LOUISVILLE, Ky.-- In response to the growing need for affordable health benefit plans for small and mid-size employers, Humana Inc. today launched SmartExpress, a family of health insurance plans designed for businesses with 2 to 299 employees that want to better control and predict health care costs while giving their employees expanded benefits and a better health plan experience.
Small businesses have struggled in recent years with providing any health insurance coverage -- let alone a plan that offers multiple options -- due to rapidly rising costs. The Kaiser Family Foundation's 2004 Annual Employer Health Benefits Survey revealed that the number of small employers (companies with 3-199 workers) offering health coverage declined from 68 percent to 63 percent over the last three years, leaving an additional five million workers without health insurance.
"While all employers have seen double-digit premium increases during the past four years, small business owners have been hardest hit," said Mike McCallister, Humana's president and chief executive officer. "Many have had to drop coverage altogether, contributing to the rise in the number of the uninsured. Others have been unable to offer their employees the broader choice of coverage, newer health care savings plans or consumer education programs that larger employers are able to provide. SmartExpress allows us to bring some of those same programs to smaller employers in a unique 'total solution' package that addresses both cost and experience."
SmartExpress includes up to three plan options, including a choice of two Preferred Provider Organization (PPO) health plans, one with co-payments and the other with benefits based on deductibles. The program also offers a personal care account (PCA), an optional prepaid savings account that employers can provide in addition to PPO coverage. The PCA is funded by the employers and accompanies a high-deductible PPO from which employees can access their funds with the HumanaAccess VISA card to pay for their deductible. Humana's PCA is a qualified Health Reimbursement Arrangement (HRA) under the Internal Revenue Service tax code.
The choice of benefit plans gives employees greater flexibility in deciding what level of benefit best meets their health care and budgetary needs while allowing employers to benefit from the tax-advantaged status of their contributions to employee PCAs. Should employees use the entire prepaid amount and their plan deductible and then need coverage for emergency hospitalizations or services, a traditional PPO plan is activated to provide further coverage. Unused PCA funds can be rolled over to the following year if the employee purchases a similar PCA plan from Humana.
SmartExpress also provides prescription drug coverage, either RxImpact which provides access to four broad drug classes at different levels of discounted pricing, or Rx4, a four-tiered selection of drugs that provides options among brand-name and generic drugs. Under RxImpact, the employer chooses the allowance amounts for each category of drugs based on their company's benefit contribution strategy. This is advantageous for companies because what they pay per prescription is a fixed amount. The employee then has the option of what drug she and her doctor believe addresses her medical
and financial needs.
