Claims cost control.

SmartResults Helps Control Claims Costs

SmartResults is a three-year partnered approach among Humana, brokers, employers, and employees designed to deliver healthier outcomes and long-term claims cost control.

Humana offers a "guaranteed solution," for 300+ self-funded groups looking for healthier outcomes and long-term control of their claims cost trend. We’re so confident that SmartResults works we'll put 40% of our benefit-administration fees at risk.

SmartResults: A Smart Choice for Self-Funded Companies

SmartResults is a bold new solution to employers' healthcare cost dilemma. SmartResults is a three-year partnered approach among Humana, brokers, employers, and employees designed to deliver healthier outcomes and long-term claims cost control.

SmartResults is currently available to self-funded accounts with 300 or more employees. Humana will put 40% of its benefit-administration fees at risk based on service and claims cost. As part of the program, Humana predicts the claims cost target to be no more than 6 to 9%, well below the 11% national average increase in health insurance premiums over the past five years.

How SmartResults Works

SmartResults offers a long-term approach that:

  • Integrates with an employer's existing plan design
  • Improves health outcomes through a proven combination of engagement and intervention strategies
  • Streamlines administration using its comprehensive turn-key solution for programs, reporting, and service

Humana's Financial Guarantee

Humana is so confident SmartResults will work for you that we offer these financial guarantees. We will:

  • Put 40% of Humana's base administrative fees at risk based on per member per month total claims cost and service performance
  • Set second - and third-year trend factors as low as 6%1
  • Cap employer's administrative fee for years two and three
  • Set aggregate stop-loss trend target as low as 6%2

1 As low as 6 percent with 100 percent fulfillment of employer commitment.
2Stop loss-guarantees are not available in Florida at this time.

SmartResults: Three Simple Steps to Lock in Future Savings

SmartResults makes it easy for employers and employees. With SmartResults:

  • Employers choose the strategy they and their employees are comfortable with
  • Employers and employees work together for employee engagement and improved health outcomes
  • Employers work with their broker and Humana to monitor their progress using a "scorecard" and reinforcing action plans as needed

Humana Works to Ensure SmartResults Success

Humana supports employers every step of the way with:

  • Strategic relationship team to consult, develop, and oversee action plan tailored to company's needs
  • Employee communications support with newsletters and other communication vehicles
  • Tracking results with the SmartResults Scorecard through quarterly reviews and plan adjustments as needed

Help your clients get SmartResults

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