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Health Care Reform

Update on the Humana Strategy for Non-Grandfathered Non-ACA compliant Individual Major Medical plans and the President's Transitional Announcement from March 2014.

As an agent for Humana, you and your clients are

very important to us. In order to provide you and our members the best service possible, we want to keep you informed about how the President’s announcement affects our Non-Grandfathered Non-ACA compliant Humana Individual Major Medical plans effective prior to January 1, 2014.

On March 5, 2014, President Obama announced an extended transitional policy that the states could adopt allowing Non-Grandfather Non-ACA compliant plans to continue through 2016. The states of Indiana, Kansas, Louisiana, North Carolina, Ohio, South Carolina, Tennessee, Texas, Utah and Wisconsin have adopted the extended transitional policy. Humana has also elected to adopt the extended transition policy in these states and will continue to allow members to keep their Non-Grandfathered Non-ACA policies under the defined rules provided by each state.

In the remaining states of Alabama, Arizona, Arkansas, Colorado, Florida, Georgia, Illinois, Kentucky, Michigan, Mississippi, Missouri, Nevada, Oklahoma, and Virginia, the state either did not adopt the extended transitional policy or Humana has elected not to continue coverage under the Non-Grandfathered Non-ACA policies. Additional communication regarding the specific strategy for these states will be provided in the upcoming months.

With the adoption of this extended transitional announcement, some members will begin to see 2014 renewals communicated to them. Below are details for the states that have adopted this transitional policy strategy and here is the renewal letter that is being sent out to the impacted members.

Below are some key points we are bringing to your attention so you can share important information with your clients:

  • In the states of Ohio and Kansas: All active Non-Grandfathered Non-ACA compliant Humana Individual Major Medical Plans with plan renewal dates between January 2014 and June 2014 will begin to renew on July 1, 2014. Remaining policies will renew starting July 1, 2014 on their normally scheduled renewal date.
  • In the states of North Carolina and South Carolina: All active Non-Grandfathered Non-ACA compliant Humana Individual Major Medical Plans will renew on October 1, 2014.
  • In the states of Indiana, Louisiana, Tennessee, Texas, Utah, and Wisconsin: All active Non-Grandfathered Non-ACA compliant Humana Individual Major Medical Plans will renew on December 1, 2014. Association policies in the state of Wisconsin are excluded from this renewal and will be terminated December 31, 2014. Separate communication will be forthcoming regarding association policies in the state of Wisconsin.
  • In the states of Indiana, Kansas, Louisiana, North Carolina, Ohio, South Carolina, Tennessee, Texas, Utah and Wisconsin, if a member wishes to renew their Non-Grandfathered Non-ACA compliant Humana Individual Major Medical Plan, all they need to do to continue their coverage is continue to pay their premiums and abide by the terms and agreements set forth in their policy/contract.
  • In the states of Kansas and Wisconsin: At any time, if a member elects to make any change to their current plan or benefits, they will no longer be eligible for coverage under the Transitional Policy. Plan changes include deductible and or copay changes, adding or removing a SAB (Supplemental Accident Benefit) Rider, or removing a Life Rider. The member would need to terminate their current Non Grandfathered Non ACA compliant policy and apply for an ACA compliant policy with a Qualified Life Event or through Open Enrollment.
  • At renewal in 2014, members will be eligible for a Special Enrollment Period (60 days prior to their renewal date and 60 days after their renewal date) during which members can choose a Humana ACA compliant policy or explore other options through Healthcare.gov. Members may also shop for ACA compliant coverage as part of the next Open Enrollment Period, which begins on November 15, 2014.

Please note that there is nothing you are required to do. This is for your information only. A link to the specific member letter is provided above. Additionally, you may reference Agent Workbench (AWB) for client-specific renewal information. Please reference the renewal tab to check when individual members are scheduled to renew in 2014.

Thank you for all you do for Humana. We look forward to continuing to serve you. If you have any questions, please contact your Humana sales representative.