments are limited to $ 250,000 (U.S.) per individual under the stop loss coverage.) - covered under any other plan. - for litigation, extra-contractual damages, compensatory damages, or punitive damages. - for claim exceptions paid by the underlying health plan at the direction of the client. Coverage will be subject to lasered deductibles as follows: 3:56 PM 9/6/2007 KerrCounty Proposal 1512-120 corridor(1).xls Version 3.1.2 Page 6 This information is provided for the purpose of illustrating the projection of claim costs, premium rates, and administration fees. The underlying factors are proprietary to Humana and not for public release. Plan Description Experience Period 08/01/06 to 07/31/07 Contract Period 01/01/08 to 12/31/08 Trend Period 02/01/07 to 07/01/08 Gross Claims (including Capitation) 51,271,859 number of claimants exceeding the specific deductible 1.00 less specific claims including deductible of: S5o,000 $103,602 less adjustments for plan changes-repricing-early retirees-etc. $77,523 less other adjustment $18,318 Net Claims 51,072,416 Annual Trend Rate 9.4% Trend Months 17 Trend Applied 13.6% Trended Claims 51,217,973 plus specific claims below the deductible $50,000 plus additional claims adjustment $0 spec deductible adjustment $0 ~pected Claims 51,267,973 Average members 403 Experience Rate PMPM $262.19 Manual Rate PMPM $238.20 Credibility Factor 70.0% Expected Blended Claims PMPM (adjusted for credibility) 5255.00 Enrollment by Plan Current as of: 07/31/07 395 Expected Annual Claims (adjusted for credibility) $1,208,676 Current Subscribers 243 Expected Blended Claims PEPM (adjusted for credibility) 5414.50 Current Annual Aggregate Attachment $1,563,939 Current Annual Aggregate Attachment PEPM $536.33 Aggregate Attachment Renewal Projection Expected Annual Claims (adjusted forcredibi~ity) 51,208,676 Accumulation Period (Months) 12 Contract Liability Factor (input contract basis in box) 15/12 1.00 Specific Deductible Adjustment 1.0000 Expected Annual Claims (adjusted for credibility) $1,208,676 Aggregate Corridor 1.20 Projected Annual Aggregate Attachment 51,450,412 ojected Annual Aggregate Attachment PEPM T2equired Renewal Adjustment to Aggregate Attachment 5497.40 -7.26% 3:56 PM 9/6/2007 KerrCounty Proposal 1512-120 corridor(1).xls Version 3.1.2 Page 7 ~, active Period: January 01, 2008 Through December 31, 2008 group Number(s): 0 '~tI11f Number of Emolovees Single 165 Single + Spouse 21 Single + Child(ren) 31 Family 26 Total 243 Total Number of Members 395 (11 Charge for Humana Admin Services Worksheet tab name Single Rate Single + Spouse Rate Single + Child(ren) Rate Family Rate Composite Total Contract Basis SPECIFIC STOP LOSS Specific Lifetime Maximum Specific Deductible (per Covered Person) Maximum Specific Benefit Coinsurance Level Specific Premium Single Rate Single + Spouse Rate ~/ Single + Child(ren) Rate Family Rate Composite Estimated Annual Specific Premium Aas~reaate Premium Single Rate Single + Spouse Rate Single + Child(ren) Rate Family Rate Composite Estimated Annual Aggregate Premium TOTAL ANNUAL PREMIUM AND ADMIN AGGREGATE STOP LOSS Projected Claims Single Single + Spouse Single + Child(ren) Family Composite Estimated Annual Claims Aggregate Attachment Point Single Single + Spouse Single + Child(ren) Family Composite Estimated Annual Attachment Point' $33.42 $33.42 $33.42 $33.42 $33.42 $97,453 $52.77 $129.65 $129.65 $129.65 $77.45 $225,837 $14.00 $14.00 $14.00 $14.00 $14.00 $40,824 $364,114 $355.30 $679.35 $529.95 $923.48 $466.37 $1,359,947 $408.59 $781.25 $609.44 $1,062.00 $536.33 $1,563,939 Covered Benefits PPO 9070, $1000/2000 ded (3x fam), 2000/4000 pop (3x fam), $50 er, $30 o.v., $10/20/35 rx (2.Sx mo) Maximum Allowable Run-in % 16% Stoploss Commission 10% __ ~~~ PPO PPO-alt 1 $37.01 $37.01 $37.01 $37.01 $37.01 $107,921 $37.01 $37.01 $37.01 $37.01 $37.01 5107,921 24112 $1,000,000 $50,000 $950,000 100% $45.16 $86.35 $67.36 $117.38 $59.28 $172,865 $4.62 $8.84 $6.90 $12.02 $6.07 $17,696 $298,482 100% $347.02 $663.52 $517.60 $901.96 $455.51 $1,328,256 125% $433.77 $829.40 $647.00 $1,127.45 $569.38 S1,660,320 `~'~ Estimated Annual Minimum Attachment Point (90%)' $1,494,288 Total Combined Est. Max. Liability $1,928,053 $1,958,802 'Final calculation will be based on actual enrollment by plan. PLEASE REFER TO PROPOSAL FOR CONTINGENCIES AND EXCLUSIONS 3:55 PM 9/6/2007 Kerr County Proposal 2412-125 corridor(1).xls Version 3.1.2 24/12 $1,000,000 $60,000 $940,000 100% $42.30 $80.89 $63.10 $109.96 $55.53 $161,926 $5.63 $10.76 $8.40 $14.63 $7.39 $21,545 $291,392 100% $349.84 $668.91 $521.81 $909.29 $459.21 $1,339,054 125% $437.30 $836.14 $652.26 $1,136.61 $ 574.01 $1,673,818 $1, 506,436 $1,965,210 Page 1 Effective Period: January 01, 2008 Through December 31, 2008 Humana is pleased to provide the following detailed description of the services included in our Medical Administration Fee, as well as other optional services that may be provided by Humana. The information below is confidential and to be used by Kerr County for the sole purpose of this bid. Please note all fees are quoted on a per employee per month (PEPM) basis unless specified otherwise. Medical Claims Administration Utilization, Case Management, Radiology and Transplant Management, Personal Nurse Predictive Modeling Eligibility Management Pharmacy Administration Core Wellness Programs -Access to My Humana web site for employer and employees - Humana Health Assessment -Wellness Calendar Program - Preventative Reminders Toll free access to customer service via phone, IVR and Internet Ongoing ID Card Administration State Surcharge Reporting Annual Plan Sponsor Summary for 5500 filing Bank and funding arrangements, additional fee for custom accounts Employee and Enrollment Communication Materials Standard Monthly Reporting Package Summary Plan Description Preparation Internet Access to Summary Plan Description Options 1) Integrated CM/DM/UM (Medical Behavioral Health Care Advantage) $2.45 2) Managed Medical Behavioral Health Care Basic $1.47 Network Access Network Administration Provider Directories via the Internet All Fees quoted on a PEPM basis unless noted Included Custom Fee for Service Vision $0.35 No COBRA (2% of premium retained by Ceridian) $0.50 Yes $0.50 HIPAA Certificates $0.25 Yes $0.25 HumanaFirst 24/7 Nurse Line, Health Planning, and Audio Library $0.37 Yes $0.37 Claims Fiduciary $1.63 No Third Party Interface Fee -Outside Reinsurance* $1.25 No Third Party Interface Fee - (per vendor)* $0.55 No Outbound Feeds** $0.10 per feed No SmartSummary Print Buyup Option $0.50 No Health Help RadConsult $0.46 No EAP Telephonic $0.73 No EAP Assess and Refer $1.06 No EAP Short-term Counseling $2.36 No 'Based on monthly feed in a standard or agreed upon format 3:55 PM 9/6/2007 Kerr County Proposal 2412-125 corridor(1).xls Version 3.1.2 Page 2 :tive Period: January 01, 2008 Through December 31, 2008 "Assumes $0.10 per feed as requested by the client, and assumes Humana's standard file format for all feeds. ~' 3:55 PM 9/6/2007 Kerr County Proposal 2412-125 corridor(1).xls Version 3.1.2 Page 3 Y~wtive Period: January 01, 2008 Through December 31, 2008 Coordination of Benefits Subrogation, Humana retains 30% of recoveries Overpayment Recovery Claims Diagnostic Software, Unbundling and Upcoding Shared Savings, Humana retains 30% of savings All fees are billed on a Per Participant Per Month basis and a $200 monthly minimum applies 5-300 300-3000 Over 3000 (PPPM) (PPPM) (PPPM) Flexible Spending Accounts $7.00 $5.50 $5.25 Personal Care Account (HRA) $7.00 $5.50 $5.25 Combined Spending Accounts $9.00 $7.50 $7.25 One-Time Set-Up for any above $1,000 $2,000 $4,000 HSA (Health Savings Account) $3.75 PPPM All fees are quoted per participant unless noted Program Level PPPM Fee Coronary Artery Disease, CAD Telephonic $69 Congestive Heart Failure, CHF Telephonic $196 Diabetes Telephonic $150 Fnd Stage Renal Disease, ESRD Onsite $431 Stage Renal Disease, ESRD Telephonic $173 OnIC Kidney Disease, CKD Onsite $173 Neonatal Intensive Care Unit, NICU Telephonic $2,073 per case Neonatal Intensive Care Unit, NICU Onsite $2,742 per case Rare Diseases -High Intensity Disease* Interactive $115 Rare Diseases -Low Intensity Disease* Interactive $81 Rare Diseases -Low Intensity Disease* Self-directed $35 Cancer Telephonic $315 Asthma - Low to Moderate Acuity Telephonic $143 per case Asthma -High Acuity Home Visit $828 per case Asthma -High Acuity Telephonic $489 per case Asthma -High Acuity Ongoing $91 Humana8eginnings $247 per case Bariatric Mana ement Pro ram $900 per sur e Telephonic Health Coaching and Tailored Web Program $190 per participant per year Ad Hoc Reporting $150 per hour *Please obtain a list of the diseases included in the High and Low categories from your Humana Representative. "Wellness programs will be billed directly by the vendor. See attached page for conditions and caveats to the above quoted programs and services ~~ 3:55 PM 9/6/2007 Kerr County Proposal 2412-125 corridor(1).xls Version 3.1.2 Page 4 This quote assumes Humana will retain 100 percent of pharmacy rebates and apply a PEPM credit against the administrative fee equal to the rebate per script. The client can elect to have the pharmacy rebates paid directly to them on behalf of the self-funded plan. If this option is selected, the ASO fee will be increased by the value of the rebate credit. Net rebates due the customer will be calculated and settled every 6 months. Actual utilization data is used when available to calculate the PEPM credit. Absent of client specific data, 1.0 scripts per member per month should be used for non-retiree populations. Unless actual mail order utilization data is available, Humana assumes 5.5% of prescriptions PMPM are mail and the rest are retail. In the case where 1.0 scripts PMPM is used, this equates to 0.95 retail scripts per member per month and 0.05 mail scripts per member per month. The pharmacy rebates are guaranteed payments based on the pharmacy benefit design; the pharmacy rebate will differ for "highly managed", "limited managed" and "unmanaged" pharmacy benefit designs and "plans not eligible for rebates" according to the below schedule. The schedule is subject to change without notice. Humana will honor this schedule and benefit design changes for 45 days from the quote dates. The quoted administrative fees, discounts and rebates are provided assuming that Humana's standard drug list, Prior Authorization list, and Medical Dispensing Limits are utilized. Level of Plan T e of Rx Plans Rebate Per Scri t Highly Managed Plan Rx3 or Rx4 Tier Plans w/copays $3.15 per retail script Delta between tier 1 and 2 is $10 or more Delta between tier 2 and 3 is $20 or more Limited Managed Plan Rx3 or Rx4 Tier Plans w/copays or tiered coinsurance $2.00 per retail script Delta between tier 1 and 2 is less than $10 (copay plans only) Delta between tier 2 and 3 is less than $20 co a lans onl Unmanaged Plan Flat and two-tiered copay plans $1.25 per retail script Rx4 Choice' Plans excludin allowance tans Plans NOT Eligible for Rebates All flat coinsurance plans NO Rebates All Rxlmpact and allowance plans and RxValue' plans All HDHP lans Humana calculates each mail order script as 3 scripts for rebate purposes. "Please see your Humana sales representatives for details associated with these benefit designs. The administrative fee in this Rating Exhibit includes a $0.40 per pharmacy claim transaction fee assuming Medical and Rx are included. ~` 3:55 PM 9/6/2007 Kerr County Proposal 2412-125 corridor(1).xls Version 3.1.2 Page 5 tive Period: January 01, 2008 Through December 31, 2008 iirr/ ~'' Effective Period: January 01, 2008 Through December 31, 2008 This proposal expires in 90 days or on the effective date of the proposal, whichever date is earliest. This proposal was developed with the information provided and is subject to change based on updated claim experience, corresponding enrollment, and large claimant information to within 30 days of the proposed effective date. Humana reserves the right to change the quoted coverage terms, rates/fees/factors or withdraw the quote if: - employer contribution for all full-time employees is less than 50% of the conventional equivalent single rate. - both Administration and Stop Loss coverages) are not awarded to Humana. - less than 75% of all eligible employees are enrolled, excluding employees who have waived coverage for another group plan. (will accept down to 50%, assuming the difference between 50% and 75% is due to spousal waivers) - a signed Disclosure Statement and Application are not received within 30 days prior to the effective date. - the disclosure statement reveals large or potential large claimants not identified prior to the release of this quote. - updated claim experience with corresponding enrollment is materially different than used to develop the quoted ratesffee/factors. - the number of employees enrolled changes by +/-10% or more, if there is a change in effective or renewal dates, or if there is a material change in the plan of benefits. - the underlying plan does not include pre-certification, utilization review, or large case management programs, including a benefit penalty for non-compliance. - the underlying plan does not include Humana's recommended transplant benefits In addition to the quoted administration fee rate, Humana may assess the following fees: - for printing/mailing SPDs, if requested, as follows: -print 8 batch mail to client at $3.00 per SPD, or -print & mail to employees' home at $5.00 per SPD - for Shared Savings at 30% of discounts obtained for out-of-network claims - for Subrogation, at 30% of savings obtained - for additional interfacing fees - for administrative services associated with run out claims after termination. - for the costs of audits beyond the audits provided by Humana, as described in our audit policy - Capitation, if applicable, may be billed separately than fee-for-service expenses. In addition, the following conditions apply to these quotes: -Humana should be notified of the sale at least 60 days prior to the effective date for timely 8 accurate implementation. - Should a higher individual stop-loss deductible be required on any individual (laser), the amount in excess of the group's individual stop-loss deductible will be excluded from coverage under the aggregate stop loss. - Aggregate coverage is available only when purchased with specific coverage. - The aggregate maximum benefit is $1,000,000. - Quote is based on offering comparable benefits, but does not necessarily provide for an exact duplication, if applicable. - Quote assumes that the National Transplant Network is utilized; otherwise, rates, fees and factors are subject to change. - Quote assumes Humana will retain 100% of Rx rebates and has applied rebate equivalent credit against the PEPM admin. fee. - If purchased, the price quoted for Humana to be the claims fiduciary assumes one level appeals. - Humana's administration fees do not include the administration of claims incurred prior to the effective date of this quote. Excluded from the quoted stop loss coverage are any expenses which are: - caused or contributed to by war or an act of war. - for any injury or illness which is eligible for reimbursement under a workers' compensation or occupational disease coverage. - for a covered person who is legally confined for any reason in a jail, prison, correctional institution, or in the covered person's home. - caused or contributed to by a covered person committing or attempting to commit an illegal act. - incurred by a covered person who is disabled on the effective date unless disclosed to us prior to the effective date. - for drugs, procedures, services, supplies or treatments which are -experimental or investigational. -not medically necessary and appropriate. -rendered or received outside the United States, except as defined by the underlying plan for emergency treatments. (Such emergency treatments are limited to $ 250,000 (U.S.) per individual under the stop loss coverage.) - covered under any other plan. - for litigation, extra-contractual damages, compensatory damages, or punitive damages. - for claim exceptions paid by the underlying health plan at the direction of the client. Coverage will be subject to lasered deductibles as follows: Deductible Name or id# Deductible Name or id# $0 $0 $0 $0 $0 $0 This information is provided for the purpose of illustrating the projection of claim costs, premium rates, and administration fees. The underlying factors are proprietary to Humana and not for public release. 3:55 PM 9/6/2007 Kerr County Proposal 2412-125 corridor(1).xls Version 3.1.2 Page 6 ~r Covered Benefits PPO 9070, $1000/2000 ded (3x fam), 2000/4000 oop (3x Number of Emolovees fam), $50 er, $30 o.v., $10/20/35 rx (2.5x mo) Single 165 Single + Spouse 21 Maximum Allowable Run-in % 16% Single + Child(ren) 31 Stoploss Commission 10% Family 26 Total 243 Total Number of Members 395 (11 Charge for Humana Admin Service s ~ ~®® _~ Worksheet tab name PPO PPO-alt 1 Single Rate $33.42 $37.01 $37.01 Single + Spouse Rate $33.42 $37.01 $37.01 Single + Child(ren) Rate $33.42 $37.01 $37.01 Family Rate $33.42 $37.01 $37.01 Composite $33.42 $37.01 $37.01 Total $97,453 $107,921 S107,921 Contract Basis 24/12 24/12 PECIFIC STOP LOSS Specific Lifetime Maximum $1,000,000 $1,000,000 Specific Deductible (per Covered Person) $50,000 $60,000 Maximum Specific Benefit $950,000 $940,000 Coinsurance Level 100% 100% Suecific Premium Single Rate $52.77 $45.16 $42.30 Single + Spouse Rate $129.65 $86.35 $80.89 ~/ Single + Child(ren) Rate $129.65 $67.36 $63.10 Family Rate $129.65 $117.38 $109.96 Composite $77.45 $59.28 $55.53 Estimated Annual Specific Premium 5225,837 $172,865 $161,926 Aggregate Premium Single Rate $14.00 $8.82 $10.23 Single + Spouse Rate $14.00 $16.87 $19.55 Single + Child(ren) Rate $14.00 $13.16 $15.25 Family Rate $14.00 $22.93 $26.58 Composite $14.00 $11.58 $13.42 Estimated Annual Aggregate Premium $40,824 $33,770 539,145 TOTAL ANNUAL PREMIUM AND ADMIN $364,114 $314,556 $308,992 AGGREGATE STOP LOSS Protected Claims 100% 100° Single $355.30 $347.02 $349.84 Single + Spouse $679.35 $663.52 $668.91 Single + Child(ren) $529.95 $517.60 $521.81 Family $923.48 $901.96 $909.29 Composite $466.37 $455.51 $459.21 Estimated Annual Claims $1,359,947 51,328,256 $1,339,054 Aggregate Attachment Point 120% 120% Single $408.59 $416.42 $419.80 Single + Spouse $781.25 $796.22 $802.69 Single + Child(ren) $609.44 $621.12 $626.17 Family $1,062.00 $1,082.35 $1,091.15 Composite $536.33 $546.61 $551.05 Estimated Annual Attachment Point' $1,563,939 57,593,907 $1,606,865 ~I Estimated Annual Minimum Attachment Point (90%)' $1,434,517 $1,446,179 Total Combined Est. Max. Liability $1,928,053 $1,908,463 $1,915,857 `Final calculation will be based on actual enrollment by plan. PLEASE REFER TO PROPOSAL FOR CONTINGENCIES AND EXCLUSIONS 3:55 PM 9/6/2007 Kerc County Proposal 2412-120 corddor(1).xis Version 3.1.2 Page 1 Effective Period: January 01, 2008 Through December 31, 2008 Humana is pleased to provide the following detailed description of the services included in our Medical Administration Fee, as well as other optional services that may be provided by Humana. The information below is confidential and to be used by Kerr County for the sole purpose of this bid. Please note all fees are quoted on a per employee per month (PEPM) basis unless specified otherwise. Medical Claims Administration Utilization, Case Management, Radiology and Transplant Management, Personal Nurse Predictive Modeling Eligibility Management Pharmacy Administration Core Wellness Programs -Access to My Humana web site for employer and employees - Humana Health Assessment - Wellness Calendar Program - Preventative Reminders Toll free access to customer service via phone, IVR and Internet Ongoing ID Card Administration State Surcharge Reporting Annual Plan Sponsor Summary for 5500 filing Bank and funding arrangements, additional fee for custom accounts Employee and Enrollment Communication Materials Standard Monthly Reporting Package Summary Plan Description Preparation Internet Access to Summary Plan Description Options 1) Integrated CM/DM/UM (Medical Behavioral Health Care Advantage) $2.45 2) Managed Medical Behavioral Health Care Basic $1.47 Network Access Network Administration Provider Directories via the Internet All Fees quoted on a PEPM basis unless noted Included Custom Fee for Service Vision $0.35 No COBRA (2% of premium retained by Ceridian) $0.50 Yes $0.50 HIPAA Certificates $0.25 Yes $0.25 HumanaFirst 24/7 Nurse Line, Health Planning, and Audio Library $0.37 Yes $0.37 Claims Fiduciary $1.63 No Third Party Interface Fee -Outside Reinsurance' $1.25 No Third Party Interface Fee - (per vendor)" $0.55 No Outbound Feeds*' $0.10 per feed No SmartSummary Print Buyup Option $0.50 No Health Help RadConsult $0.46 No EAP Telephonic $0.73 No EAP Assess and Refer $1.06 No EAP Short-term Counseling $2.36 No 'Based on monthly feed in a standard or agreed upon format 3:55 PM 9/6/2007 Kerr County Proposal 2412-120 corridor(1).xls Version 3.1.2 Page 2 !ive Period: January 01, 2008 Through December 31, 2008 'fir' "Assumes $0.10 per feed as requested by the client, and assumes Humana's standard file format for all feeds. ~+' 3:55 PM 9/6/2007 Kerr County Proposal 2412-120 corridor(1).xls Version 3.1.2 Page 3 motive Period: January 01, 2008 Through December 31, 2008 Coordination of Benefits Subrogation, Humana retains 30% of recoveries Overpayment Recovery Claims Diagnostic Software, Unbundling and Upcoding Shared Savings, Humana retains 30% of savings All fees are billed on a Per Participant Per Month basis and a $200 monthly minimum applies 5-300 300-3000 Over 3000 (PPPM) (PPPM) (PPPM) Flexible Spending Accounts $7.00 $5.50 $5.25 Personal Care Account (HRA) $7.00 $5.50 $5.25 Combined Spending Accounts $9.00 $7.50 $7.25 One-Time Set-Up for any above $1,000 $2,000 $4,000 HSA (Health Savings Account) $3.75 PPPM All fees are quoted per participant unless noted Program Level PPPM Fee Coronary Artery Disease, CAD Telephonic $69 Congestive Heart Failure, CHF Telephonic $196 Diabetes Telephonic $150 F-~~t Stage Renal Disease, ESRD Onsite $431 Stage Renal Disease, ESRD Telephonic $173 ionic Kidney Disease, CKD Onsite $173 Neonatal Intensive Care Unit, NICU Telephonic $2,073 per case Neonatal Intensive Care Unit, NICU Onsite $2,742 per case Rare Diseases -High Intensity Disease* Interactive $115 Rare Diseases -Low Intensity Disease* Interactive $81 Rare Diseases -Low Intensity Disease* Self-directed $35 Cancer Telephonic $315 Asthma -Low to Moderate Acuity Telephonic $143 per case Asthma -High Acuity Home Visit $828 per case Asthma -High Acuity Telephonic $489 per case Asthma -High Acuity Ongoing $91 Humana8eginnings $247 per case Bariatric Management Program $900 per surgery Telephonic Health Coaching and Tailored Web Program 90 per participant per year Ad Hoc Reporting $150 per hour *Please obtain a list of the diseases included in the High and Low categories from your Humana Representative. ** Wellness programs will be billed directly by the vendor. See attached page for conditions and caveats to the above quoted programs and services '\r+` 3:55 PM 9/6/2007 Kerr County Proposal 2412-120 corridor(1).xls Version 3.1.2 Page 4 This quote assumes Humana will retain 100 percent of pharmacy rebates and apply a PEPM credit against the administrative fee equal to the rebate per script. The client can elect to have the pharmacy rebates paid directly to them on behalf of the self-funded plan. If this option is selected, the ASO fee will be increased by the value of the rebate credit. Net rebates due the customer will be calculated and settled every 6 months. Actual utilization data is used when available to calculate the PEPM credit. Absent of client specific data, 1.0 scripts per member per month should be used for non-retiree populations. Unless actual mail order utilization data is available, Humana assumes 5.5% of prescriptions PMPM are mail and the rest are retail. In the case where 1.0 scripts PMPM is used, this equates to 0.95 retail scripts per member per month and 0.05 mail scripts per member per month. The pharmacy rebates are guaranteed payments based on the pharmacy benefit design; the pharmacy rebate will differ for "highly managed", "limited managed" and "unmanaged" pharmacy benefit designs and "plans not eligible for rebates" according to the below schedule. The schedule is subject to change without notice. Humana will honor this schedule and benefit design changes for 45 days from the quote dates. The quoted administrative fees, discounts and rebates are provided assuming that Humana's standard drug list, Prior Authorization list, and Medical Dispensing Limits are utilized. Level of Plan T e of Rx Plans Rebate Per Scri t Highly Managed Plan Rx3 or Rx4 Tier Plans w/copays $3.15 per retail script Delta between tier 1 and 2 is $10 or more Delta between tier 2 and 3 is $20 or more Limited Managed Plan Rx3 or Rx4 Tier Plans w/copays or tiered coinsurance $2.00 per retail script Delta between tier 1 and 2 is less than $10 (copay plans only) Delta between tier 2 and 3 is less than $20 co a tans onl Unmanaged Plan Flat and two-tiered copay plans $1.25 per retail script Rx4 Choice* Plans excludin allowance tans Plans NOT Eligible for Rebates All flat coinsurance plans NO Rebates All Rxlmpact and allowance plans and RxValue* plans All HDHP tans f Humana calculates each mail order script as 3 scripts for rebate purposes. * Please see your Humana sales representatives for details associated with these benefit designs. The administrative fee in this Rating Exhibit includes a $0.40 per pharmacy claim transaction fee assuming Medical and Rx are included. 3:55 PM 9/6/2007 Kerr County Proposal 2412-120 corridor(1).xls Version 3.1.2 Page 5 five Period: January 01, 2008 Through December 31, 2008 ~IrrEffective Period: January 01, 2008 Through December 31, 2008 This proposal expires in 90 days or on the effective date of the proposal, whichever date is earliest. This proposal was developed with the information provided and is subject to change based on updated claim experience, corresponding enrollment, and large claimant information to within 30 days of the proposed effective date. Humana reserves the right to change the quoted coverage terms, rateslfeeslfactors or withdraw the quote if: - employer contribution for all full-time employees is less than 50% of the conventional equivalent single rate. - both Administration and Stop Loss coverages) are not awarded to Humana. - less than 75% of all eligible employees are enrolled, excluding employees who have waived coverage for another group plan. (will accept down to 50%, assuming the difference between 50% and 75% is due to spousal waivers) - a signed Disclosure Statement and Application are not received within 30 days prior to the effective date. - the disclosure statement reveals large or potential large claimants not identified prior to the release of this quote. - updated claim experience with corresponding enrollment is materially different than used to develop the quoted rates/fee/factors. - the number of employees enrolled changes by +/-10% or more, if there is a change in effective or renewal dates, or if there is a material change in the plan of benefits. - the underlying plan does not include pre-certification, utilization review, or large case management programs, including a benefit penalty for non-compliance. - the underlying plan does not include Humana's recommended transplant benefits In addition to the quoted administration fee rate, Humana may assess the following fees: - for printing/mailing SPDs, if requested, as follows: -print & batch mail to client at $3.00 per SPD, or -print 8 mail to employees' home at $5.00 per SPD - for Shared Savings at 30% of discounts obtained for out-of-network claims - for Subrogation, at 30% of savings obtained - for additional interfacing fees - for administrative services associated with run out claims after termination. - for the costs of audits beyond the audits provided by Humana, as described in our audit policy - Capitation, if applicable, may be billed separately than fee-for-service expenses. In addition, the following conditions apply to these quotes: - Humana should be notified of the sale at least 60 days prior to the effective date for timely 8 accurate implementation. ~~ - Should a higher individual stop-loss deductible be required on any individual (laser), the amount in excess of the group's individual stop-loss deductible will be excluded from coverage under the aggregate stop loss. - Aggregate coverage is available only when purchased with specific coverage. - The aggregate maximum benefit is $1,000,000. - Quote is based on offering comparable benefits, but does not necessarily provide for an exact duplication, if applicable. - Quote assumes that the National Transplant Network is utilized; otherwise, rates, fees and factors are subject to change. - Quote assumes Humana will retain 100% of Rx rebates and has applied rebate equivalent credit against the PEPM admin. fee. - If purchased, the price quoted for Humana to be the claims fiduciary assumes one level appeals. - Humana's administration fees do not include the administration of claims incurred prior to the effective date of this quote. F~ccluded from the quoted stop loss coverage are any expenses which are: - caused or contributed to by war or an act of war. - for any injury or illness which is eligible for reimbursement under a workers' compensation or occupational disease coverage. - for a covered person who is legally confined for any reason in a jail, prison, correctional institution, or in the covered person's home. - caused or contributed to by a covered person committing or attempting to commit an illegal act. - incurred by a covered person who is disabled on the effective date unless disclosed to us prior to the effective date. - for drugs, procedures, services, supplies or treatments which are -experimental or investigational. -not medically necessary and appropriate. -rendered or received outside the United States, except as defined by the underlying plan for emergency treatments. (Such emergency treatments are limited to $ 250,000 (U.S.) per individual under the stop loss coverage.) - covered under any other plan. - for litigation, extra-contractual damages, compensatory damages, or punitive damages. - for claim exceptions paid by the underlying health plan at the direction of the client. Coverage will be subject to lasered deductibles as follows: deductible Name or id# Deductible Name or id# 0 $0 $0 $0 $0 $0 This information is provided for the purpose of illustrating the projection of claim costs, premium rates, and administration fees. The underlying factors are proprietary to Humana and not for public release. 3:55 PM 9/6/2007 Kerr County Proposal 2412-120 corridor(1).xls Version 3.1.2 Page 6 Plan Description Experience Period 08/01/06 to 07/31/07 Contract Period 01/01/08 to 12/31/08 Trend Period 02/01/07 to 07/01/08 Gross Claims (including Capitation) $1,271,859 number of claimants exceeding the specific deductible 1.00 less specific claims including deductible of: $50,000 $103,602 less adjustments for plan changes-repricing-early retirees-etc. $77,523 less other adjustment $18,318 Net Claims $1,072,416 Annual Trend Rate 9.4% Trend Months 17 Trend Applied 13.6% Trended Claims $1,217,973 plus specific claims below the deductible $50,000 plus additional claims adjustment $0 spec deductible adjustment $0 ~,Apected Claims $1,267,973 Average members 403 Experience Rate PMPM $262.19 Manual Rate PMPM $237.37 Credibility Factor 70.0% Expected Blended Claims PMPM (adjusted for credibility) $254.75 Enrollment by Plan Current as of: 07/31/07 395 Expected Annual Claims (adjusted for credibility) $1,207,506 Current Subscribers 243 Expected Blended Claims PEPM (adjusted for credibility) $414.10 Current Annual Aggregate Attachment $1,563,939 Current Annual Aggregate Attachment PEPM $536.33 Aggregate Attachment Renewal Projection Expected Annual Claims (adjusted for creditiiity) $1,207,5011 Accumulation Period (Months) 12 Contract Liability Factor (input contract basis in box) 24!12 1.10 Specific Deductible Adjustment 1.0000 Expected Annual Claims (adjusted for credibility) $1,328,256 Aggregate Corridor 1.20 Projected Annual Aggregate Attachment $1,593,907 1•ojected Annual Aggregate Attachment PEPM $546.61 equired Renewal Adjustment to Aggregate Attachment 1.92% 3:55 PM 9/6/2007 Kerr County Proposal 2412-120 corridor(1).xls Version 3.1.2 Page 7 °ective Period: January 01, 2008 Through December 31, 2008 roup Number(s): 0 HUMANA.~, e$, ~ when you need it most KERR COUNTY SPECIFIC AND AGGREGATE STOP LOSS INSURANCE THIRD PARTY MEDICAL CLAIMS ADMINISTRATION GROUP TERM LIFE AND AD&D HEALTH REIMBURSEMENT ARRANGEMENT CAFETERIA PLAN (IRS CODE 125) ADMINISTRATION PRESCRIPTION BENEFIT MANAGEMENT PLEASE FILL IN THE FOLLOWING INFORMATION NEEDED AND SUBMIT WITH PROPOSAL. The undersigned proposer, by signing and executing this proposal, certifies and represents to Kerr County that proposer has not offered, conferred or agreed to confer any pecuniary benefit, as defined by (1.07 (a) (6) of the Texas Penal Code, or any other thing of value as consideration for the receipt of information or any special treatment of advantage relating to this proposal; the proposer also certifies and represents that the proposer has not offered, conferred or agreed! to confer any pecuniary benefit or other thing of value as consideration for the recipient's decision, opinion, recommendation, vote or other exercise of discretion concerning this proposal, the proposer certifies and represents that proposer has neither coerced nor attempted to influence the exercise of discretion by any officer, trustee, agent or employee of Kerr County concerning this proposal on the basis of any consideration not authorized by law; the proposer also certifies and represents that proposer has not received any information not available to other proposers so as to give the undersigned a preferential advantage with respect to this proposal; the proposer further certifies and represents that proposer has not violated any state, federal, or local law, regulation or ordinance relating to bribery, improper influence, collusion or the like and that proposer will not in the future offer, confer, or agree to confer any pecuniary benefit or other thing of value of any officer, trustee, agent or employee of Kerr County in return for the person having exercised their person's official discretion, power or duty with respect to this proposal; the proposer certifies and represents that it has not now and will not in the future offer, confer, or agree to confer a pecuniary benefit or other thing of value to any ~'" officer, trustee, agent, or employee of Kerr County in connection with information regarding this proposal, the submission of this proposal, the award of this proposal or the performance, delivery or sale pursuant to this proposal. The proposer shall defend, indemnify, and hold harmless Kerr County, all of its officers, agents and employees from and against all claims, actions, suits, demands, proceeding, costs, damages, and liabilities, arising out of, connected with, or resulting from any acts or omissions of contractor or any agent, employee, subcontractor, or Supplier of contractor in the execution or performance of this RFP. I have read all of the specifications and general proposal requirements and do hereby certify that all items submitted meet specifications. COMPANY: w`G~v~ Cry t ` ~.. (r AGENT NAME: ~ ~ F ~-'"` ` `Q ~ ~ (~~ ~ ~ \ ~ ~ ~~~ AGENT SIGNATURE: _ ADDRESS: c.~3 ~ r~i'C~CS. e ~ lC< $ ~ ~ when you need it most CONFLICT OF INTEREST QUESTIONNAIRE FOR VENDOR OR OTHER PERSON DOING BUSINESS WITH A LOCAL GOVERNMENT ENTITY This questionnaire is being filed in accordance with chapter 176 of the Local Government Code by a person doing business with a government entity. By law this questionnaire must be filed with the records administrator of the local government not later than the 7th business day after the date the person becomes aware of the facts that require the statement to be filed. See section 176.006, Local Government Code. A person commits an offense if the person violates Section 176.006, Local Government Code. An offense under this section is a Class C Misdemeanor. Name of person doing business with local government entity. ^ Check this box if you are filing an update to a previously filed questionnaire. (The law requires that you file an updated completed questionnaire with the appropriate filing authority not later than September 1 of the year for which the activity described in Section 176.006(a) Local Government Code, is pending and not later than the 7th business day after the originally filed questionnaire becomes incomplete or inaccurate.) Describe each affiliation or business relationship with an employee or contractor of the local government entity who makes recommendations to a local government officer of the local government entity with respect to expenditure of money. Describe each affiliation or business relationship with a person who is a local government officer and who appoints or employs a local government officer of the local government entity that is subject of this questionnaire. Name of local government officer with whom filer has an affiliation or business relationship. (Complete this section only if the answer to A, B or C is YES) This section, item 5 including subparts A, B, C & D must be completed for each officer with whom the filer has affiliation or business relationship. Attach additional s as necessary. A. Is the local government officer named in this section receiving or likely to receive taxable income from the filer of this questionnaire? ^ YES ~ NO Is the filer of the questionnaire receiving or likely to receive taxable income from or at the direction of the local government officer named in this section? ^ YES ~ NO Kerr County HUMANA~~ ~, r = ~ . ~< 3 d _-. ~ when you need it most Is the filer of this questionnaire affiliated with a corporation or other business entity that the local government officer serves as an officer or director or holds an ownership position of 10% or more? ^ YES r~NO Describe each affiliation or business relationship. Describe any other affiliation or business relationship that might cause a conflict of interest. Signatures 1 I ~~ ~~ Signature of person doing business with the Date Governmental entity Kerr County 4 HUMANA.. ~ r _ ~ F°?~ ~ when you need it most .. KERR COUNTY SPECIFIC AND AGGREGATE STOP LOS5 INSURANCE THIRD PARTY MEDICAL CLAIMS ADMINISTRATION GROUP TERM LIFE AND AD&D HEALTH REIMBURSEMENT ARRANGEMENT CAFETERIA PLAN (IRS CODE 125) ADMINISTRATION PRESCRIPTION BENEFIT MANAGEMENT NOTICE TO PROPOSER Information provided in these specifications is to be used for purposes of preparing a proposal detailing costs of providing the services and insurance specified. It is further expected that each proposer will read these specifications with care, since failure to meet each condition or a combination of specified conditions may disqualify proposal. Information provided by Kerr County includes: Current census Plan documents Rate history "` Standard Loss Information High Claim Losses KERB COUNTY reserves the right to reject any or all proposals or any portion thereof and to accept the proposal deemed most advantageous to KERB COUNTY. Proposer is required to submit quotations on the basis of these specifications. Alternative quotations (for service on a basis different from requested in these specifications) will receive consideration if such alternatives are clearly explained. Any exceptions to coverage requested herein must be clearly noted in writing and be included as a part of the proposal. KERR COUNTY believes that the data contained in these specifications is sufficient for preparation for a proposal. The information is believed to be accurate and is based upon the latest available information, but it is not to be considered in any way as a warranty. Requests for additional information should be directed in writing to Gary Looney REBC, Insurance Consultant, 3201 Cherry Ridge Drive, Suite D 405, San Antonio, Texas, 78230, Phone (210) 930-6665 Fax (210) 930-1838 Email address glooney,~a~alamoinsgrrp.com Kerr County HUMANA C ~ ~ ; 3 ° when you need it most KERR COUNTY SPECIFIC AND AGGREGATE STOP LOSS INSURANCE THIRD PARTY MEDICAL CLAIMS ADMINISTRATION GROUP TERM LIFE AND AD&D HEALTH REIMBURSEMENT ARRANGEMENT CAFETERIA PLAN (IRS CODE 125) ADMINISTRATION PRESCRIPTION BENEFIT MANAGEMENT GENERAL INFORMATION and INSTRUCTIONS 1. The information contained in these specifications is confidential and is to be used only in connection with preparing a proposal for all or part of the following employee benefit plans: Specific and Aggregate Stop Loss Insurance, Third Party Medical Claims Administration, Group Term Life and AD&D, Health Reunbursement Arrangement, Cafeteria Plan (Ills code 12~ Administration, Prescription Benefit Management Understood and agreed. ~r 2. KERB COUNTY reserves the right to accept or reject all or any part of the proposals, waive minor technicalities, and award the proposal to best serve the interest of KERB COUNTY. KERB COUNTY also reserves the right to waive or dispense with any of the formalities contained herein. Understood and agreed. 3. Proposals are to be submitted on the basis of the specifications contained herein. Alternate proposals will also be considered, if the alternatives are clearly explained. All deviations from the specifications must be clearly identified and explained. Understood and agreed. 4. The information contained herein is believed to be accurate and up-to-date, but is not intended to be an express or implied warranty. Understood and agreed. 5. No telephone or fax proposals will be accepted. Proposals will only be accepted if delivered by U.S. Postal Service, contract carriers, hand delivery, etc. KERB COUNTY will not be responsible for missing, lost or late mail. Any proposals received after the deadline will be returned to the proposer unopened. Understood and agreed. Kerr County HU1~/IANA.~- .; ~; ~ ~. ~° ~~hcn you need it most ~r 6. At the proposal opening, only the identity of the proposers will be disclosed by KERB COUNTY. The contents of each proposal will not be disclosed in order to protect the integrity of the follow-up negotiation process with short-listed candidates. Understood and agreed. 7. To obtain the best final offer(s), revisions by short-listed candidates may be permitted after original proposal submission, and before contract award. Understood and agreed. S. All proposals will later be made available to the public for inspection after the contract is awarded. If a proposer indicates and justifies in his proposal(s) that certain information in the proposal(s) is confidential or a trade secret, KERR COUNTY will review those materials with the proposer prior to releasing the materials for public inspection after the contract award. Understood and agreed. 9. Gary R Looney REBC is the independent insurance consulting agent providing technical assistance to Kerr County during the RFP process. Gary R Looney is compensated by KERB COUNTY on a fee basis, and is not compensated by the service provider. Understood and agreed. 1Q Vendors are cordially invited to the proposal opening, but are not required to attend. Understood and agreed. Kerr County 7 HUl~/IANA~~~ ~. ~ ~; ~~ ~ ~ , ~ ° when you need it most KERR COUNTY SPECIFIC AND AGGREGATE STOP LOSS INSURANCE THIRD PARTY MEDICAL CLAIMS ADMINISTRATION GROUP TERM LIFE AND AD&D HEALTH REIMBURSEMENT ARRANGEMENT CAFETERIA PLAN (IRS CODE 125) ADMINISTRATION PRESCRIPTION BENEFIT MANAGEMENT TIMETABLE 1. These specifications are to be released for action at 10:00 am August 6, 2007. 2. One original and two (2) copies of the proposals are to be delivered or mailed to Kerr County Courthouse, C/O Judge Pat Tinley, 700 Main, Kerrville, Texas 78028 to arrive by September 4, 2007, 11:00 am. 3. Consideration and action on the Proposals will be presented to the Commissioner's Court on or about September 24, 2007. 4. The successful proposer will be notified on or about September 24, 2007. 5. Coverage is to be effective January 1, 2008. 6. Policies or contracts are to be provided to KERB COUNTY no later than 30 days after such effective date. ~'"' 7. The contract term desired is three years with years two and three subject to County Commissioner's Court approval. PREPARATION OF PROPOSAL The proposer shall prepare their proposal in one original and two (2) copies on the attached proposal form with attachments as necessary to fulfill the specifications contained herein. Unless otherwise stated, all blank spaces on the proposal or s, applicable to the subject specification, must be correctly filled. A unit price must be stated for each item, either typed in or written in ink. Any exceptions or deviations from the requested services must be clearly indicated in writing and submitted with and form a part of the proposal form. Failure to follow these instructions will be grounds for disqualifications of a proposal. Complete and sign all documents provided including the Conflict of Interest Questionnaire (CIQ) which is included in the information you have received. Kerr County 8 HUl~/IANA.~, .~ ( ~t ~~ when you need it most ::~ ; w;~.:~_ KERR COUNTY SPECIFIC AND AGGREGATE STOP LOSS INSURANCE THIRD PARTY MEDICAL CLAIMS ADMINISTRATION GROUP TERM LIFE AND AD&tD HEALTH REIMBURSEMENT ARRANGEMENT CAFETERIA PLAN (IRS CODE 125) ADMINISTRATION PRESCRIPTION BENEFIT MANAGEMENT WITHDRAWAL OF PROPOSAL Proposers may withdraw their proposals anytime up to the time specified as the closing time for acceptance of proposals. However, no proposer shall withdraw or cancel their proposal for a period of 60 days after said closing date for acceptance of proposal nor shall the successful proposer withdraw or cancel or modify their proposal, except at the request of KERR COUNTY, after having been notified that KERR COUNTY has accepted the said proposal. Withdrawal or cancellation of a proposal after the closing date for acceptance of proposals shall result in the forfeiture of the bid security. CRITERIA USED [N EVALUATING PROPOSALS a No insurance proposals will be accepted from insurers without a Best's Rating, of at least an "A-" in the most recent edition of BEST'S KEY RATING GUIDE FOR LIFE/HEALTH,. ~r b. Any insurers, agents or third party administrators shall be duly licensed by the state of Texas, and comply with all applicable state insurance laws and requirements or duly constituted applicable insurance regulatory authorities. A local government self-insurance pool organized under the Texas Interlocal Cooperation Act or other state law shall also be an acceptable provider. G The proposal must be in easily understood format with coverage clearly outlined. d. Proposals will be first evaluated on technical factors other than cost, including coverage, benefits, services and financial stability. After a preliminary evaluation of the technical criteria, cost will be included in the evaluation process. Cost will be evaluated on an equal basis with the technical criteria. For the evaluation of cost, fixed administrative cost for athree-year period will be considered first; followed by total first year cost for stop loss insurance premiums and maximum claim cost. For aggregate stop loss insurance maximum claim cost, additional specific deductibles (lasers) will be added to maximum claim cost, if not an allowable claim expense for aggregate maximum claim cost. Kerr County 9 HUMANA.~. . ~ . ~ ° ~ +: ~~ ° when you need it most f KERB COUNTY SPECIFIC AND AGGREGATE STOP LOSS INSURANCE THIRD PARTY MEDICAL CLAIMS ADMINISTRATION GROUP TERM LIFE AND AD&D HEALTH REIMBURSEMENT ARRANGEMENT CAFETERIA PLAN (IRS CODE 125) ADMINISTRATION PRESCRIPTION BENEFIT MANAGEMENT QUALIFICATION OF COMPANIES AND AGENTS SUBMITTING PROPOSALS. All companies and agents submitting proposals must be licensed by the state of Texas and have demonstrated level of good performance with municipalities, school district or other public entities in Texas. The company or agent must have an Errors and Omissions (E&O) policy with a minimum limit of $1,000,000. Understood and agreed. An agent submitting a proposal must maintain a fully staffed office for the servicing of the program. The agent must have been in business for at least five years and must assign a minimum of one qualified account representative to service KERR COUNTY to include assisting with enrollment responsibilities. This representative must have a minimum of five years experience in employee benefits, or hold the CLU, CEBS and or RHU designation. Understood and agreed. DEVIATION FROM SPECIFIED COVERAGE OR SERVICE Proposals are to be submitted on the basis of the specifications contained herein. Proposer MUST include the RFP Submission Forms with its proposal. All costs to be incurred and billed to KERB COUNTY will be firm and included in these forms. Alternative proposals will also be considered, provided the alternatives are clearly explained. All deviations from the specifications must be clearly identified and explained. UNDERWRITING DATA KERB COUNTY has assembled the underwriting exposure, and loss data included in these specifications. While every effort has been made to ensure the accuracy of this information, it cannot be guaranteed. It shall be the responsibility of the successful proposer to review this information and work with KERB COUNTY on an ongoing basis to ensure all relevant exposures are included in KERB COUNTY'S program. If it becomes necessary to revise any part of this proposal, a written addendum will be provided to-all proposers who have submitted an "Intent to Bid Form". KERB COUNTY is not bound by any oral representation, classifications, or changes made in the written specifications by KERB COUNTY employees, unless such classification or change is provided to proposers in a written addendum from an authorized representative of KERB COUNTY or KERB COUNTY'S insurance consultant. COMPLIANCE WITH LAWS All proposers involved shall observe and comply with all regulations, laws ordinances, etc., of local, state, and federal government as they apply to this proposal process err' Kerr County 10 HUMANA~: 3. Can you install PPO discounts for Direct contracts with providers? If so, what is the charge? Provider discounts are loaded in Humana's automated system; therefore, the majority of Humana's networks do not require repricing by an outside vendor. The provider discount files are maintained by the internal Network Administration department. 4. How many different PPOs do you interface with currently? Who are they? This question is not applicable as Humana uses its own PPO network discounts. 5. Which PPOs are you currently using? (attach directory or website access) This question is not applicable as Humana uses its own PPO network discounts. REPORTING 1. Provide a list of reports available in your standard reporting package. What is the cost of these reports? Please refer to Attachment titled "Sample Standard Reporting Package" for a sample standard reporting package. Humana's standard reporting structure offers comprehensive analysis capabilities for its ASO clients. The following reports typically are provided on an annual basis, however, more frequent production of all or specific reports is negotiable. • Management Summary o Medical Costs-Distribution by Provider o Demographics o Medical Costs-Per Member Per Month o Hospital and Other Facility Costs-Per Member Per Month o Primary Care Provider Utilization o Specialist Utilization o Emergency Utilization o Ancillary Provider Utilization o Large Claims >$25,000 per year • Membership o Plan Demographics • Web Reporting o Subscriber Registrations o Web Transactions • Health Management o Clinical Management Program Participation • Health Status o Diagnostic Conditions Summary • Medical Costs o Medical Cost Recap Kerr County l3 HUMANA ~ ~ ~ t ~; ~~~ ~ ~t-c' when you need it most k o Medical Cost by Type of Claimant o Claims Expense Stratification by Dollars-Medical (Plan Cost per Claimant) o Claim Stratification by Age of Claimant o Medical Cost by Month o Hospital and Other Facilities Costs-Comparison to Prior Period o Hospital and Other Facilities Costs-Comparison to Peer o Hospital and Other Facilities Costs-Comparison to Prior Period-Utilization o Hospital and Other Facilities Costs-Comparison to Peer-Utilization o Hospital and Other Facility Costsby Facility-Inpatient o Hospital and Other Facility Costs-by Facility-Outpatient o Physician and Other Provider Costs-Comparison to Prior Period o Physician and Other Provider Costs-Comparison to Peer o Physician and Other Provider Costs-Participating vs. Non-Participating o Physician and Other Provider Costs-Top 30 Non-Par Providers o Large Claims Summary o Large Claimant Report-Detail (Top 20 Claimants) • Pharmacy Reporting o Introduction o Pharmacy Executive Summary o Pharmacy Industry Happenings o Cost Summary o Cost Breakdown o Member Cost Share o Generic vs. Brand o Mail Order vs. Retail o Pharmacy Network Value o Drug List Utilization by Level o Top Drugs by Cost o Top Drugs by Volume o Top Drugs Classes by Cost o Top Drugs Classes by Volume o Prescription Drugs by Retail Cost o Medical Pharmacy Costs o Top Medical Pharmacy Drugs by Volume o Clinical Management Program Participation Report 2. Can you generate customized reports? Are reports available through Internet? What is the charge? Humana provides its standard reporting package at no cost to the group. Humana is willing to discuss customer-specific reporting needs; including details such as scope, frequency, contact, and associated costs prior to making commitments in connection with client-specific reports. Any applicable fees can be negotiated at the time of the request. "~rr+ Kerr County 14 HUMANA~~ 1 ~ ~ ~ ~ ~ ;Y rt ~ ° whrn you need it most 3 3. How are paid claims reported? Paid claims reports are included in Humana's standard reporting package. 4. How does your firm report claims to Excess Loss carriers? If an external reinsurance carrier is used, the claims are initially funded by the self-funded plan. The policyholder is ultimately reimbursed by the reinsurance carrier once that reinsurance carrier determines a reimbursement is warranted. Humana provides assistance if the policyholder chooses to use a reinsurance carrier other than Humana, but there is an additional administrative fee charged for this assistance. Each month, Humana generates a claim report that shows the self-funded plan's claims experience for the month, as well as year to date. This report is provided to both the plan administrator as well as the external reinsurance carrier. The external reinsurance carrier typically determines if any aggregate stop loss reimbursements are warranted based on the plan's actual claims experience and the provisions of their aggregate stop loss policy. For specific stop loss, the process differs. Humana provides both the plan administrator and the external reinsurance carrier a monthly large claim report that shows the claims experience for each claimant that has exceeded 50 percent of the specific stop loss deductible. For each claimant that has exceeded 100 percent of the specific stop loss deductible, Humana makes a copy of the claims associated with the claimant, gathers the corresponding case management notes, ships the material to the reinsurer, and answers questions from the reinsurer regarding these claims. These activities are performed monthly when the large claims report is generated. For these processes to work effectively, the specific stop loss deductible amount must be given to Humana at the outset of the plan year to use as an automated trigger. 5. Can you report on PPO savings? Humana provides savings reports for self-funded groups. In addition, Humana's standard reporting package includes a provider medical cost report comparing participating to non-participating providers. GENERAL 1. What is the cost for producing a plan document? Is it included in your cost assumptions? The plan management agreement is prepared once the group has approved and signed the new case document. Upon receipt of the signed new case document, the plan management agreement is provided to the group within 30 days. It is included in Humana's cost assumptions. 2. What is the cost for producing a Summary Plan Description? Is it included in your cost assumptions? Humana will provide Kerr County an electronic copy of the master SPD and make the SPD available to their members via Humana's Website free of charge. °~r+ Kerr County l5 HUl~/IANA~. i ~ ~ ~ ~ ~~~ r ~ ~ s ~- =when you need it most While self-funded clients are obligated to provide an SPD to each of their employees, they may avoid some of the printing costs by providing the SPD to their employees via the Web. For example, Humana provides SPDs to its own employees via the Web. During the enrollment process, Humana employees are asked whether they prefer to receive their SPD electronically or in printed form. Employees are encouraged to access documents electronically because it is conveniently available at any time, at home or at work, and because the Web makes it easier to search for specific information when they need it. Plus, an employee can print a copy of the SPD, or specific pages, whenever desired. As a result, the vast majority of Humana employees choose the Web alternative. 3. What is the cost of having the Plan Document and SPDs changed due to regulatory changes? Is it included in your cost assumptions? Humana will be happy to discuss this request upon selection as a finalist. 4. What is the cost of printing the 500 Summary Plan Descriptions for the plan participants? Is it included in your cost assumptions? Humana will be happy to discuss this request upon selection as a finalist. 5. What is the cost for printing 1000 ID cards? Is it included in your cost assumptions? The cost for printing ID cards is included in Humana's cost assumptions. ~r-, 6. What is the cost of Explanation of Benefits: Is it included in you cost assumptions? If so, how many do you assume? Explanation of benefits are included in Humana's cost assumptions. 7. Is there an initial set-up fee charged for the installation of our plan? Please refer to Humana's financial proposal for all related fees and expenses. 8. Please disclose any additional fees or expenses that are borne by the client. Please refer to Humana's financial proposal for all related fees and expenses. 9. Do you offer assistance in the administration of COBRA benefits? HIPPA Certificates? Please explain the type of assistance and/or administration duties you provide. Humana offers COBRA administration through CobraServ, a division of Ceridian, which is a third party agency. These services include initial notification, qualifying event notices, customer service telephone support, premium billing and collection, employer reporting, and rate renewal notification. There is an additional administrative fee for these COBRA services for ASO groups. Ceridian monitors participants' eligibility, and reports enrollment and changes to Humana. err Kerr County 16 HUl~/IANA~w: ~ ~ t r ~~~ ~~ ~~ ~ ~ ~.~~. ~ when you need it most s ~, _ .; err .. Members who elect COBRA through CobraServ are reenrolled in the Humana systems for claims adjudication. ~.r Ceridian's COBRA administration staff has access to in-house counsel and prominent, national ERISA law firms in New York and Washington , D.C. that are on retainer for new information regarding COBRA and HIPAA regulations. These resources allow Ceridian to effectively monitor anticipated changes in legislation that affect services. HRA QUESTIONNAIRE 1. Do you offer HRA administration in conjunction with your claims administration? Humana combines its PCA with a PPO plan. Employees may use PCA funds to pay for qualified medical expenses. These expenses refer to services covered under the medical plan as well as some services not covered under the medical plan. The standard medical PPO product sold with the PCA does not have copayments, except for prescriptions. PCA funds are used to pay medical expenses, prescriptions, and to pay toward the plan deductible. Once employees spend all their PCA funds, they must satisfy the remaining deductible and coinsurance for their PPO plans. 2. How often do you reimburse a claimant for expenses incurred that are filed on a paper claim form? Members with a health reimbursement arrangement (HRA/PCA) receive Humana's debit card, the HumanaAccess Visa Debit Card, to use to pay for virtually all PCA-eligible expenses at the point of sale. Members who have Humana pharmacy benefits as a part of their plan may use the card at the point of sale to pay for prescription cost share. Charges for services and copayments at a provider's office that accepts Visa can also be debited on the HumanaAccess Card. For any eligible expense members incur that is not paid at the time of purchase using the HumanaAccess Card, the receipt may be submitted manually for reimbursement or by including the HumanaAccess Card number on the provider bill. 3. Do you provide a debit card for all participants? Yes, all participants receive a debit card. 4. Do you require the use of a specific banking institution? For PCA based CDHPs, groups submit apre-fund amount typically equal to four percent of the anticipated first month's claims. As claims are paid, groups replenish this pre-fund amount to maintain the balance. For SmartExpress customers, the pre-fund is replenished via daily ACH transactions. These transactions are created automatically by Humana's in-house administration system. The ACH transactions are generated as funds are used by the employees. For example, if a member swipes his or her card on Tuesday (assuming the transaction settles on Tuesday), the Humana administration system, HumFlex ,will generate an ACH on Wednesday and the funds would be moved from the group's bank Kerr County 1'7 HUl~/IANA~ t ~ _ ~~. ~~ ~ g ; f -K F when you need it most account to the Humana bank account on Thursday. For self-funded customers, the funding process is negotiated on a group by group basis. For HSA based CDHPs ,employers, and employees make contributions to the HSA via a check and list, electronic, or payroll vendor method. Below are descriptions of these methods. 5. Is there a minimum funding requirement? If so what? Humana's PCA requires employers to contribute only the minimum balance at the beginning of the plan year. This gives employers more flexibility in their cash flow because the funds in their accounts are notional. Notional dollars allow employers to set up the account without physically having the entire PCA balance in the account. At renewal, employees who choose the same type of plan can rollover unspent PCA funds to the next plan year. 6. Please describe your HRA administration in relationship to your medical claims administration. Kerr County must make a deposit into a Humana owned account. Humana recommends that the deposit be either $2,000 or at least four percent of the total annual benefit elections. The initial deposit goes into a bank account set up by Humana, in Humana's name. This deposit acts as a funding buffer as there is typically a two day lag between when Humana funds the swipe or paper claims reimbursement on the customer's behalf and when Humana receives reimbursement back from the employer. These funds represent apre-fund/deposit that must always be maintained (but due to timing, the deposit will often go below the initial amount until the funding ACH's "catch-up" the balance). The funds in the account belong to the employer. Humana offers three options to employers for making their initial deposit: 1. A check made payable to Humana Inc. Brokers should forward this to Treasury along with a copy of the EGA at: Humana Inc Treasury Department, 1 lth Floor 500 West Main Street Louisville, Kentucky 40202 2. An electronic payment initiated by Kerr County, instructing their bank to wire funds to the Humana owned account. 3. Automated Clearing House (ACH) transfer initiated by Humana The initial deposit should be made at least two weeks prior to the effective date of the plan, in order to provide time to set up the bank account, deposit the funds, and set up the banking information in the benefits administration system, Humflex. Debit cards will be sent to employees who select PCA benefits, but the debit card functionality will not be enabled until the initial funding has been received. The cards can be turned off (and manual claims denied/pended) if the ongoing funding or administrative fees are not paid by the employer group. FSA/PCA products require only a single bank account for the entire employer group. There are not err Kerr County 18 HUMANA~~ t 3.- aF ~c ~ a,~~ ~ 4 when you need it most individual accounts for each member. Ongoing funding Payments are passed-through Humana, not made by Humana. These are basically administrative services only (ASO) payments. Humana is making the payments on the behalf of Kerr County, with Kerr County's money. For any day that a participating employee requests a reimbursement either through the card or a manual claim, Kerr County will receive a request for funding of that amount. An e-mail is sent to the employer contact provided in the banking agreement when the funding ACH is sent to Humana's bank, indicating that a funding pull will be made in the next two banking days. Humana does not control whether the pull occurs the next day or in two days. Large groups have the option of selecting daily funding or weekly funding. Daily funding will function the same way as for small groups. Weekly funding pulls will be initiated on Fridays for a Monday effective date and will include all funding activity for the week in one lump sum. 7. Identify all costs associated with your HRA administration package to include all costs and services provided. It is Humana's belief that personal care accounts (PCA) should be funded at a level that engages the consumer. Humana analyzed the experience of its own 13,000+ employees and found that approximately 45 percent used $500 a year or less in medical services. Humana, therefore, has purposefully set its PCA for employee-only coverage at $500. At this level, members are encouraged to use services wisely. In addition, research indicates that assigning the consumer more than 50 percent of the deductible will significantly reduce consumer engagement. This will reduce the effectiveness of consumer driven health plans in keeping medical costs down for the employer. 8. Do you include access to accounts via the Internet? At what additional cost if any? Members have access to the Flexible Spending Account (FSA) planner, Health Savings Account (HSA) planner, and Dependent Care Flexible Spending Account (DFSA) planner as a part of their online enrollment experience for those customers using Humana's online enrollment tool. For all customers, the FSA planner, HSA planner, and DFSA planner are available from Humana.com. The FSA and HSA planners assist in estimating healthcare expenses, while the DFSA planner assists in estimating child or adult day care related costs. Each planner helps members when planning for contributions into these spending accounts. Members also have the ability to access their HSAs, FSAs, Dependent Care FSAs and health reimbursement arrangements (HRA) to review account balances, review account activity, and when applicable, invest funds. This information is available via My Humana. Kerr County 19 HUMANA..: ~_ ~~~ ~ -~ ~ :°_~;~° when you need it most PRESCRIPTION BENEFIT MANAGER QUESTIONNAIRE Please find the current prescription drug plan design in the medical plan summary attachment. 1. Please describe your retail pharmacy network (number of independents and number of chains; are all chains in the network?) including its relationship to you (e.g. owned or leased). The Humana pharmacy provider network currently has over 60,000 pharmacies. This includes all national chains, all major regional chains, and over 21,000 independent pharmacies. Approximately 64 percent of the network is made up of chain pharmacies which include, but are not limited to, the following: • Albertson's/Supervalue • Costco • CVS • KashN'Karry • Kmart • Kroger • Meijer • Osco • Publix • Rite-Aid • Safeway • Target • Walgreens • Wal-Mart • Winn Dixie 2. Please confirm that prescription drugs prescribed by any licensed health care provider, including dentists, will be covered by the pharmacy program. Confirmed. 3. Is the use of a formulary mandatory? Please attach a copy of the formulary for review. This question is not applicable to Humana's multi-tiered prescription drug benefit. Prescription drugs are assigned levels with applicable copayments relative to the level, or tier, in which the drug has been placed; therefore, the group has access to all available drugs at varying copayment levels. For self-funded groups, the tier structuring is flexible in order for Humana to work with the group to meet their specific needs. Please refer to attachment titled "Formulary". 4. Does the retail brand discount include savings from formulary, network spread, clinical savings, DUR savings? The retail brand discount does not include savings from formulary, network spread, clinical savings or DUR savings. ~r Kerr County 20 HU1~/IANA~x a. ~~.~~~~~~c~~~s-~._~ when you need it most .. ... .. .., ~' . H~Y. .. _ r. 5. Is the brand discount a hard discount? The brand discount is apass-through rate of Humana's negotiated rates with network pharmacies. 6. Is the brand discount an average? Is it based on 11 digits NDC? The brand discount is a weighted rate based on the 11 digit NDC. 7. Is the brand discount at mail order based on 100 units or actual acquisition NDC? The mail order discount is based on actual acquisition NDC. 8. Is the mail discount based on 11 digit NDC? The mail order discount is based on actual acquisition NDC. 9. Is pricing for retail brand and overall generic effective rate guaranteed? Humana is proud to offer Kerr County full pass-through of its negotiated pharmacy network discounts (i.e., the client group is always billed the same amount as that paid by Humana to the pharmacy). Humana operates on a fully transparent model. Humana offers full pass-through of its negotiated ,; discounts with network pharmacies to its clients and shares revenue obtained from rebates in order to provide Humana's customers with the most competitive profile. 10. Your quote must include a traditional pricing model and a transparency full pass-thru model. Is the pricing guaranteed? Humana will be happy to discuss this upon selection as a finalist. 11. What is the discount for specialty drugs? What is the dispensing fee? Is the specialty drug program apass-thru under a transparency model? Are supplies included in the pricing? The average discount for specialty drugs is approximately 18 percent. There is no dispensing fee for specialty drugs. Yes, the specialty drug program is a pass thru under a transparency model. Routine supplies are included in the AWP discount price for the medications. 12. Please provide your definition of "generic". Also provide a definition of the generic included in the overall generic guarantee. A generic drug is identical, or bioequivalent to a brand-name drug in dosage form, safety, strength, method of administration, quality, performance characteristics and intended use. Although generic drugs are chemically identical to their branded counterparts, they are typically sold at substantial discounts from the branded price. According to the Congressional Budget Office, generic drugs save consumers an estimated $8 to $10 billion a year at retail pharmacies. Kerr County 21 HUMANA .~ g' > _ < ~ x.~ ~ ~ T.s when you need it most 13. What quantity is an AWP based on for mail order? Humana uses the full 11-digit NDC code to determine AWP for mail order. 14. How are manufacturer rebates handled? Will KERB COUNTY share in the rebates? If so, what percentage? Humana passes pharmaceutical rebates on to its self-funded clients. Self-funded groups have the option to receive pharmacy rebates attributable to the drug utilization of the group, or to permit Humana to retain pharmacy rebates. Self-funded groups that permit Humana to retain pharmacy rebates receive a reduction in their administration fees equal to the value of their pharmacy rebates. 15. Do rebates have a minimum guarantee per claim? Per brand? Humana does not guarantee a minimum or maximum rebate. There is one rebate amount guaranteed that is for every paid claim. 16. Are rebates paid quarterly? If not, when? Rebates are paid semi-annually. Payment is made in accordance with the group's contract period; rebates are payable on 45 day terms. For example, if the effective date is April 1, 2007, the rebates are due on November 15, 2007 for April through September prescriptions. Rebates are typically credited to the ,, special services invoice; however, a check may be issued upon the client's request. 17. Under transparency pricing model, are rebates a 100% pass thru of Gross? Humana shares approximately 87 percent of the revenue it obtains from rebate programs of pharmaceutical manufacturers and uses the remaining 13 percent to cover the administrative cost associated with the rebate program. 18. Will coverage of OTC impact rebates? If so, how much? Rebates should not be impacted since OTC's are typically excluded from the Pharmacy benefit. 19. Do rebates survive termination? When are they paid after termination? Humana requires further clarification in order to accurately respond. 20. Are rebates paid on specialty drugs? Rebates quoted are calculated based on every paid prescription including specialty drugs. 21. Do you contract directly with manufacturers for formulary rebates or do you use another PBM? If yes, who handles? Humana provides its own rebate payment. Kerr County 22 HUMANA~~ .X r a ~ ~ ~~ ~ ~ ~: ~s when you need it most 22. Please describe how the drugs for the formulary are selected, and who is responsible for the selection. The Humana National Pharmacy and Therapeutics committee is responsible for the Drug List selection. The Humana National Pharmacy and Therapeutics committee is comprised of 12 members, which include market medical directors, corporate pharmacists, and personnel from key corporate and market departments. This committee meets on a quarterly basis to discuss and review pharmacy issues. A main function of the committee is the review and evaluation of new medications as introduced to the market, as well as the review and evaluation of current medications as new information becomes available. The Pharmacy and Therapeutics committee is responsible for the approval of medications included in the Humana Drug List and those needing special monitoring, and, subsequently, prior authorization. New medications are considered as quickly as possible based on available information. Medications can be added to the drug list as early as their initial release date based on the urgency of availability and alternatives currently in place on the Drug List. Humana considers further details of its National Pharmacy and Therapeutics committee to be proprietary; therefore, a membership listing, by specialty and affiliation, has not been included. 23. Do you own your own mail service? If not, who do you sub-contract with and do you retain revenue? Humana's wholly owned subsidiary, RightSources"', provides mail order services. 24. Do you own your own Specialty Pharmacy? Or subcontract? If yes, who handles specialty pharmacy? Yes, Humana owns its Specialty Pharmacy. 25. What is the average turnaround time for mail order pharmacy? Humana's subsidiary, RightSources"', defines and measures dispensing efficiency ("order processing time") in terms of Average Turnaround Time (ATT). Average Turnaround Time is the time from receipt of a prescription to time of shipping. The standard turn-around time for "clean" prescriptions is two business days. The dispensing performance represents "true" ATT. Totals Phoenix, Arizona Avera a Turnaround Time Clean Business Da s 2.0 Avera a Turnaround Time Exce tions Business Da s 5.0 Exceptions turnaround time goal is 48 hours. Both the member and the prescriber are contacted about the problem to resolve the issue. If no response is received, the prescription is returned to the member. Kerr County 23 HUl~/IANAw .z ~v r s ~1 g q > ; . ° when you need it most 26. Can mail order pharmacy be ordered on-line? When ordering a mail order prescription through RightSource, memberr may choose the convenience of Humana's touch tone or internet refill options. By using a dedicated toll-free line or Humana's Internet site, Humana.com, members are free to manage their refills whenever they choose. The Humana Pharmacy Network is also pleased to announce the addition of Drugstore.com to Humana's network. Drugstore.com is an online pharmacy that is contracted to provide 30-day retail prescription services to Humana members. Drugstore.com has a delivery fee on all prescription orders. While Drugstore.com ships orders to the customers, it is not a mail order vendor (defined as a pharmacy that fills 31-90 day orders via the mail) for Humana members. Members wishing to use their mail order benefit should use RightSource. 27. Does the PBM allow 90-day fills at retail in addition to mail order? If so, what contracted pharmacies participate? What is the discount to KERB COiJNTY fora 90-day network? What plan design is used? In addition to filling 30-day prescriptions for Humana members, over 43,000 of Humana's network retail pharmacies are now offering Humana members a 90-day supply of their maintenance medication for their appropriate copayment. This program is in addition to Humana's 90-day mail order program. While the network rate is slightly `~" less than 90 day mail order, it accomplishes the objective of encouraging members to pursue a 90-day prescription from the physician for maintenance drugs; Research of prior consumer programs has shown that our members want to be informed of convenience and cost saving opportunities. Members will be able to enjoy the convenience of filling their maintenance medications for 90-days at a retail setting. This service also benefits members wanting to preserve patient/pharmacist face to face interaction. Humana has negotiated a reduced mail order rate for 90-day at retail claims. This does not replace Humana's mail order services, but offers options for our members. Mail order continues to be the primary recommendation; however, 90-day at retail is an opportunity to transition members from retail to mail utilization in a stepped approach. 28. Do you offer alternatives in the pharmacy program that can help control or reduce the plan costs? If so, please provide details and approximate savings for each feature. Humana's position is not to dictate prescribing; rather, Humana wants to provide guidance to both physicians and members regarding cost effective treatment options that can help contain the rising price of healthcare. This goal is achieved through a variety of mediums: • Pharmacy Benefit Design: Lowering member cost share is the motivating factor that directs consumers to utilize drugs that cost the sponsoring payer less. Several designs are available, including generic-only plans, traditional tiered copayment designs, and individualized products. Kerr County 24 HUMANA~. ( rtrt~~~ ,~F ;.~ when you need it most X~.. ' S`'.L~ ~. ~. .~,y:. ~ ~ 'r~ ~e'' _. e~. ~~~4.14v'~~5~, h t 4 ... _ • t ' ,si S ~ `~!: IrA+. • Drug List Maintenance: Clinical efficacy, drug cost, other associated costs (e.g. avoided hospitalizations), rebates, and other issues are considered when determining placement on the Drug List. Humana's internal Pharmacy and Therapeutics committee, consisting of medical and pharmacy leadership, considers data regarding a drug as it enters the market or changes status on clinical guidelines. • Cost Effective Pharmacy Network: Humana negotiates contracts that allow favorable rates for dispensing rates and pricing discounts. Through these efforts, Humana can potentially save the average employer approximately six percent of the prescription drug cost. Proof of these savings can be shown in Humana's repricing model. • Prior Authorization/Step Therapy: Humana uses these tools as a method to maintain adherence to treatment guidelines established for specified conditions. Certain criteria need to be met before selected medications are adjudicated. An appeals process is in place for instances where professional opinion requires these treatment options despite not achieving the criteria. • Collaboration with Distributors: Humana has a synergistic relationship with Caremark Specialty Pharmacy Services , a distributor of specialty drugs. Through this collaborative agreement, Humana minimizes acquisition costs for specialty drugs, keeping healthcare costs down. Amember-directed letter campaign introduces the convenience and possible out-of-pocket savings of obtaining specialty medications through this vendor. • Generic Drug Dispensing: Humana encourages the utilization of cost effective generic drugs when deemed appropriate by the prescribing health professional. Member-directed letters, pharmacy benefit designs favoring use of generic drugs, informative pieces addressing concerns with generic drugs, and a Website dedicated to generic medication support this initiative. Humana has a generic incentive "irr program which targets twenty highly utilized branded medications which have an "A" rated generic available. When a pharmacy dispenses one of these branded medications, a letter is generated for the patient informing them of this program. • Member-directed Letter Campaigns: When a new prescription is filled for a higher level brand- name drug, a letter is sent to the member mentioning the availability of a lower-level brand-name or generic drug for the same therapeutic outcome. Another type ofinember-directed letter campaign alerts the member of generic alternatives for multi-source brand drugs they are using. Financial incentives are passed along to members through mailed rebates for products. One example is a rebate for Claritin or Alavert that was sent to Humana membership. Response was favorable and eased patients into use of these over the counter antihistamines. Member-directed letters instruct patients to speak with their physician for further direction. • Drug Utilization Review: Overuse or misuse of drugs by members or prescribers can be observed through Humana's drug utilization review programs. Clinical Action Teams, such as the antibiotic Clinical Action Teams, review utilization of drugs as compared to established guidelines and educate members and physicians accordingly. • Member and Provider Education: With the focus of providing guidance to healthcare consumers, Humana provides educational pieces to members and providers via numerous mediums. Direct mailings, Internet sites, and member/provider newsletters provide various avenues through which information can be passed. An educated consumer, e.g. regarding overuse of antibiotics, is less likely to demand medication from his/her doctor when unnecessary. • Convenient Drug List Availability: Through association with a handheld computer program company, Humana makes accessible two of its most popular pharmacy benefit designs: Rx3 and Rx4. These free downloadable lists are a resource for members and physicians when drug cost is a factor in Kerr County 25 HUMANA~. t, ~ ~ > t /e: ;~ ~: -, ` W11Cn yOll IICCd It IIlOSt . ,:4 , c ,_, ,. ., the treatment of a condition. For those without handheld computers, the Humana Website which contains this information and is available as a resource. Benefit modeling: Humana works with employers to "model" an employee population, illustrating the differences between plan designs. In doing so, Humana helps employers understand potential cost savings and the impact to employees. Current clients can contact Humana about benefit modeling. Prospective clients only need to supply a sample of prescription drug claims to use as a baseline. Humana can also model the potential savings groups may realize through deeper discounts and lower dispensing fees at Humana's participating network pharmacies. Models will soon be available for the 1txImpact ,1ZxValue and Mandatory Mail benefit designs as well. Maximize Your Benefit: Humana delivers personalized, educational message to Humana members by mail, a-mail, or interactive telephone messaging explaining prescription drug alternatives for members to talk about with their doctor. Members may save on copayments and decrease their prescription drug costs as well. Early results of Maximize Your Benefit include: ^ Over 20 percent of Humana members contacted switched to a lower-cost drug ^ Almost $7 million in annualized savings (in the form of copayments) to Humana members who switched to less expensive drugs ^ Employers saved over $5 million in lower prescription drug coverage costs ^ Individual member savings of $175 to $350 per year, per drug 29. Please explain your Drug Utilization Review process for these programs: a. Prospective Humana reviews scientific information, conducts literature searches, and stays abreast of developments in pharmaceutical research and development in order to identify and prevent DUR problems from occurring. Prospective DUR includes monitoring: excessive utilization, minimum and maximum dosing, drug-drug interactions, duplicate therapy, availability of preferred or cost- effective alternatives (e.g, generics), late refill, multiple pharmacies/providers, drug-disease contraindications, and appropriate medication selection. Humana employs a team of clinical pharmacists with expertise in drug therapy, DUR, drug information, and formulary management who constantly develop programs to identify/prevent, monitor, and manage D1JR issues for members on a prospective basis. b. Concurrent The concurrent DUR system will provide Humana's clients with the ability to minimize the number of potentially dangerous conditions that result from improper drug utilization by members. When the pharmacist enters the information for the prescription, the system evaluates the incoming drug claim with respect to the member's history. The system identifies potential drug therapy problems, and the pharmacist is alerted to potential problems through online messaging and directed to take additional steps to evaluate the order (e.g., call the prescribing physician). The following elements are among the numerous edits that are reviewed at the time of dispensing individual prescriptions to address the improper use of drugs: • Duplicate prescription Kerr County 26 HUMANA~n ~ rtti<~rrrtc~~' when you need it most • Exceeding maximum dosage • Refill too soon • Duplicate therapy • Monitoring for therapeutic appropriateness • Under-utilization • Appropriate use of generic products • Therapeutic duplication • Drug-disease contraindications • Drug-drug interactions • Incorrect drug dosage or duration of drug treatment • Clinical abuse/misuse (refill too soon) • Age-sex interaction • Drug-pregnancy contraindication • Ineligible member • Quantity duration • Drugs that are contraindicated in highs risk groups, e.g., >65 years The concurrent drug utilization review system is a proprietary system developed by Argus, Humana's claims processor. The clinical information regarding online prospective drug utilization review is supplied by First DataBank (FDB). FDB employs a clinical staff, including pharmacists, to research and maintain its suite of clinical products. Argus uses FDB's basic drug utilization review standards including the Drug-Drug Interaction Module, and the Min/Max dosing guidelines for pediatrics, adults, and geriatrics. Humana has defined the parameters regarding the age limits and length of time to review claims history, and then the clinical content (for example Drug A conflicts with Drug B) is supplied by FDB. c. Retrospective Humana's retrospective drug utilization review is a clinical tool utilized to identify potential adverse drug events and drug utilization and to provide clinical information to enhance the quality of patient care. Retrospective drug utilization review includes an evaluation of therapy and intervention, where necessary, after the therapy has been started. Retrospective evaluations may involve assessment of drug use in individual patients or analysis of prescribing and dispensing patterns. If a potential problem is discovered, intervention letters are sent to all providers who ordered a drug relevant to the identified problem. An intervention consists of an informational letter to the prescriber, a response form for the prescriber to complete, apre-addressed return envelope, and a patient drug profile. Humana's retrospective drug utilization review program currently reviews the following: • Therapeutic appropriateness • Over- and under-utilization • Appropriate use of generic products • Therapeutic duplication Kerr County 2~ HUMANA~. ~ ~r=tc~~~~t~a` when you need it most t ,~.,, . eY ~. F .~,:. ~~~«~'hl+rxt't•~'.t~k:; fir; ti~ :a: .~"': • Drug-disease contradictions • Drug-drug interactions • Incorrect dosage or duration of therapy • Clinical abuse/misuse 30. Please submit a sample of your standard reporting package. Attach samples of your standard reporting package that is included in your quote. Please note if your paid claims numbers are based on paid or incurred claims figures. Please refer to Attachment titled "Humana's Standard Reporting Package." 31. Include in your response a PPI report, a specialty drug report, and a net cost per day for mail or retail report w/ specialty and acute meds removed. The following list of prescription drug reports are included as part of Humana's standard reporting structure for its large group clients and are typically provided on an annual basis for employer groups. More frequent production of all or specific reports is negotiable and can be requested through the account manager. Summary of prescription drug reports supplied: • Membership Summary: Includes member counts and utilization • Pharmacy Executive Summary: Aone-page summary that shows net paid, utilization, and member ~,,,. cost share; three detailed sheets expand on each of the different components • Generic vs. Brand: Shows current utilization and net paid comparison; also shows opportunity for savings through generic utilization • Mail vs. Retail: Shows current distribution of utilization and net paid across mail/retail and brand/generic • Utilization by Level: Prescriptions, drug costs, and net paid are displayed by level • Top 50 Drug: Top drugs listed by net paid and utilization • Prescription Drugs by Retail Cost: Shows 10 highly-utilized drug classes and the distribution of drugs in each class by cost per prescription • High Cost Claimants: Top 20 individuals (de-identified) based on total net paid displayed including drug class with highest total net paid • Medical Pharmacy Summary: Prescriptions that are considered "medical pharmacy" are excluded from all previous sections and are summarized in this one-page report • Network Value Report: A summary of Humana's pharmacy network value, specific to the group's utilization • Pharmacy Web Utilization Report: Member Web communication metrics • Pharmacy Maximize Your Benefit Report: Provides conversion metrics, estimated cost savings for member and plan, and contacts Please refer to Attachment titled "Humana's Standard Reporting Package." Humana provides its standard reporting package at no cost to the group. Humana is willing to discuss customer-specific reporting needs; including details such as scope, frequency, contact, and associated Kerr County 28 HUl~/IANA.N: ( ~trr~~~~t° when you need it most UNIQUE CHARACTERISTICS 1. What do you feel is unique about your firm that will offer the best value to Kerr County for Section 125 Administration services? This is not applicable as Humana does not offer cafeteria plan administration. 2. Please comment on any other characteristics of your organization that are considered unique in the industry. This is not applicable as Humana does not offer cafeteria plan administration. REFERENCES 1. Provide the names, addresses, telephone numbers and contact names for three of your clients. For each client listed, provide the number of employees covered (on your capacity as a Section 125 Administrator). Also state whether or not any of the Section 125 Administration Agreements with these firms are on a fee for services rendered basis. This is not applicable as Humana does not offer cafeteria plan administration. 2. Please include a resume of the contact person responsible for this case. This is not applicable as Humana does not offer cafeteria plan administration. WELLNESS AND PREVENTION QUESTIONNAIRE: 1. Provide an executive summary of the wellness services you provide. Healthy Behavior Wellness Program The Humana Wellness program is a healthy behavior program designed to enhance the health of consumers. The Wellness program offers a broad array of activities and interventions that focus on lifestyle behavior change, awareness, and knowledge, as well as creating supportive environments. The ultimate goal is to promote healthier living by implementing effective behavior change that will help prevent the development or escalation of risk factors into more costly chronic or acute illness. These healthy behavior programs help to impact healthcare costs and improve productivity, morale, absenteeism, and presenteeism, disability, and employee turnover. Six health topics frame the services that constitute the Humana Healthy Behavior Wellness program: • Tobacco cessation • Physical activity • Nutrition • Stress management • Back care • Weight management Kerr County 38 HUl~/IANA.N fa~~,<~,t< ~° when you need it most Core Wellness Package Available to all clients at no additional cost, the Core Wellness Package serves as the foundation for developing a culture that proactively addresses employees' health. MyHumana atHumana.com Members, whether healthy or ill, can turn to MyHumana, their personalized home page on Humana.com. This one-stop Website has assessments, tracking tools, recipes, drug information, discounts, and practical health information organized into "centers" that meet members on their own terms. MyHumana is segmented into health centers to address specific concerns for men, women, children, or seniors. Condition Centers focus on a variety of issues, from headaches, to diabetes, to substance abuse. The site presents information to address the needs of the newly diagnosed members, those actively managing a condition, and those successfully living with ongoing issues. There is something to meet the needs for everyone on MyHumana. Humana Health Assessment This online, confidential lifestyle questionnaire allows immediate identification of risks and offers real time feedback in the form of a personalized health report. It includes actionable steps towards healthier living and customized links to resources that will be of value to the member. In addition, it is fully integrated with the programs and services offered by Humana through its health resources so that it directly feeds the to the appropriate medical management teams at Humana such as, HumanaBeginnings , the Personal Nurse service, and disease management. Targeted mailing and telephone reminders Proactive, targeted campaigns deliver messages of primary preventative care. These are delivered in a variety of methods including voice activated technology, mailers/postcards, or e-mails. Topics include mammography screenings, vaccinations, immunizations, and more. Wellness Calendar Program Employers can elect to receive an electronic package each month with a dedicated focus to a wellness topic. Included in the monthly distribution are workplace posters, flyers, educational articles, and more. It contains information for you to deliver to your employees and helps promote the tools available to them and the importance of lifestyle choices. To build on the foundation of the core offerings, these additional options help guide individual health behaviors and overall organizational health. These include: • Wellness Plus Package • Custom Wellness Wellness Plus Package Humana has gained a leadership position in the behavioral health field through the acquisition of Corphealth, a recognized leader in promoting lasting behavior changes. Corphealth adds value to the wellness offering by providing health coaching that delivers proven guidance techniques to help create a lasting transformation to a more informed, healthy lifestyle. ~/ Kerr County 39 HUMANA~ a ~ ~e j ~; f ~ ° when you need it most Telephonic health coaching Members elect to receive a series of evidence-based outbound calls from behavioral health specialists, health educators, coaches, or registered nurses, who are specially trained experts in behavior modification and motivational interviewing. Strategies, successes, challenges, and failures are discussed during each call. The health coach provides member support and guidance based on a personalized plan. Members may also reach out to their coach as often as needed. Health coaching is available on the six main topics of Humana's wellness solution. Tailored Web program Offered in conjunction with health coaching, members receive tailored communication based upon their confidential topic assessments. These include a written personalized action plan (also used with health coach) along with a series of newsletters to motivate desire into action. Custom Wellness Provided through a collaborative consultation, Humana can work with Kerr County to design a solution specific to Kerr County. This approach combines the Core Wellness Package, Wellness Plus offerings, and an a la carte selection of services below: Health fair facilitation Employers receive the support to plan and run an onsite health fair. The health fair facilitator works with Kerr County to understand its goal and help plan what will be included in the fair, such as whether to include health screenings, what topics to cover, budget, etc. They then connect with local resources and providers for participation in the fair. During the event, they provide onsite coordination. Fees from third party vendors are not included in the purchase of this service. Physical activity rewards program HEALTHMIL.ES PLUST"' by VIRGIN LIFE CARET"' offers afirst-of--its-kind physical activity incentive and rewards program to promote and motivate employees covered under any health benefit provider to increase their activity level and physical fitness. Members earn HEALTHMILES PLUS for effort, measurement, and achievement. These miles are redeemable at more than 50 national retailers, allowing members to walk, dance, or run their way to valuable merchandise. Wellness Consultants At the heart of a customized solution, employers receive ongoing support for onsite wellness activities. Purchased in increments often hours per week as a year-long commitment, the wellness consultant serves as a resource for Kerr County. Trained in fields such as exercise science, nursing, public health, and nutrition, these wellness experts work with Kerr County to establish along-term strategy. They provide facilitation of events such as workshops and seminars, worksite health screenings, health fairs, employee campaigns, and walking programs. Wellness consultants serve the organization as a focused leader in motivating positive health behaviors and healthy living. Printed Humana Health Assessment As a supplement to the online health assessment, paper-based versions provide this tool to those without Internet access. Kerr County 40 HUl~~IANAr~: ~ ~iric~~t~zc~~° when you need it most n4 w Print brochures and pamphlets Custom print brochures and pamphlets are available as an option. Customers may request to have print brochures available to employees at a worksite location. Customer groups who operate remote operations or do not have access to the Internet may want to offer printed brochures to their employees. Custom brochures and printed educational materials may be customized to meet the specific goals of the employer group customer upon special request. Not just for healthy employees Wellness is for everyone, not just for the healthy population. If anything, those suffering from ongoing chronic conditions benefit from the wellness services even more. Education and empowerment around fitness, nutrition, and weight management affect a number of chronic conditions such as heart disease, diabetes, and high blood pressure. Additionally, asthma and cancer patients are critical targets for tobacco cessation efforts. These programs foster better health decisions, behaviors, and ultimately healthier lifestyles. The Humana Wellness program is a combination of health education, promotion, and disease prevention tools that will improve the health of your employees by: • Improving members' overall health profile • Reducing short term illnesses and associated costs • Reducing absenteeism and presenteeism • Reducing overall health benefit claims • Increasing employee retention 2. Are wellness and prevention medical services your main line of business? If not, please explain in detail where and how wellness fits into your business plan. Humana has made great strides in integrating its clinical programs but continues to develop and enhance its systems and processes to provide a more cohesive clinical offering. To this effort, Humana is currently developing and implementing an integrated medical management and claims payment operating system for use by all staff members, which should be fully implemented by the fall of 2007. Specific impacts of this system include: • Better patient outcomes resulting in reduced overall medical cost trend • Enhanced ability to share and exchange patient-centric clinical information across all Humana operational areas • Better, faster, and more consistent decision-making by presenting the clinical user the right information at the right time through integrated business rules and clinical guidelines • Improved flexibility to adapt to an ever-changing environment by promoting workflow and process changes without the need to change underlying technology • Improved control and flexibility by putting the power of the system in the hands of the business users through systems configuration and business rule development • Creation and management of clinical interventions that drive member touches '~r-' Kerr County 41 HUlVIANA~: 4 fr~~~+gt~< ~° when you need it most HEALTH RISK ASSESSMENT (HRA) SERVICES: 1. Describe the Health Risk Assessment (HRA) tool your organization offers. Please attach a sample. Humana offers the Humana Health Assessment, which provides employers and members with an online health risk assessment that is fully integrated with all of Humana's Health Resources. The assessment is the key driver, indicator, and entry point to Humana's nursing and wellness programs. Available to all members 18 years of age and older, the Humana Health Assessment provides value through instant member feedback, direct program referrals, and aggregate reporting capabilities. Through answers to a confidential lifestyle questionnaire, Humana can identify an individual's health risks and provide steps to improvement more quickly than relying solely on analysis of claims data. The Humana Health Assessment: Provides personalized, real-time results ^ Members receive instant feedback with actionable steps towards better health ^ Instant links to in-depth health information from trusted informational sources Offers quick identification into nursing and wellness programs and services ^ Rather than wait on claims lag, the member gets routed to nursing and wellness programs more quickly, impacting their health earlier in the progression of their condition or disease Engages employees ^ Immediate feedback increases the member's awareness of their health situation and behaviors ^ Online environment allows for interaction and new content, encouraging members to re-visit ~v As Humana learns more about who engages in health improvement strategies and what makes particular strategies effective, it will be making additional modifications to help target clinical interventions through the Humana Health Assessment .The Humana Health Assessment is tightly integrated into Humana's predictive models and is used to increase the specificity of its resource allocation engine as the early identification of individuals that would benefit from Health Resources programs will help get members participating in programs sooner and decrease overall costs. Perhaps as importantly, Humana is working to ensure that the feedback it delivers to consumers is fun and entertaining in its attempt to make the experience engaging and increase member participation and satisfaction. 2. In what languages are your HRA, website, and employee materials available? Humana does not provide its HRA services in additional languages. Please see Attachment labeled "Resources for Spanish-speaking Members." 3. What is the average participation rate for your clients? For groups where employers work with Humana to promote participation, expected participation is 40 to 70 percent. Kerr County 42 HUl~/IANA~.~ ~. ~ { r~~ ~ r r $~ ~ -when you need it most `~r~` .t `:5 & ~ i ~ v z Y; ~Fr~'. ,.tc~ i_y~F'ib ~~,5 ,~ ., a,y J.,. J~J~Yr i.''. .~°+ ``'i 4. Explain your experience designing incentive systems to drive participation, including your most successfully designed incentive program. Employer support and incentives are key drivers to generate Humana Health Assessment participation. Humana is happy to work with Kerr County to develop a communication plan and incentive program to encourage participation. 5. Please complete the grid below with a checkmark or specific answer if your HRA includes the feature described. Please refer to the completed grid below for Humana's responses. 6. How often do you recommend that the members have an HRA? Humana recommends that members complete an HRA each new plan year. 7. Please describe turnaround time for each of the following areas: a. Providing the HRA results to individuals. Members receive instant feedback with actionable steps towards better health. Employers may access reports, which are refreshed daily, via the employer portal. b. Contacting individuals for possible interventions. Results from a members HHA are provided to Humana's clinical team who than follows up with the member. c. Providing Kerr County with a summary report of the initial HRA results. All employer groups, regardless of size, have online, real-time access to Humana Health Assessment participation reports. Groups of more than 50 have access to Health Status Snapshots, which provide a composite look at employees' health status. 8. Please describe how your company would communicate with individuals to assist them in understanding how to utilize the HRA and how to interpret the results. 9. Describe how your company will set and reach HRA participation goals? To encourage participation in the Humana Health Assessment, Humana has developed an approach that will allow employers to easily and effectively promote and implement the Humana Health Assessment. Plan components include: • Message templates ^ Introductory message: non-marketing approach to introduce the assessment ^ Midpoint message: reinforcement and measurement ^ Final reminder: last call for participation Kerr County 43 HUMANA.~- ~ ~ra~~c~r~l7~~~c~ when you need it most ~.-. ^ Wrap-up message: show appreciation and announce winners of incentives and participation Additional tactics/opportunities ^ Internal champions: peer ambassadors promote on a daily basis ^ Lunch-n-Learn: Humana Account Advisors can educate on benefits and "how to" in an informal presentation ^ Payroll envelope staffers: print and insert with payroll ^ Workplace posters: put them up in high traffic areas 10. Do you recommend using incentives? If so, please describe sample incentives your company might recommend. Employer support and incentives are key drivers to generate Humana Health Assessment participation. Humana is happy to work with Kerr County to develop a communication plan and incentive program to encourage participation. 11. How is the individual's HRA record updated in working with the disease management staff? The Humana Health Assessment is designed to provide early identification of individuals that would benefit from one of Humana's disease management programs. Once identified as eligible, members are contacted for enrollment by nurses for each respective program. 12. Do you monitor and report individual HRA changes from year to year? HRA PRODUCT FEATURE Included? See HHA Web-based HRA attachment. See HHA Pa er-based HRA attachment. See HHA Biometric clinic based attachment. See HHA Provides information on confidentialit attachment. See HHA Provides information on how data will be used attachment. DATA COLLECTED See HHA Health status attachment. See HHA Chronic conditions attachment. See HHA Famil health histo attachment. See HHA Medications attachment. See HHA Lifest le risks attachment. See HHA Safet attachment. Preventive exams See HHA Kerr County 44 HUl~/IANA~: ~, ~~eir~~~?~p~`a° when you need it most attachment. See HHA Immunizations attachment. See HHA Biometrics attachment. See HHA Readiness to chan a attachment. INDIVIDUAL RESULTS High-risk clinical situations are identified and appropriate steps can be taken for immediate See HHA intervention. attachment. See HHA Score communicated attachment. See HHA Focus/ riorit of individual's health/lifest le areas are communicated attachment. See HHA Health im rovement recommendations are made attachment. See HHA Action ste s rovided attachment. See HHA Can o to s ecific to ics within web site attachment. See HHA Summa re ort is available online attachment. See HHA Summa re ort can be rinted attachment. See HHA Links to additional health information are available attachment. See HHA Provides information or links to risk reduction ro rams attachment. Employer can customize messages on their URL to include references and links to internal See HHA ro rams or other vendors attachment. EMPLOYER REPORTS See HHA Web-based/electronic re orts available attachment. See HHA Re orts can be rinted attachment. See HHA Lifest le risks are re orted attachment. See HHA Health status are re orted attachment. See HHA Chronic conditions are re orted attachment. IMPLEMENTATION & COMMUNICATION STRATEGY: 1. Please provide a proposed communication plan for introducing an onsite wellness program and reference the ongoing communication process. Outline your company's responsibilities in these processes. Please include copies of your educational materials and timelines for distribution. Kerr County 45 HUl~/IANA~N~ (. ~tfi<~~~~3~tk:-~~ when you need it most •~-~ ~ r,~ `~-'` ~ ~'~'~~-tip:, ~~xi~~uu.~ ~".~ f ~+- To stress the importance of receiving a flu vaccination and pneumonia vaccination, Humana sends targeted communications to commercial and Medicare members. The communications outline the Centers for Disease Control and Prevention's (CDC) recommendations for who should receive flu and pneumonia vaccinations. Humana also sends a-mail, direct mail, and outbound voice activated telephone calls to the following: • Members who are enrolled in a Humana disease management program • Members diagnosed with a chronic disease related to the heart, lung, kidney, diabetes, or other high acuity condition • Children older than six months and under five years of age • Members age 50 and older, including Medicare members The communication will outline CDC recommendations, encourage members to receive appropriate vaccinations, and promote the Flu and Pneumonia condition center located within MyHumana, the member's password-protected, personal page on Humana.com. Additional wellness communication includes: • Greeting cards to members eligible for the Quality Oncology program but who have not responded to the standard outreach effort • Female cancer screening reminder via a-mail • Male cancer screening reminder via a-mail • Diabetes medication compliance direct mail • Diabetes "tests you should have" voice activated telephone call ~"''` • HumanaBeginnings®/Women's Health a-mail or direct mail • Rare disease direct mail about working with family members to understand the disease process Please refer to attachments titled "Wellness Communications" for samples of this material. err 2. How can employees communicate with the medical team? Within each market, Humana has a medical officer who is responsible for professional affairs. These officers serve as the major interface with the physician advisory board, medical organizations in the community, and participating professionals. Each medical officer plays an invaluable role in establishing a physician network and facilitating physician participation and cooperation. One of the medical officer's primary responsibilities is the implementation of quality management and utilization review. The medical officer is responsible for the recruitment and supervision of physician advisors in the utilization review process, network physician orientation and education, and matters relating to professional and medical affairs. The medical officer also works with customers and prospective clients to help them understand the clinical programs and initiatives Humana has created and how they can improve both clinical outcomes and manage medical costs. This support includes analysis, recommendations, and guidance. The medical officer is also a key participant in the market cost management team that focuses on delivering maximum value for customers and members. Other duties of the medical officer include: Kerr County 46 HLTMANA.k. ~ r~~~~~~~at~~° when you need it most a ,; Involvement with clients through face-to-face meetings to address group issues and concerns Acting as the liaison between the market and the Personal Nurse service, Transplant Management department, and other specialized clinical services that Humana provides Serving as an internal consultant for quality and clinical issues and overseeing accreditation and credentialing activities 3. Discuss the frequency and type of communications that eligible persons will receive throughout the program period. Humana provides ongoing communication to members before, during, and after enrollment. Humana's communication and marketing strategies are aimed at building awareness and educating members about Humana products and services, assisting members in making wise healthcare decisions, and giving members ongoing guidance and support. Before enrollment, Humana educates members and builds awareness through: • Employee newsletters • Quick tip sheets • Posters to remind employees of enrollment During the enrollment period, Humana helps members choose the benefit plan that is right for them and their family through a variety of visuals and materials: • Benefit charts, plan description guides, pharmacy drug lists, and provider directories • Employee presentations • Enrollment toolkits • Humana's online enrollment center and Wizard enrollment tool • Humana's online plan enrollment guide for SmartSuite product After enrollment, Humana continues to offer guidance and support through member education materials and Humana's online tools and resources. • My Humana: This is apassword-protected, personal home page for members on Humana's Website, Humana.com. At MyHumana, members can review their plan benefits, take a health assessment, create a health record, and browse a health library. Members also can look for participating doctors, pharmacies, and dentists, find a lower cost drug, learn about medical conditions, check the status of a claim, and much more. • Member Guide Package: Members automatically receive a Member Guide Package mailed to their home prior to their effective date. The package provides "getting started" information and guides members to Humana's tools and resources. • E-newsletter: By providing their a-mail address or registering for MyHumana, members automatically receive Humana's monthly e-newsletter. The newsletter contains short articles on a variety of health topics and tips on how to get the most from their benefits. • Lunch and Learn: Members can attend "Lunch and Learn" presentations, which are short PowerPoint presentations that reinforce the consumer-choice messages and offer simple suggestions for healthier lifestyles and wise use of their coverage. 4. Provide your web address and any access codes needed to explore your services. Kerr County 47 HUl~/IANA,r ~ ;~~r~c~~~ ~., when you need it most 1. r ~- c ~ ~ « . <~ S! ~ 'm~1 v.~ Humana's Website is Humana.com. 5. How would you suggest reaching spouses? Humana is able to customize its wellness communications to all enrolled members. ~r+ Kerr County 48 Directors /Officers Report ~r ~hr- Humana Insurance Company Daniel 5. Feruck Market President - GA/NC/SC Primary Address: 900 Ashwood Parkway, Suite 400 Atlanta, Georgia 30338 Robert T. Hitchcock Regional President -Senior Products/North Primary Address: 550 West Adams Street, 7th Floor Chicago, IL 60661 Michael A. Kasper Market President -Chicago Primary Address: 550 W. Adams Street, 6th/7th Floors Chicago, Illinois 60661 Scott T. Latimer M.D. Regional President -Senior Products/Central Florida Primary Address: 5401 W. Kennedy Boulevard, Suite 161 Tampa, FL 33609 Edward J. Leary M.D. Regional President -Senior Products/Central Region Primary Address: 7311 W. 132nd Street, Suite 200 Overland Park, Kansas 66213 Bruno A. Littleton Market President -Jacksonville Primary Address: 76 South Laura Street Jacksonville, Florida 32202 Veronica L. Martin Market President -Indianapolis Primary Address: 8888 Keystone Crossing Boulevard Indianapolis, Indiana 46240 Kevin R. Meriwether Regional President -Senior Products/East Primary Address: 500 W. Main Street Louisville, Kentucky 40202 George Renaudin Regional President -Senior Products/South Primary Address: One Galleria Blvd., Suite 850 Metarie, Louisiana 70001 James E. Schlottman Primary Address: Kristine N. Seymour Primary Address: Market President -Louisiana One Galleria Blvd. Metairie, Louisiana 70001 Market President -Wisconsin N19W24133 Riverwood Drive, Suite 300 Waukesha, Wisconsin 53188 Page 3 of 6 Directors /Officers Report ~r Humana Insurance Company George F. Smith Regional President -Senior Products/Southwest Primary Address: 8431 Fredericksburg Road, Suite 450 San Antonio, Texas 78229 Pattie D. Tye Market President -Houston Primary Address: 1980 Post Oak Boulevard, Suite 1900 Houston, Texas 77056 Richard T.P. Willis Market President - Austin/West Texas Primary Address: 2701 Regents Park Austin, TX 78746 C. Evans Looney Market President -Tennessee Primary Address: 6075 Poplar Avenue, Suite 221 Memphis, TN 38119 Sandra G. Ganoni Market Vice President Primary Address: 1100 Employers Boulevard DePere, WI 54115 James H. Bloem Senior Vice President, Chief Financial Officer & Treasurer Primary Address: 500 West Main Street Louisville, KY 40202 Bruce J. Goodman Senior Vice President Primary Address: 500 West Main Street Louisville, KY 40202 Thomas J. Liston Senior Vice President Primary Address: 500 West Main Street Louisville, KY 40202 Jonathan T. Lord M.D. Senior Vice President Primary Address: 500 West Main Street Louisville, KY 40202 Heidi S. Margulis Senior Vice President Primary Address: 500 West Main Street Louisville, KY 40202 Steven O. Moya Senior Vice President Primary Address: 500 West Main Street Louisville, KY 40202 Page 4 of 6 Directors /Officers Report Humana Insurance Company ~` Frank M. Amrine Primary Address: Appointed Actuary 500 W. Main Street Louisville, KY 40202 George G. Bauernfeind Primary Address: Elizabeth D. Bierbower Primary Address: John E. Brown Primary Address Stefen F. Brueckner Primary Address: J. Gregory Catron Primary Address: Gerald L. Ganoni Primary Address: P. Anthony Hammond Primary Address: David K. Jarboe Primary Address: Mark M. Matzke Primary Address: Khalid Nazir Primary Address: Vice President 500 West Main Street Louisville, KY 40202 Vice President 500 West Main Street Louisville, KY 40202 Vice President 101 East Main Street, ] 2th Floor Louisville, Kentucky 40202 Vice President -Senior Products 500 West Main Street Louisville, KY 40202 Vice President 500 West Main Street Louisville, Kentucky 40202 Vice President 1100 Employers Boulevard Green Bay, W [ 54344 Vice President and Chief Medicare Actuary 500 West Main Street Louisville, KY 40202 Market Vice President 255 Alhambra Circle, Suite 500 Coral Gables, Florida 33134 Vice President 325 Reid Street DePere, WI 54115 Vice President 500 W. Main Street Louisville, Kentucky 40202 Page 5 of 6 Directors /Officers Report w Humana Insurance Company Theresa R. Ostert Primary Address: Kathleen Pellegrino Primary Address: Vice President 1100 Employers Boulevard Green Bay, WI 54344 Vice President and Assistant Secretary 500 West Main Street Louisville, KY 40202 Weston P. Scott M.D. Market Vice President/CMO -Senior Products/San Antonio Primary Address: 8430 Fredricksburg Road, Suite 450 San Antonio, Texas 78229 Terry G. Smith M.D. Market Vice President/CMO-Senior Products/South Florida Primary Address: 3501 S.W. 16th Avenue Miramar, Florida 33027 William J. Tait Vice President Primary Address: 500 West Main Street Louisville, KY 40202 John T. Terry Vice President Primary Address: 4626 Frey Street, Box 5620 Madison, WI 53705 Gary D. Thompson Vice President Primary Address: 500 West Main Street Louisville, KY 40202 Mark D. Wernicke Vice President Primary Address: 1100 Employers Boulevard Green Bay, WI 54344 Ralph M. Wilson Vice President Primary Address: 500 West Main Street Louisville, Kentucky 40202 Tod J. Zacharias Vice President Primary Address: 1100 Employers Boulevard Green Bay, WI 54344 Joan O. Lenahan Vice President and Secretary Primary Address: 500 West Main Street Louisville, KY 40202 Page 6 of 6 Policyholder: Policy Number: Effective Date: (Anniversary Date: Humana Insurance Company [ABC Company) [ 123456789] )oo~oaoo) (ooiooioo)) Phis Policy is delivered in and governed by the laws o£ Ohio This Policy is issued in consideration of the Policyholder's Application, a copy of which is attached and made pars of this Policy, and such Policyholder's payment of premiums as provided under this Policy. This Policy and the insurance it provides become effective on the date stated above at 12:01 A.M. at the address of the Policyholder. This Policyand'the insurance it provides terminate at 12:01 A.M., same time zone, on the date of termination: The provisions fated above and on the following pages are parts of this Policy. [Signature of Officer] [Typed Name of Officer] [Title of Officer] SL.P-2004-I&P-2/2005 ~1rrr° GROUP STOP-LOSS POLICY ISSUED BY HUMANA INSURANCE COMPANY POLICY NO.: [123456789] EFFECTIVE DATE: [00/00/00] [ANNIVERSARY llATE: [00/00,'00]] ARTICLE 1-STOP-LOSS PROVISIONS SECTION 1. INSURING AGREEMENT. In consideration of the Application and premiutnpayment, this Policy is entered into by and between the Policyholder identified on the cover page of this Policy and Humana Insurance Company (the Company). The Company will reimburse the Policyholder for Eligible Expenses that satisfy the applicable terms and conditions of this Policy, that are in excess of the applicable Stop-L,ass deductible amounts} set forth in Sections 2 ANI? 3 of this ARTICLE, and that do not exceed t.~e applicable Maximum Benefit. Reimbursement will be made for only Covered Benefits specified in the Application for this Policy and subsequent amendments. Reimbursement to the. Polic_yholderunder this Policy shall be subject to ARTICLE III -LIMITATIONS AND EXCLUSIONS. SECTION 2. AGGREGATE STOP-LOSS.. After the end of each Policy Year, the Company will reimburse the Policyholder, in accordance with the provisions of this Section 2, the percent of Eligible Expenses, as indicated by the Stop-Loss Coinsurance an the Schedule, that are in excess of the Annual Aggregate Deductible, or the Minimum Annual Aggregate Deductible, whichever is greater, and that do not exceed the Annual Aggregate Maximum Benefit, if any, as specified in the Schedule. The amount, if any, to be Paid to the Policyholder by the Company under the Aggregate Stop-Loss provisions of this Policy shall be determined after the end of each Policy Year and shall. be calculated in the following manner: (1) The number of Covered Units at the beginning of each mouth during the Policy Year will be multiplied by the Monthly Aggregate Deductible Factors specified in the Schedule. The product of this calculation shall be the Monthly Aggregate Deductible for that month. The sum ofall the Monthly Aggregate Deductible Amounts for the Policy Year shall be the Annual Aggregate Deductible. Ifthe Annual Aggregate Deductible is less than the Minimum Annual Aggregate Deductible set forth in the Schedule to this Policy, then the MinimLUn Annual Aggregate Deductible will be used instead of the Annual Aggregate Deductible. Retroactive changes to Covered Units submitted after the Settlement Period will not be included in the calculations of the Monthly Aggregate Deductible amounts. th the event ofa strike, lockout or work stoppage caused by any disagreement between the Policyholder and all or part of the employees covered under the PoIicyholder's Plan, the number of Covered Units for any month rr~ 2 SLP-2004-I&P-2/2005 during which the event continues shall be the number ofCovered Units for the month immediately preceding the month. during which the event commenced. (2} The Annual Aggregate Deductible and the Monthly Aggregate Deductible Factors shall apply separately to each Policy Year and shall be re-determined each succeeding Policy Year. The Company shall have the right to change the Monthly Agl~regate Deductible Factors with written notice at least thirty (30) days prior to the effective date of the change. No change will be made to the Monthly Aggregate Deductible Factors on any date other than the Policyholder's Anniversary unless such change is due to a Change of Risk. Policyholder shall provide the Company with at least thirty (30) days advance written notice of any Change of Risk. Upon such notice, the Company may, in its sole discretion, determine whether changes to the Monthly Aggregate Deductible Factors are necessary. (3) These Eligible Expenses shall apply toward the Annual Aggregate Deductible: Eligible Expenses that are within the Annual Individual Deductible of any Individual Stop-Loss coverage and that do not exceed the Individual Lifetime Maximum Benefit or, if lower, any applicable Lrnique Individual Lifetime Maximum Benefit. (4) These Eligible Expenses shall not apply to any Annual Aggregate Deductible and are also excluded from the Aggregate Stop-Loss coverage: (i} Eligible Expenses that are in excess of the Annual Individual Deductible (even if a Unique Individual Deductible applies); (ii) Eligible F,xpenses'that have been or are reimbursable under any Individual Stop-Loss coverage; and.{iii I?.lgible Expenses that are in excess of the lndividua.l Lifetime Maximum Benefit or, if lower, any applicable Unique Individual Lifetime Maximum Benefit. ~ SECTION 3. INDIVIDUAL STOP-LOSS. For any Covered Parson during the corresponding year of this Policy, the Company will reimburse the Policyholder; in accnrdanc,~ with the provisions of this Section 3, the percent of the Eligible Expenses, as indicated by the Stop-Loss Coinsurance in the Schedule, that are in excess of the Annual Individual Deductible, but'only up to the applicable Individual Lifetime Maximum Benefit. The Annual Individual Deductible is set tbrth in the Schedule and applies separately to each Covered Person during each Policy Year. The Individual Lifetime Maximum Benefit for each Covered Person is set forth in the Schedule and subsequent amendttts. For any Covered Person so identified in the Schedule, the reimbursement from the Company to the Policyholder will be based on a Unique Annual Individual Deductible and/or a Unique Individual Lifetime Maximum Benefit. SECTION 4. AGGREGATE STOP-LOSS CLAIM SETTLEMENT. The Company will reimburse the Policyholder for any eligible Aggregate Stop-Loss claim within the Settlement Period. Any such claim must be properly documented in accordance with ARTICLE IV, Sections 9 and 10 of this Policy. SECTION 5. INDIVIDUAL STOP-LOSS CLAIM SETTLEMENT. The Company will reimburse the Policyholder for any eligible Individual Stop-Loss claims as soon as reasonably possible following receipt of the Policyholder's claim for reimbursement. Any such claim must be properly documented in accordance with ARTICLE IV, Section 10 of this Policy. In no event will the Company delay reimbursement to the Policyholder for a period SLP-2004-I&P-2/2005 of more than thirty (30) days following receipt of the Policyholder's claim for reimbursement, unless the Company deems it necessary to conduct an investigation or obtain additional information from the Policyholder to perfect the claim. SECTION 6. EXPENSES INCURRED BEFORE THE EFFECTIVE DATE OF THIS POLICY. If so requested in the Application and approved by the Company, for the initial Policy Year, the Company will treat as Eligible Expenses all expenses otherwise satisfying the Policy's def nition of Eligible Expenses that are Incurred during the "Run-In" time period specified in the Schedule immediately before the Policy's effective date and that are Paid during the initial Policy Year under the Aggregate Stop-Loss [and,`or Individual Stop-Loss] provisions of this Policy. This Section 6, however, shall onlyapply to those Eligible Expenses that do not exceed the Run-In Limits set forth in the Schedule and that could not be documented, processed and Paid in accordance with the provisions of any prior stop-loss policy not issued by the Company. SECTION 7. THIRD PARTY RECOVERIES OR REIMBURSEMENTS. In the event the Company pays a claim under either or both the Aggregate Stop-Loss or Individual Stop-bass provisions of this Policy, the Company shall be subrogated to the rights of the Policyholder and shall be entitled to be reimbursed fast from any net proceeds subsequently recovered from responsible third parties, their insurers or others whc~ inay be responsible to pay or indemnify the Covered Person or the Covered Person's estate. Any balance remaining'after the Campanyhas been reimbursed shall then be credited or remitted to the Policyhofcler. ARTICLE II -DEFINITIONS ANNUAL AGGREGATE DEDUCTIBLE means the clailar amount that must be satisfied by Eligible Expenses before any eligible Expenses become reunbursable under the Aggregate Stap-Loss provisions of this Policy. ANNUAL AGGREGATE M1~XIMUM BENEFIT means the maximum amount the Company may he required to pay the Policyholder under the Aggregate Stop-Loss provisions of the Policy for that Policy Year. ANNUAL INDIVIDUAL DEDUCTIBLE means the dollar amount that must be satisfied by Eligible Expenses for any one Covered Person, before any Eligible Expenses for that Covered Person become reimbursable under the Individual Stop-Loss provisions of this Policy, for any one Policy Year. CHANGE OF RISK means any one, or more than one, of the following events: (t} a substantial change in the benefits provided under the Policyholder's Plan; (ii) a [ 10%] or greater change in the number of Covered Units i.n one month when compared to the prior month or a [25%] or greater change in the number of Covered Units in any three month period when compared to the prior three month period; (iii) the addition or deletion of a business location at which Covered Units are employed by the Policyholder. COBRA means the continuation of employee and dependent health benefits provided under Title X of the Consolidated Omnibus Budget Reconciliation Act of i 985 as amended. COBRA UNITS means those individuals originally covered under the Policyholder's Plan who elect to continue in the Policyholder's Plan via COBRA. 4 SLP-2004-I&.P-212005 COVERED PERSON means a person who is both eligible for benefits and validly enrolled for coverage under the Policyholder's Plan. Such person is not directly covered under this Policy and is not entitled to receive any direct payment or reimbursement hereunder. COVERED UNITS means the sum of those eligible employees (including, if applicable under the Policyholder's Plan, retirees, surviving spouses, and COBRA Units), who are both eligible for benefits and validly enrolled far coverage under the Policyholder's PLan on a monthly basis. Covered Units shall include both employees enrolled for "employee only" coverage as well as employees enrolled for "employee and dependent" coverage. ELIGIBLE EXPENSES means demand for payment for services or supplies provided to or on behalf of a Covered Person, that are covered under the terms and provisions of the Policyholder's Plan, that are not excluded under the terms of this policy, and that are both Incurred by the Covered Person and Paid by the .Policyholder's Plan or a claims administrator on behalf of the Policyholder's Plan within the time periods specified in the Schedule to this Policy. Such expenses are eligible for reimbursement under this Policy, subject to the Stop-Loss Coinsurance, once the corresponding deductibles of this policy are satisfied, but only up to any applicable maximum benefit amount. EXPIRATION .DATE means the last anniversary of the last Policy Year on which this ~'olicy remains in force. INCURRED means the time the service or supply to which the expense rclafes is provided. INCURRED AND PAID means a coverage option that includes claims Paid after the end of the Policy Year. INDIVIDUAL LIFETIME MAXIMUM BENI/I'I'1' means the maximum amount the Company may be required to pay the Policyholder for a Covered Person utider the Individual Stap-Loss provisions of this Policy. M11VIML'M ANNUAL AGGREGA'T'E I~EbUCTIBLE means that amount calculated as set forth in the Application and as specified irl the Schedule. "The Minimum Annual Aggregate Deductible always remains the responsibility of the Policyholder and is not subject to reimbursement by the Company under the Aggregate Stop-Loss provisions of this Policy. MONTHLY AGGREGATE DEDUCTIBLE means the product of the multipiieation of the number of Covered Units at the beginning of each month by the corresponding Monthly Aggregate Deductible Factor. The sum of all Monthly Aggregate Deductibles for a Policy Year, or such shorter period resulting from a Termination of the Policy under ARTICLE TV, Section 4, is the Annual Aggregate Deductible. MONTHLY AGGREGATE DEDUCTIBLE FACTORS means those dollar amounts shown on the Schedule, which, when multiplied by the corresponding number of Covered Units for a month, produce the Monthly Aggregate Deductible for that month. PAID means the date the payment check or draft is issued by the Policyholder's Plan or by a claims administrator on behalf of the Policyholder's Plan, provided it is promptly delivered to the payee, and provided also that the account upon which the payment is drawn contains sufficient funds to permit the check or draft to be honored. SLP-2d{?4-I&P-2/2005 PLAN ADMINIS'T'RATOR means that person or entity identified in the documents describing the Policyholder's Plan as responsible for the operation and administration of the Policyholder's Plan. If no such person or entity is identified, then the person or entity establishing or maintaining the Plan will be deemed to be the Pian Administrator. The Company is never the Plan Administrator. POLICYHOLDER means the legal entity named as the policyholder on the face page of this Policy. POLICYHOLDER'S PLAN means the plan of benefits which are provided under the Policyholder's written welfare benefit plan or other employee health care benefit plan and which are eligible for Stop-Lass reimbursement as set forth in the Application for this Policy. No benefits provided under the Policyholder's Plan, which are insured under a separate policy, are eligible for reimbursement under this Policy. POLICY YEAR means the period of time from the Effective Date of this Policy to the Policy Anniversary during the first year and the period of time between Policy Anniversaries for each year thereafter. SCHEDULE means the Schedule of Coverage attached to this Policy, as periodically amended, which contains information specific to this Policy, the Policyholder and the Policyholder's Plan. SETTLEMENT PERIOD means the Sixty (60) day period immediately following the end of each Palicy Year, or, if specified in the Schedule, the end of any time period following the Policy`"Year. In the event of termination of this policy, SETTLEMENT PERIOD means ttie Sixty(60} day p~.xiod immediately following the termination date of this Policy or, if specified in the Schedule, the end of any time period following the 'Termination date of this Policy Policyholder's Plan, that are within the Annual Individual Deductible of any ~~, Individual. STOP-LOSS COINSURANCE means the percent of Eligible Expenses that are reimbursable to the Policyholder under the terms of this Policy: TERMINATION means the end of this Policy and-the Stop-Lass coverage it provides. Termination may occur at the end of the Policy Year'.or ~n a date other than an Anniversary Date, as specified in ARTICLE IV, Section 4 of this Policy. UNIQUE ANNUAL INDIVIDUAL DEDUCTIBLE means the dollar amount that must be satisfied by Eligible Expenses for any one Covered Person who is identified separately in the Schedule, before any Eligible Expenses for that Covered Person. became reimbursable under the Specific Stop-Loss provisions of this Policy. UNIQUE INDIVIDUAL LIFETIME MAXIMUM BENEFIT means the maximum amount the Company may be required to pay the Policyholder under the Individual Stop-Loss provisions of this Policy for any Covered Person identified in the Schedule with a Unique Individual Lifetime Maximum Benefit. 6 SLP-2004-I&P-2/2005 ARTICLE III -LIMITA'T'IONS AND EXCLUSIONS THE COMPANY will not reimburse the Policyholder far any of the fallowing, nor will any of the following be applied toward. satisfaction of the Annual Aggregate Deductible, the Annual Individual Deductible or any Unique Annual individual Deductible; nor shall any of the following be considered Eligible Expenses under this Policy: SECTION 1. Any liability, expense or loss Incurred by the Policyholder as a result of its failure to comply with any applicable taw, rule or regulation (for example, if the Policyholder has not filed and/or registered with the state of New York as required by the state's Health Care Reform Act of 1996, as amended. In this example, only expenses associated with claims For medical services, and not the surcharge to fund indigent care, will be considered Eligible Expenses.); SECTION 2. Any Liability, expense or Lass that is not specifically covered under the Policyholder's Plan or that is in excess of the benefits covered under the Policyholder's Plan, even if the Policyhaltler ar the Plan Administrator should decide to cover such an expense; SECTION 3. Any expenses Paid or authorized for payment by the Policyholder's Plan, its Plan Administrator, ar its claims administrator for a person who is not a Covered Person under the Policyholder's Plan; SECTION 4. Any expenses that are Incurred prior to the et~'ectve date of cnti~erage of a Covered Person; SECTION 5. Any payments made ar authoci,zed by the l'olieyhaider's Plan, its Plan Administrator, ar its claims administrator with respect to;>~ligible Expenses -that are in excess of the lesser of usual, customary and reasonable charges or the maxi~uni allowable fee as defined in the Policyholder's Plan; SECTION 6. Any expenses Paid or authorized for payment by the Policyholder's Plan, its Plan Administrator, or its claims administrator that are Incurred on a date on which this Policy is not in force, except as specified under ARTICLE I, Section 6 or as specified under an Incurred and Paid Option reflected in the Schedule; SECTION 7. Any payments made or authorized by the Policyholder, its Plan Administrator, or its claims administrator on behalf of a Covered Person. due to a bodily injury, sickness or death arising out of; and in the course of, employment with respect to which benefits are Paid or payable under any Worker's Compensation or Occupational Disease Act or Law; SECTION 8. Any expense, loss, damage or legal fees resulting from any claims or demand arising under the Policyholder's Plan which may be made against the Policyholder, the Plan Administrator or the Plan for other than the benefits due or on behalf of a Covered Person under the terms and provisions of the Policyholder's Plan; ~w' SLP-2004-I&P-212405 SECTION 9. A.ny expense relating to gene therapies, xenografts, cloning, or non-human organ or tissue transplants; SECTION I o. Any cost of claims administration, payments or other services provided by the Policyholder's claims administrator, or for consulting fees or for expense of any litigation; SECTION 11. Any Eligible Expenses that are eligible for reimbursement to the Policyholder under any other excess or stop- loss policy; SECTION 12. Any Eligihte Expenses that is grreater than the Individual Lifetime Maximum Benefit or the Unique Individual Lifetime Maximum Benefit, applicable to a Covered Person; SECTION 13. Any expense Incurred that is eligible for reimbursement through any national health plan regardless of a Covered Person's country of citizenship; jSECTION 14. Any non-emergency Eligible Expenses Incurred outside of the geographic haundaries of the United States of America, or its territories, by any Covered Person. However, Eligible Expanses Incurred for emergency care outside the geographic boundaries of the United States of AnTerca, or its territories, for any Covered Person, will be considered up to [$250,000], less the Annual Individual Deductible applicable to such Covered Person, per Policy Year.] ARTICLE IV -CONTRACT PROVISIONS SECTION L ENTIRE CONTRACT, STATEMENT, CHANGES. This Policy and the Application of the Policyholder, a copy of which is attached, and the Schedule, shall constitute the entire contract between the parties. The term Application as used in this ARTICLE shall refer to the original Application and to any subsequent amendments or supplemental Applications submitted by the PofieyhoIder to the Company with. respect to the coverage afforded under this Policy. The term Schedule shall refer to the original Schedule and to any revised Schedule forming a part of this Policy as set forth in this ARTICLE IV, Section 1. Any statement made by the Policyholder will be deemed a representation and not a warranty. No such statement shall void this insurance or reduce any benefits under this Policy unless it is contained in a written Application signed by the Policyholder, a copy of which has been furnished to the Policyholder. This Palicy may be changed at any time by mutual agreement between the Company and the Policyholder. No change in this Policy shall be valid unless approved in writing by an Executive Officer of the Company and endorsed or attached to this Policy. No agent, broker or consultant has authority to change this Policy or to waive any of its provisions; to extend the time for payment of premium; or to bind the Company by snaking any promise or representation or by giving or receiving any information. '~wr 8 SLP-2004-I&P-2/2005 The Company may revise the Schedule in accordance with the provisions of ARTICLE I, Section 2 (2) of this Policy. In the event such revisions are unacceptable to Policyholder, Policyholder may terminate this Policy in accordance with Section 4, of this ARTICLE IV. Payment of any amount due under this Polley by Policyholder aver the revised Schedule has been provided to Policyholder by the Company shall constitute the Policyholder's acceptance of the revised Schedule. The revised Schedule shall then become part of this Policy without the necessity of obtaining Policyholder's signature on the Schedule. This Policy is a contract solely between the Policyholder and the Company. This Policy does not create -nor should it be construed to create -any rights or legal relationships between the Company and the Policyholder's employees and/or their dependents. Any payments made under this Policy shall be only for the benefit of the Policyholder. No Covered Person shal} have any rights to any of the proceeds of any stop-loss insurance provided under this Policy. SECTION 2. INCONTESTABILITY. After two years from the Effective Date of this Policy, no representation of the Policyholder in its Application shall be used to void this Policy. In the eventthe Policyholder submits a supplemental. or amended application, the two-year period specified in this Section shall run from the date Policyholder submits such supplemental. or amended application with respect to representations contained therein. SECTION 3. POLICY TERtiI. The term of this Policy begins on the Effective Date at 1?:O1 A.M., at the address of the Policyholder and ends at. 12:01 A.M., same time zone, on the first Policy Anniversary. Subsequent terms also begin and end at 12:0 l A.M., at the address of the Policyholder, and run from Anniversary to Anniversary. Except as provided in this ARTICLE IV, Sections 4 ~ncl 6, the Company will not }nitiate any termination proceedings during the twelve (12) tnonth,period unrnediately following the Policyholder's acceptance of any Anniversary premium rate adjustment. SECTION 4. TERMINATION OF ENTIRE POLICY. If any premium is not Paid before the expiration of the grace period, this Policy shall automatically terminate at the expiration of the grace period. But ifthe Policyholder has given the Company written notice in advance of an earlier date of termination during the grace period, then this Policy sha}1 terminate as of the earlier date. The Policyholder may terminate this Policy on any monthly premium due date by providing advance written notice to the Company when such Termination shall become effective, but no such Termination shall become effective during any period for which a premium has been Paid to the Company. The Company may terminate this Policy on any Policy Anniversary by providing at least sixty (b0) days advance written notice of the Company's intent to terminate this Policy. Subject to ARTICLE IV, Section 2 hereof, the Company may also terminate this Policy on any monthly premium due date by providing at least ten (10) days advance written notice to the Policyholder of the Company's intent to terminate this Policy if the .Policyholder has misrepresented any material fact in the Application far this Policy or if, at any time, the Policyholder breaches any of the conditions of this Policy. `~rrr 9 SLP-2004-I&P-2/2005 The Company reserves the right to terminate this Policy on the date the Policyholder's Plan is substantially changed so as to constitute a Change of Risk, if the Policyholder has not given the Company written notice as specified in this Policy prior to the effective date of such change. The Company also reserves the right to terminate this policy on the date of termination of the administrative services agreement between Policyholder and its designated claims administrator. The Company may also terminate this Policy immediately upon the Company's receipt of information from the Policyholder's claims administrator that the Policyholder has failed to find its bank account established to pay benefits under the Policyholder's Plan or if any of Policyholder's checks issued for benefit payments have been returned for insufficient funds. If this Policy terminates, the Policyholder shall be liable to the Company for all unpaid premiums for the period during which this Policy was in force. If this Policy terminates prior to the Policy's Anniversary, the Com.pany's Annual Aggregate Maximum Benefit shall be limited to the same percentage that the number of months the. Policy was in effect bears to the number of months in the stated Policy Year. (For example, when a policy with a' 12 month Policy Year is terminated at the end of 6 months, the Annual Aggregate Maximum Benefit will be limited to'/z or 50%of the amount specified in the Schedule.) If this Policy terminates prior to the Policy's Anniversary, and if an' Ineutr~d and Paid coverage option is reflected in the Schedule, coverage shall. be limited to c[aiins Paid during a period after the termination effective date equal to the period that the Incurred and Paid option exceeded the Policy year. (For example, when a policy with a 12/ I S Incurred and .Paid option is terminated at the end of the 6"' month of the plan year, the coverage option will revert to a 6!9 Incurred and :Paid Qptian.) If this Policy terminates, the Minimum Annual Aggregate Deductible set forth in the Schedule to this Policy shall apply in full, even if the Policy is tctminated prior to the Folicy's Anniversary. SECTION 5. PREMIUM RATES. The prerniupa;rates for the initial term of this Policy are shown in the Application for this Policy and are guaranteed until the fixst Anniversary. 'The Company shall have the right to modify the rates for the coverages) provided hereunder except that no such modification will take effect on other than an Aruziversary unless, due to an action of the Policyholder, the nature of the insurance risk is substantially changed in which event the Company shall have the right to modify premium rates upon ten (10) days advance written notice to the Policyholder. In all other instances, the company shall provide the Policyholder with thirty (30) days advance written notice of any change in premium rates. SECTION 6. PREMNM PAYMENT. Premiums are due and payable monthly in advance at the address indicated on the statement. Failure to pay any premium on or before its due date shall constitute a default entitling the Company to terminate the Policy, if premiums are not Paid by the end of the grace period. 10 SLP-2004-I&P-2!2005 SECTION 7. AUTHORIZED DEDUCTIONS. The Policyholder authorizes the Company to deduct monies that otherwise may be due and payable to the Company from any outstanding monies that the Company, for any reason, may owe the Policyholder. This clause will not prevent the termination of this Policy for the non-payment of premium under Section 4 of this ARTICLE IV. SECTION 8. GRACE PERIOD. A grace period of thirty (30) days will be granted to the Policyholder for the payment of each premium falling due after the first premium, during which grace period this Policy shall continue in force unless the Policyholder has given the Company written notice of discontinuance in accordance with ARTICLE IV, Section 4 hereof. The Policyholder shall be liable to the Company for the payment of any premium due for the time this Policy continues in force during the grace period. SECTION 9. RECORDS. The Policyholder shall forward the information required by the Campany in connection with the administration of this Policy and the determination of the premiums and I~vments. The Policyholder shall forward to the Company, or make available for inspection, atl records that have a bearing on this insurance. Such records shall be open to the Company for inspection at any time for up to six years after termination of this Policy, including, if any, the period of a Terminal Liability Option. The Company shall not be liable for the fulfillment of any obligation dependent upon information. to t>e furnished by the Policyholder prior to the Company's receipt of that information in a form satisfactory to the Caixipany. Incorrect information may be corrected if the Company has not acted to its prejudice by relying. on it. SECTION 10. CLAIM PROVISIONS. Accounting records and other written proof of the basis upon which payments were made must be furnished to the Company as soon. as reasonably possible following the end of the Policy Year or such. other period to which this Stop-Loss insurance applies. The Company shall not be liable for the reimbursement of any claim prior to the Company's receipt of all information, in a form satisfactory to the Company, it deems necessary to perfect the claim. Incorrect information may be corrected if the Company has not acted to its prejudice by relying on it. SECTION 11. LITIGATION. No action at law or in equity shall be brought to recover on this Policy prior to the expiration of sixty (60} days after a properly documented claim has been submitted in accordance with the requirements of this Policy. No such [demand or) action shall be brought after the expiration of three (3) years after the date upon which the Applicable Settlement Period ended or in the case of a claim under the Individual Stop-Loss coverage, the earlier of that date or three (3) years after the date upon which the properly documented claim that is the subject of the litigation was submitted. If any time limitation of this Policy with respect to [making a demand for arbitration or for) bringing an action at law or in equity to recover on this Policy is less than that permitted by the law of the jurisdiction of Issue, that limitation is hereby extended to agree with the minimum permitted by that law. ter' SLP-2004-I&P-2/2005 SECTION 12. ADMINISTRATION OF THE POLICYHOLDER.'S PLAN. The Policyholder, ora designee acceptable to the Company, will make payments under the Policyholder's Ptan and will properly investigate and settle or defend against all claims arising from the operation of said Plan. The Company will not reimburse the Policyholder f'or any expense Incurred in such investigation, settlement or defense, nor will any such expense be used to satisfy the stop-loss deductible provisions of this Policy. The Company has no obligation to defend any legal action or claim brought to recover benefits due under the Policyholder's Plan. The Policyholder agrees to indemnify the Company and hold the Company harmless Pram any [iabitity or expenses including but not limited to attorneys' fees and legal expenses Incurred by the Company in connection with and as a result of the Company being named as a defendant in any legal action brought to recover benefits due or otherwise connected with the Policyholder's Plan. The- Company does, however, at its own election and expense, have the right to participate with the Policyholder in the defense of or to appeal any action, suit or proceeding in which the Company may, in its own judgment, become involved. SECTION 13. TAXES..Policyholder shall hold the Company harmless from any state premium taxes the Company may incur with respect to claims Paid (as distinct from the premiums Paid to the Company by the Policyholder} under the Policyholder's Flan. The Policyholder agrees to reimburse the Company annually for such tax expenses, if any, as determined by the Company. Such reimbursement shall be payable by Pdlcyholder upon notification by Company to the Policyholder that reimbursement under this Section 13 is due.. SECTION 14. INSOLVENCY. In the event of the Policyholder's insolvency, all stop-loss insurance proceeds are to be Paid directly to the liquidator, receiver, trustee or statutory successor of the Policyholder without diminution because of the Policyholder's insolvency. SECTION 15. REINSTATEMENT. If this Policy has terminated:. for any reason anal the Policyholder requests that it be reinstated, the Company may, at its sole option, reinstate this Policy. The Policyholder agrees to furnish the Company with any forms, records car data the Company may require to evaluate the requested reinstatement. If this Policy has terminated and's a~bsequently reinstated, the Policyholder agrees to pay the Company any premiums due but unpaid on the date of termination and all premiums that would have been due had this Policy remained in effect continuousty and without interruption. SECTION 16. WAIVER. The waiver by either the Company or Policyholder of its right to enforce or require compliance with any provision of this Policy shall not constitute a waiver of any future right to enforce or require compliance with such provision. The Company's delay ar failure to exercise any right or enforce any obligation in this Folicy, and no course of dealings between the Company and Policyholder, shall operate as a waiver. SECTION 17. OFFSET. In all cases, the Company shall have the right to offset against payments due under the Policy any amount due the Company by the Policyholder (including, but not limited to, amounts previously reimbursed by the Company if the Policyholder's check or wire transfer for benefit payments has been returned or denied for insufficient funds). l2 SLF-2004-I&P-2/2005 SECTION 18. CONFORMITY WITH STATUES. Any provision of the policy that is not in conformity with applicable state laws} or other applicable law(s) shall not be rendered invalid, but shall be construed and applied as if it were in full compliance with the applicable state law(s) and other applicable law(s). `tirr+ IN WITNESS WHEREOF, Humana Insurance Company has caused this Agreement to be executed at its Home Office to take effect at 12:01 A.M., at the address of the Policyholder, on the date stated above. HUMANA INSURANCE COMPANY [MICHA.EL $. MCCALISTER, PRESIDENT] 13 SLP-2004-I&P-2/2005 HUl~/IANA~: l r f n ~r ~ 3 ~ when you need it most HUMANA NATIONAL TRANSPLANT NETWORK FACILITY LISTING fir' The following is a listing of Humana's national transplant network: Alfred t. DuPont Hospital for Wilmington Delaware Liver Children All Children's Hos ital St. Petersbur Florida Stem Cell, Heart Arkansas Children's Medical Little Rock Arkansas Stem Cell, Heart Center Banner Health Phoenix Arizona Stem Cell, Kidney, Pancreas, Pancreas/Kidne ,Liver Ba tist Memorial Mem his Tennessee Stem Cell, Heart Barnes-Jewish Hospital St. Louis Missouri Stem Cell, Heart, Heart/Lung, Lung, Kidney, Liver Ba for All Saints Fort Worth Texas Kidne ,Liver Baylor Medical Center Dallas Texas Stem Cell, Heart, Heart/Lung, Lung, Kidney, Pancreas/Kidney, Liver Broward General Medical Fort Lauderdale Florida Liver Center Carolinas Medical Center Charlotte North Carolina Stem Cell, Heart, Kidney, Pancreas, Pancreas/Kidne Children's Hos ital Denver Colorado Stem Cell, Heart, Kidne ,Liver Children's Hos ital New Orleans Louisiana Kidne Children's Hospital Medical Cincinnati Ohio Stem Cell, Heart, Kidney, Liver Center Children's Hospital of Orange County California Stem Cell Oran a Count Children's Hospital of Milwaukee Wisconsin Stem Cell, Heart, Kidney Wisconsin Children's Medical Center of Dallas Texas Stem Cell, Heart, Kidney Dallas Children's Memorial Chica o Illinois Stem Cell, Heart, Kidne ,Liver Children's Merc Kansas Cit Missouri Stem Cell, Kidne ,Liver Christ Hospital (Health Cincinnati Ohio Kidney Alliance Christus Santa Rosa San Antonio Texas Kidney, Pancreas, Pancreas/Kidne Clarian Health: Indiana Indianapolis Indiana Stem Cell, Kidney, Pancreas, University Hospital Pancreas/Kidney, Intestinal, Liver Clarian Health: Methodist Indianapolis Indiana Heart, Heart/Lung, Lung, Kidney Hos ital Clarian Health: Riley Indianapolis Indiana Stem Cell, Kidney Hos ital For Children Cook Children's Fort Worth Texas Stem Cell Dartmouth-Hitchcock Lebanon New Hampshire Stem Cell Medical Center Duke University Health Durham North Carolina Stem Cell, Heart, Heart/Lung, System Lung, Kidney, Pancreas/Kidney, Liver Kerr County HUMANA.~, ~; F~a ~ ~. 5<.c° when you need it most err , Emory University Hospital Atlanta Georgia Auto Islet Cell, Stem Cell, Heart, Kidney, Pancreas, Pancreas/Kidne Florida Hos ital Orlando Florida Stem Cell, Kidne Froedtert Memorial Lutheran Milwaukee Wisconsin Stem Cell, Kidney, Pancreas, Hos ital Pancreas/Kidne ,Liver H. Lee Moffitt Cancer Center Tama Florida Stem Cell Indiana Blood and Marrow Indiana olis Indiana Stem Cell Jackson Memorial Hospital Miami Florida Stem Cell, Heart, Lung, Kidney, Pancreas/Kidney, Intestinal, Liver Jewish Hospital Louisville Kentucky Heart, Heart/Lung, Lung, Kidne ,Pancreas/Kidne ,Liver Jewish Hospital (Health Cincinnati Ohio Stem Cell Alliance Johns Hopkins Baltimore Maryland Stem Cell, Heart, Heart/Lung, Lung, Kidney, Pancreas, Pancreas/Kidne Kosair Louisville Kentuck Stem Cell Le Bonheur Children's Memphis Tennessee Kidney Hos ital Loyola University Medical Chicago Illinois Stem Cell, Heart, Kidney, Center Pancreas/Kidne ,Liver Lutheran General Chica o Illinois Stem Cell M. D. Anderson Houston Texas Stem Cell Mayo Clinic Jacksonville Jacksonville Florida Heart, HeartlLung, Lung, Kidney, Pancreas, Pancreas/Kidne ,Liver Mayo Clinic Rochester Rochester Minnesota Stem Cell, Heart, Heart/Lung, Lun ,Kidne ,Liver Mayo Clinic Scottsdale Scottsdale Arizona Stem Cell, Heart, Kidney, Pancreas, Pancreas/Kidne ,Liver Medical Cit Dallas Dallas Texas Heart Memorial Hermann Houston Texas Kidne ,Liver Memorial Sloan Kettering New York New York Stem Cell Cancer Center Methodist Hospital Memphis Tennessee Kidney, Pancreas, Pancreas/Kidne ,Liver Methodist Hospital of Dallas Dallas Texas Kidney, Pancreas, Pancreas/Kidne ,Liver Methodist Specialty and San Antonio Texas Kidney, Pancreas, Trans lant Hos ital Pancreas/Kidne ,Liver Newark Beth Israel Medical Newark New Jersey Heart, Kidney, Pancreas, Center Pancreas/Kidne Northside Hospital and Blood Atlanta Georgia Stem Cell and Marrow Transplant Grou of Geor is Northwestern Memorial Chicago Illinois Stem Cell, Kidney, Pancreas, Hos ital Pancreas/Kidne ,Liver Ochsner Clinic Foundation New Orleans Louisiana Heart, Kidney, Pancreas/Kidney, Liver Piedmont Hos ital, Inc. Atlanta Geor is Kidne Kerr County HUl~/IANAk. r ~ ~ ~ ~ 9 ; a -when you need it most Porter Adventist Hospital Denver Colorado Kidney, Pancreas, Pancreas/Kidne Presbyterian St. Luke's Denver Colorado Stem Cell, Kidney, Pancreas, Pancreas/Kidne Research Medical Center Kansas City Missouri Kidney, Pancreas, Pancreas/Kidne Roswell Park Cancer Institute Buffalo New York Stem Cell Rush-Presbyterian - St. Chicago Illinois Stem Cell, Kidney, Pancreas, Luke's Medical Center Pancreas/Kidne ,Liver St. Barnabas Care Systems Livingston New Jersey Kidney, Pancreas, Pancreas/Kidne St. Jude Children's Research Memphis Tennessee Stem Cell Hos ital St. Louis Children's Hospital St. Louis Missouri Stem Cell, Heart, Heart/Lung, Lun ,Kidne ,Liver St. Luke's Episcopal (Texas Houston Texas Heart, Kidney, Liver Heart Institute St. Luke's Hospital Milwaukee Wisconsin Stem Cell, Heart, Kidney, Pancreas, Pancreas/Kidne St. Paul Universit Hos ital Dallas Texas Lun Seton Medical Center Austin Texas Heart Shands Hospital Gainesville Florida Stem Cell, Heart, Heart/Lung, Lung, Kidney, Pancreas, Pancreas/Kidne ,Liver Strong Memorial Hospital New York New York Stem Cell, Heart, Kidney, Pancreas, Pancreas/Kidne ,Liver Tampa General Tampa Florida Heart, Kidney, Pancreas, Pancreas/Kidne ,Liver Texas Children's Hospital of Houston Texas Stem Cell, Heart, Lung, Kidney, Houston Liver Texas Trans lant Institute San Antonio Texas Stem Cell The Methodist Hospital Houston Texas Stem Cell, Lung, Kidney, Pancreas, Pancreas/Kidne ,Liver The Nebraska Medical Center Omaha Nebraska Stem Cell, Kidney, Pancreas/Kidney, Intestinal, Liver Tulane University Hospital New Orleans Louisiana Kidney, Pancreas, and Clinic Pancreas/Kidne ,Liver Universit Hos ital San Antonio Texas Kidne ,Liver University Hospital (Health Cincinnati Ohio Heart, Auto Islet Cell, Kidney, Alliance Pancreas, Pancreas/Kidne ,Liver University Medical Center Tucson Arizona Stem Cell, Heart, Heart/Lung, Lun ,Kidne ,Pancreas/Kidne University of Alabama- Birmingham Alabama Kidney, Pancreas, Birmin ham Pancreas/Kidne ,Liver University of Arkansas Little Rock Arkansas Stem Cell, Kidney, Pancreas, Pancreas/Kidne ,Liver University of California Los Angeles California Stem Cell, Heart, Heart/Lung, Lun ,Intestinal, Liver University of California San San Diego California Stem Cell, Lung, Kidney, Liver Die o UCSD Kerr County HUl~/IANA~. .~ rr when you need it most .a . r .w ~1rr `~r+ University of California San San Francisco California Stem Cell, Heart, Lung, Kidney, Francisco Medical Center Pancreas, Pancreas/Kidney, UCSF Intestinal, Liver University of Chicago Chicago Illinois Stem Cell, Heart, Auto Islet Cell, Kidney, Pancreas, Pancreas/Kidne ,Liver University of Colorado Denver Colorado Stem Cell, Heart, Heart/Lung, Hospital Authority Lung, Kidney, Pancreas, Pancreas/Kidne ,Liver University of Illinois Chicago Illinois Stem Cell, Kidney, Pancreas, Pancreas/Kidney, Intestinal, Liver University of Iowa Hospital Iowa City Iowa Stem Cell, Heart, Kidney, and Clinics Pancreas, Pancreas/Kidne ,Liver University of Kentucky Lexington Kentucky Stem Cell, Lung, Kidney, Medical Center Pancreas, Pancreas/Kidne ,Liver University of North Carolina Chapel Hill North Carolina Stem Cell, Kidney, Liver Hos itals University of Tennessee, Memphis Tennessee Stem Cell Mem his University of Utah Hospitals Salt Lake City Utah Stem Cell, Heart and Clinics University of Wisconsin Madison Wisconsin Stem Cell, Heart, Heart/Lung, Hospital and Clinics Lung, Auto Islet Cell, Kidney, Pancreas, Pancreas/Kidne ,Liver Virginia Mason Medical Seattle Washington Kidney, Pancreas, Center Pancreas/Kidne Zale Lipshy University Dallas Texas Stem Cell Ho sital Kerr County Directors /Officers Report Humana Insurance Company ''`""~ Directors Michael B. McCallister Primary Address: Bruce J. Goodman Primary Address: +~rr+ ~rrr+ Jonathan T. Lord M.D. Primary Address: James E. Murray Primary Address: Officers Michael B. McCallister Primary Address: 500 West Main Street Louisville, KY 40202 500 West Main Street Louisville, KY 40202 500 West Main Street Louisville, KY 40202 500 West Main Street Louisville, KY 40202 President and Chief Executive Officer 500 West Main Street Louisville, KY 40202 Craig A. Drablos Regional Chief Executive Officer - FL/GA/LA/NC/SC Primary Address: 5401 W. Kennedy Boulevard, Suite 161 Tampa, FL 33609 Gary E. Goldstein M.D. Regional Chief Executive Officer -Texas/Arizona/Colorado Primary Address: 1221 S. Mopac Suite 200 Austin, TX 78746 Linda T. Hummel Market Chief Executive Officer -South Texas Primary Address: 8431 Fredericksburg Road, #570 San Antonio, TX 78229 Mark E. ICiffer D.O. Market Vice President/CMO -Senior Products/Phoenix Primary Address: 20860 N. Tatum Boulevard Phoenix, Arizona 85050 Steve A. Lee M.D. Market Vice President/CMO-Senior Products/Central Florida Primary Address: 135 Executive Circle Daytona Beach, Florida 32114-1180 Page 1 of 6 Directors /Officers Report Humana Insurance Company Kenneth S. Malcotmson Market Chief Executive Officer -Dallas/Austin/West Texas/Houston Primary Address: 3502 Edgewater Dallas, Texas 75205 James E. Murray Chief Operating Officer Primary Address: 500 West Main Street Louisville, KY 40202 Larry A. Rambo Regional Chief Executive Officer-Wisconsin/Michigan Primary Address: Two Riverwood Place, N19 W24133 Riverwood Drive Waukesha, WI 53188 Larry D. Savage Regional Chief Executive Officer - IN/KY/MO/OH/TN Primary Address: 655 Eden Park Drive, 1 North Cincinnati, OH 45202 Michael A. Seltzer Regional Chief Executive Officer -Senior Products/Florida Primary Address: 3501 S.W. ] 60th Avenue Miramar, FL 33027 Debra A. Smith Regional President -Senior Products/West Primary Address: 20860 N. Tatum Boulevard Phoenix, Arizona 85050 Leslie H. Andrews Primary Address: Jeffrey B. Bringardner Primary Address: J. Timothy Cappel Primary Address: Denise L. Christy Primary Address: Market President -Colorado 8400 E. Prentice Avenue #1400 Englewood, Colorado 80111 Market President -Kentucky 201 West Main Street Louisville, Kentucky 40202 Market President -Ohio 655 Eden Park Drive Cincinnati, Ohio 45202 Market President -Michigan 3150 Livernois, Suite 250 Troy, MI 48083 Colin P. D'Arcy Market President -South Florida Primary Address: 3501 S W 160th Avenue Miramar, Florida 33027 Page 2 of 6 err" ® .4~ ° CERTIFICATE OF LIABILITY INSURANCE DA ) 09/06/ 007 PRODUCER THIS CERTIFICATION IS ISSUED AS A MATTER OF INFORMATION Wfpis North America Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE , HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR PO Box 305191 N h i ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. v as lle, TN 37230-5191 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: Managed Car@ Ind@mnity, Inc. Humana Insurance Company INSURER B: 8431 Fredericksburg Road INSURER C: San Antonio, TX 78229 INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INS LTR ADD'L TYPE OF MiSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MMfOD/W POLICY EXPIRATION DATE MMIDDMI LIMITS GENERAL LUU30.1TY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY PREMISES Ee xcurence $ CLAIMS MADE ~ OCCUR MED EXP (Any one person) $ PERSONAL 6 ADV INJURY $ GENERAL AGGREGATE S GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OP AGG $ POLICY PE O LOC $ AUTOMOBILE LUIBILnY ANY AUTO COMBINED SINGLE LIMIT (Ea acddent) $ ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS BODILY INJURY NONAWNED AUTOS (Per acddeM) $ PROPERTY DAMAGE (PeracddeM) $ OARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESSAIMBREILA LIABILITY EACH OCCURRENCE $ OCCUR ~ CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKER8 COMPENSATION AND TORY LIMITS ER ~~ EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYE $ If yes, describe under SPECIAL PROVISIONS bebw E.L. DISEASE -POLICY LIMIT $ A OTHER Errors and Omissions P00015-1 01!01/2007 01/01!2008 1,000,000 per aggregate DESCRIPTION OF OPERATK)NS I LOCATIONS/ VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS This cert~cate is Issued to show insurance coverage for this RFP. CERTIFICATE HOLDER Kerr County 700 Main Kertviile, Texas 78028 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO 80 SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AOENTS OR REPRESENTATIVES. ~~ ~ ~ _ ~~ AUTHORIZED REPRESENTATIVE „ .~~ _ • 25 IMPORTANT If the cert~cate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statment on this certificate does not confer rights to the cert~cate holder in lieu of such endorsement(s). tf SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. x x 0 N ~' .-~ Z 0 ~~ W /~/^ W ~/ r~ / M N ~' ~ W J a a~ v' m a Q W W ~ O ~ ~ ~ z W ~ ~ ~ OC •^ V N ~ N ~ V ~ ~ _ ~ ~_ .. ~ U o o Z g o ~ ~; ~ o ~ m ~ ~ ~ ~ ~ ~ -~ a o Q ° ~ ~ Q ~ ~, ~` `'`rr~` fir" ~~`"~~'`~ Management Summary Company Nathe: XYZ12 6REIAIAPPt,.~Sg123455789Q Reporting Perfod: From 1210t12003 to 41!30/2004 Llnk'Numb~ar, 12345689 kAaricet: AI.L Grauta Number; ALt Prod, ASa PeerMarketRlame: 234*aS79~1234587890'1234 BasiS.` ENCffRRE~D PFatform: LV Medical Costs -Distribution by Provider The "Medical Costs -Distribution by Provider" Report directs your attention to costs that maybe increasing rapidly or are high in relation to your peer group. Generally, the distribution of costs by provider should be comparable from year to year and comparable to your peer group. X YZ12 GREEN APPLESan12 34567890 From 12/01/2003 12/01/2002 To 11/30/2004 11/30/2003 Difference PRIMARY CARE 7.0% 9.5% (2.6%) SPECIALIST 28.0% 21.0% 7.0% HOSPITAL 34.1 % 44.6% (10.5%) OTHER FACILITY 4.0% 3.1% 0.9% PHARMACY 14.0% 12.0% 2.0% OTHER* 12.9% 9.7% 3.2% 100.0% 100.0% From 12101!2003 to 11130/2t~04 XYZ12GREENAPPLES OF TPA 890 Peer Difference 7.0% 6.5% 0.5% 28.0% 24.8% 3.2% 34.1 % 38.9% (4.8%) 4.0% 5.2% (1.2%) 14.0% 16.9% (2.9%) 12.9% 7.7% 5.2% 100.0% 100.0% * Includes Other Providers, ProviderRisk-Sharing Surplus (Deficit), Other(Non-Hospital) costs and Completion Factoramount. Report Id: MS_MEDCSTPROVDIST1 20 Date: 03/01 /2005 ~NCVm~At*r:r~~ Management Summary Gip t~iarce XYZ12 GREENAPPCESg1234567&9Q Repart#ng Period: From 1210i12U03 to 1113t?CL004 ,, Link Nurser; 23455789 Mark+at~ A1:t. Group'Numi~r ALL Prvdock: 'ASCU Platform: I<,V Sasis: IHCLtRREI] ~~ Medical Costs -Distribution by Provider Company Medical Costs -Current Period SPECIALIST 28.0°~ :~ ~ ~~ ; ~~- HOSPITAL 34.1 °h d F{ 4_ r { l,; i ~'~ c., ~: ~ 'r: :_ ' ~I PRIMARY CARE 7.0% ~'~ PHARMACY 14.0% °'~ ` OTHER 12.9°k ~ OTHER FACILITY 4.0°r6 Company Medical Costs -Prior Period SPECIALIST 21.0°h ~ .,~z ""- ~f ~~' r..F~ ` {~ '"_ F ~ ''' '' j !! - HOSPITAL 44.6°k PRIMARY CARE 9.5°h -- I PHARMACY 12.0% -~ 1~`" OTHER FACILITY 3.1°h ~ OTHER 9.7°k Report Id: MS_MEDCSTPROVDIST2 30 Date: 03/01 /2005 xurv~g~*r~~ Management Summary 'Com~anY Name X12 GREENAPPLESg1234567890 Reporiii~g Perie-d: from 12/01/2003 to 11/30/2004 Ltnk Nut~en 12345&788 ~4arkeY. ALL Group Number: ALL Product; ASO PeerMarket Name: fi234567$90123458789{?123d BasLs: (tVCURREQ Phatfom-: LV Medical Costs -Distribution by Provider Peer Medical Costs -Current Period SPECIALIST 24.8°k HOSPITAL 38.9°r6 PRIMARY CARE 6.5% PHARMACY 16.9°~ OTHER 7.7% ~ OTHER FACILITY 5.2% Report Id: MS_MEDCSTPROVDIST3 35 Date: 03/01 /2005 ~+" HLJMf4:C'~t1.~ 5 :ompany N Group Number; A,Lt Peer,MAarkat Name: Ptatlnrm: LY Demographics Management Summary Z GRE~t+lAPRt~Sg1234557$~ Etaportit}g Period.£ The graph below depicts the score for your companys employees (insofar as they have selected Humana for their medical plan). The score is anactuarially-determined value that captures the effect of age and sexon expected medical costs. Younger members generally have lower medical costs than older members. Females generally have higher medical costs than males at ~rounger ages and lower medical costs than males at older ages. The score captures these complex relationships in a single value. You will wantto keep your companys score in mind as you compare your companys current period medical costs to the prior period and to your peer. Acceptable Caution Warning ~r+' Comparison to prior demographic risk score Comparison to peer for current period: Report Id: MS_DEMOG 40 Date: 03/01/2005 err ~~~~' Management Summary CvmpanY Name JCY~12 GF2F~NAPPLESg1234567890 Reporting Perloc~: From i2i01/2003 to 11i30t2004 twMic Number:'123456789 Marked ALL GrauP ir+lumbe~; A[.L Product: A30 Peer Martcet Name..1'234567890123+~587$9(1't234 Basis; ~+(CURREA Platform: LV Medical Costs -Per Member per Month The graph below depicts your companys medical costs e~ressed in dollars per member per month. The amounts shown are after the effect of membercopays and deductibles, Humana claims processing savings, and Humana contracting savings. Generally, your companys medical costs per member should be comparable to your peer group and the increase in your companys medical costs should be comparable to the increase for your peer group. Acceptable Comparison to prior period costs: The Company's medical costs were 17.6%greaterthan the priorperiod. The peer's medical costs were 25.6% greaterthan the prior period. Comparison to peer for current period: Warning Caution The Company's medical costs were 18.7% less than peer costs in the current period. Medical Cost per Member per Month Report Id: MS_MEDCSTRECAP 50 Date: 03!01 /2005 $173.58 $147.66 $213.48 $169.96 ~~~• Management Summary Company dame: XYZ12GitElWl~APPt.E5g1234567&~ F24porting Perlpd- Fram 12f01f2(t03 to 14I30i2004 ,, Link {Vumber> :423456789 Market: ALL Group Numtaer: A1L Product: ASO f~eerMarkettVame: .4234567$901234567$904234 Basis: iNCURR~t? Platform: LV Hospital and Other Facility Costs -Per Member per Month The graph below depicts your companys hospital and otherfacilitycosts e~ressed in dollars per member per month. Generally, your companys hospital and other facilitycosts should be comparable to your peer group and the change in your companys hospital and other facility costs should be comparable to the change in your peer group. Acceptable Caution ~r- `~w+ Comparison to prior period: ^ The Company's hospital /other facility costs were 6.2% less than the prior period. The peer's hospital /other facility costs were 15.3% greater than the prior period. Comparison to peer for current period: The Company's hospital /other facility costs were 29.7% less than peer costs in the current period. Warning Report Id: MS_MEDCSTHOS 60 Date: 03/01 /2005 >I~urv~gra~a Management Summary `Company Name XYZ12 GREEt1APPt.ESgi2345678~ iteporE3~ Period: Frain 1210ii2003 to 11130120t14 t_tnic Number: '12789 Nlarkst: Group`Number: ACt. Pr~ducl= ASS ..Peer Market Name: 12345t37$9012345b?8901234 Basis: iNGIll2RI4U Ptatfarm: LV In-Plan Utilization -Hospital and Other Facilities When your employees seek care at in-plan facilities, two good things happen: your employees receive the advantages of higher in-plan benefits and lower cost sharing, while you receive the contract savings Humana has negotiated with in-plan facilities. Generally, your companys in-plan utilization should be comparable to your peer group and to the prior year. Note, however, that the location of your employees' homes will influence in-plan utilization. Acceptable Comparison to prior period: The Company's in-plan utilization was 3.9% greater than the prior period. The peer's in-plan utilization was 5.4 % greater than the prior period. Comparison to peer for current period: Caution Warning ^ ~, r. The Company's in-plan utilization was 4.5% greater than peer utilization. `~rrr In-plan Utilization - Hospital 8~ Other Facilities 1zo. 100. _ ~~~~ ~ ~ ,._ ~ lid, 80. ~ ° a . ~.~ ~ x~~ 1~ ~ ~~~` 60.0 ~. ''' 3 z ; ~ .. N_. .. L A11. .,. H~ ..~ 40.0 err ~ `;: t,,,~ t£~s ~. s` '~ ~ ~h~' s~ 20. .~ , wf ~ ~,Yl~~ r ~ ~`1 a .F~'y~ _. 0. ... ~ __ ____ Company -Current Period ~ Company Prior Period Peer -Current Period Peer -Prior Period 96.9% 93.0% 92.4% 87.0% Report Id: MS_HOSUTIL 70 Date: 03/01 /2005 ~~ ~~~~` Management Summary Cumpan]r Names XY~'{2 GRPLESg234567890 ~po>~ Period:. From 12i01l2003 to 11 /3 012 4 04 :Link Number: 123456789 MarkeL• Al..t.. Q'aap +fttmtiar< ALL Product: A£~Q Peer Market Name: 12345$789012345&T$90123d Basis: H~tA Platform: LV Primary Care Provider Utilization The graph below depicts your companys primarycare provider utilization e~ressed in encounters per thousand members per month. Generally, your companys primarycare provider utilization should be comparable to your peer group, and the change in your companys utilization should be comparable to the change for your peer group. Comparison to prior period: Acceptable Caution Warning The Company's primary care provider utilization was 8.9% less than the prior period. The peer's primary care provider utilization was 54.7% greater than the prior period. Comparison to peer for current period: ^ ^ The Company's primary care provider utilization was 16.6% greater than fhe peer's in the current period. ~/ ~1n Report Id: MS PCPUTIL 90 Date: 03/01 /2005 ~'~-~~~~~` Management Summary Clergency Room Utilization The graph below depicts youremployees' utilization of hospital emergencyrooms, e~ressed in annual emergency room visits per thousand members per month. Generally, yourcompanys emergency room utilization should be comparable to your peer group and the change in emergency room utilization from year to year should be comparable to the change for your peer group. Note, however, that medical plan benefit design and demographic factors will influence your emergency room utilization. Acceptable Caution Warning Comparison to prior period: ^ ^ The Company's emergency room utilization was 0.0% greaterthan the prior period. The peer's emergency room utilization was 8.3% greater than the prior period. Comparison to peer for current period: ~ ^ The Company's emergency room utilization was 107.7% greater than the peer's in the current period. Report Id: MS EMERGUTIL 110 Date: 03/01 /2005 -~ H'r-J~~'`~"a~' Management Summary Ctmit~atty?s1a: X5~'~'f~~RETtAPP~~S9T2345&7$90 Rq~arEing Period: Frarn t2/01t2{183 to 9913f112QU4 Lind Mummer. 123~b789 11Aarket, All. Group Number; ALt; Product: ASO ~eBr AAarket Natn~: 1234~5S789Q12345678901234 BasFs. MIDURRED Platform: LV Ancillary Provider Utilization The graph below depicts your company's ancillary providerutiluation e~ressed in encounters per thousand members per month. Generally, your companys ancillary provider utilization should be comparable to your peer group, and the change in your company's utilization should be comparable to the change for your peer group. Acceptable Caution Warning Comparison to prior period: ^ The Company's ancillary provider utilization was 3.6% greater than the prior period. The peer's ancillary provider utilization was 49.1 % less than the prior period. Comparison to peer for current period: The Company's ancillary provider utilization was 34.9% greater than the peer's in the current period. `\r-° Report Id: MS ANCILUTIL 120 Date: 03/01 /2005 - ~~~~~° Management Summary Company INarrtaz X~fZ12 Cs PP1MFSg123it5fiT880 Reparttng Per1~c~,d: 1~r4m 12/4t12003 to 1 1 130/2 0 0 4 Ur>4c Number:: 123456189 1i11ar[cet: ALL Group t~mbe~: ALL Product, '~LSC? Phatform: t_v Basis: It+IGt.B'2f2~D Large Claims > $25,000 per Year Mostemployees typically have low medical costs during a year. However, a few employees may have very high costs. The incidence ofemployees with high claim costs can be a significantcontributorto your companys medical costs. The graph below summarizes the percentage ofyour companys total claim costs that were claims in excess of $25,000. For the average commercial group, we would effect members with claims over $25,000 to represent 25.8%oftotal claims. Your companys medical costs are favorablyimpacted ifyour large claims are less than the benchmark and adverselyimpacted if large claims are greaterthan the benchmark. Acceptable Caution Warning Increase in large claims (as a % of total claims) from prior period ® ^ ^ to current period: Large claims for the current year in comparison to benchmark: Note: Benchmark is notadjusted fordemographic mix orplan benefitdesign. Benchmark is valid only if the reporting period covers a 12 month period. Large Claims as a %of Total Claims Benchmark - 25.8 'if~r ~+"'' Report Id: MS_MEDCSTLGCLM 130 Date: 03/01 /2005 company-current reno° ~.ompany-rnor re~ivu 24.1 % 30.6% t N L G x, ~r gym, ""t st a 0 0 ~- 0 ..~ M O O Q N Q ~~~ ~ a ~..u~ Y ~ ~ ~~a`,a~ N V t L d a O W ~ h p'j m ~ ~ M ~ N ~ ao ~ !~ r ~Q O 8! 06 ti ~ tq W ,... ~ N ~„ M ~ N ~ ~ r m Gi .^ is ...~ ~~zA~ ~~~~o ~:~t'~aa i o C O O ~ to ~ ~ OD ~ t~t~ N9 ~ ~ N i ~ P v m m M M N ~ m Q m a ~ g w a F- ~ L o 0 0 0 0 0 0 0 y q~ c CO h N ~ 00 ~ N N N r M a o ooa ~ o00 ~~ 00 fp 1~ O M M O O ~ ~ M N N m to V' M N ` O O CD ~ 10 ~~ ~ ,~ O M O ~ N iG N Cp CO a m ~ a Q ~ m ~ N M O ~ M O O N r ~ M N r O~ ~ ~ ~ . 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