Humana No Longer Offering Regional PPO?

Sep 7, 2016

  1. Gulfman
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    Anyone hear about this?

    What??? (i heard this from one of my FMO guys)

    HUMANA will continue to offer their regional ppo (which allows client to go out of network) but not through agents???. This is HUMANA's most popular plan but will not be paying any commissions on new business. (they will continue to pay comm.on old business but not new)

    However, HUMANA is going to be offering a their local ppo to agents and their clients?

    Anyone else hear this news?

    (BTW, this is Florida News, not sure if this is happening round the country or not)?

    Can anyone make sense out this?


    Thanks

    .
     
    Gulfman, Sep 7, 2016
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  2. axeman462
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    Yes, they are changing to the LPPO model. They are mailing to all the 074 clients in hopes they will call humana to roll over to the new LPPO. If they do, Humana promises, that the writing agent will remain AOR, and you will keep your commission etc.. They say they are here to help you.
     
  3. Gulfman
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    Thanks axe,

    Does that mean they are dis-continuing the Regional plan altogether?

    .
    .
     
    Gulfman, Sep 7, 2016
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  4. FLM2
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    The 074 plan is most likely being terminated but we will have to wait until Humana rolls out the plans to be sure.

    Axe, that's an interesting piece of information about the mapping-even though I trust Humana to keep us as AOR if they have it in writing or present it as fact during the roll out presentations I will still make sure that is the case before the end of AEP.
     
    FLM2, Sep 7, 2016
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  5. axeman462
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    They said they are keeping the 074 plan for 2017. But I suspect that 074 will be terminated in 2018. During the Humana Rollout in Orlando, they seemed pretty adamant about rolling all the 074 business into the new LPPOs, which is why I suspect 2017 will be a transition year for them, and in 2018 074 will be gone.

    They did say several times during the rollout that the writing agent will remain AOR. And that we dont have to do anything, they will take care of the rollover. Naturally, there was about 165 questions about that when they said it, so they basically just repeated themselves 166 times.

    the new LPPO (at least here in central FL) is very competitive, and according to them, has the exact same network as the 074. I don't see any reason not to roll the business.
     
  6. SecureHealth1
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    I thought the LPPO has a monthly premium? Maybe I'm mistaken.
     
  7. axeman462
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    The new LPPOs here in central FL, do not. Maybe in other parts of the state they do, that i am not sure.
    The PFFS plan has a premium, and i believe one of the RPPOs do
     
  8. FLM2
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    That's good to hear-for the most part my clients on the 074 have been really happy with the plan and there isn't much reason to actively switch them if it will still be in place in 2017.
     
    FLM2, Sep 7, 2016
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  9. axeman462
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    if you dont to roll them yourself, just be prepared for the phone call you will get from your clients in regards to the mailers Humana is goin to send out.
    First one will be sent on Oct 1, second on Oct 15, third will be on Nov 1. The mailers will say "call humana to switch to the new LPPO in your area"
     
  10. vic120
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    I don't know about retaining AOR Maybe.

    I know I have had issues when the esig is not going through and the call Tech support number listed they take AOR, I had this happen with long time client switching to humana couldn't do sig till day I was at a funeral. Humana doesn't care what the issue is they take AOR. I have lost few PDP's because something just wasnt clicking Just could get the log in all Info verified

    One time I called and told the girl we clarified everything a dozen times but log in just not working. She said have client call, I said I will not get credit, She said do you care about client or my commission.

    I just came to accept that Humana will take a portion of my buis I send them and they are a necessary evil
     
    vic120, Sep 7, 2016
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