Smart results

Healthier outcomes through SmartResults

Humana offers a "guaranteed solution,”1 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 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

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

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