Humana simplifies underwriting requirements
Getting a new business underwritten quote for 10-99 Fully Insured or Level Funded Premium just got easier. Beginning 7/1/18 for 9/1/18effective dates, we are launching the Humana Risk Analytic Engine (HRAE). For new medical small business groups 10-99 enrolled and less than 100-eligible employees, Humana only requires two pieces of information to underwrite using the new HRAE:

1.A completed member census

2.Group’s most current renewal letter

For groups with less than 10 enrolled, Humana will continue requiring member census, employee applications, and current carrier renewal.
Humana has eliminated the following requirements for up to 100 enrolled:
  • Employee applications (applications still required for less than 10 enrolled)
  • Current carrier bill
  • Risk Assessment Form (RAF)
  • Current carrier claim reporting for currently Self-Funded and TXHB2015 groups
New! Member Census Revisions for 10-99 enrolled:
Along with the introduction of HRAE and the need for fewer documents, the member census has been revised for 10-99 enrolled groups. In addition to the current quote requirements, to obtain an underwritten quote, the following census information is needed for employee, spouse/partner and dependent(s):
  • First/Last Name
  • Date of Birth
  • Home Zip Code
For more details on how to obtain a 2-99 Fully Insured or Level Funded Premium underwritten quote, please read the New Medical Quoting and Underwriting Requirements for 2-99.
What is HRAE? A learning model designed to predict underlying risk and future claims cost. The model is built on data derived from multiple sources that include, but are not limited to, medical and pharmacy claims data. The HRAE allows us to reduce our underwriting requirements, and gives us an accurate view of future risk without the use of burdensome health questions. For more information, please read the FAQ.
We are overhauling our small business practices from start to finish. To view a few of these highlights that you will begin to experience in 2018, please read YOU talked, we listened.
If you have any additional questions, contact your Humana sales representative.