Sample certificates for employer coverage

By-state coverage information and plan provisions for employer-sponsored medical plans

If you are not currently enrolled in a Humana medical plan, but are considering enrolling, use the links below to see samples of details regarding services covered or excluded in employer-sponsored plans in your state, as well as terms and provisions of the health plan named in the certificate.

NOTE: Based upon final plan selection or other factors, the actual certificate issued for a specific plan may vary from the samples provided below. Should any details conflict between the samples provided and the certificate that is issued, defer to the issued certificate.

Sample certificates by state

Sample certificates by state
State	Sample plan certificate
Florida	FL CR (1-50) HMO FL CR (1-50) Indemnity FL CR (1-50) POS FL CR (1-50) PPO FL NCR (51+) HMO FL NCR (51+) Indemnity FL NCR (51+) POS FL NCR (51+) PPO
Georgia	GA CR (1-50) HMO GA CR (1-50) Indemnity GA CR (1-50) POS GA CR (1-50) PPO GA NCR (51+) HMO GA NCR (51+) Indemnity GA NCR (51+) POS GA NCR (51+) PPO
Illinois	IL CR (1-50) HMO IL CR (1-50) Indemnity IL CR (1-50) POS IL CR (1-50) PPO IL NCR (51+) HMO IL NCR (51+) Indemnity IL NCR (51+) POS IL NCR (51+) PPO
Indiana	IN CR (1-50) POS IN CR (1-50) PPO
Louisiana	LA CR (1-50) HMO LA CR (1-50) Indemnity LA CR (1-50) POS LA CR (1-50) PPO LA NCR (51+) HMO LA NCR (51+) Indemnity LA NCR (51+) POS LA NCR (51+) PPO
Nevada	NV NCR (51+) Indemnity NV NCR (51+) POS NV NCR (51+) PPO
Ohio	OH CR (1-50) HMO OH CR (1-50) Indemnity OH CR (1-50) POS OH CR (1-50) PPO OH NCR (51+) HMO OH NCR (51+) Indemnity OH NCR (51+) POS OH NCR (51+) PPO
Tennessee	TN CR (1-50) Indemnity TN CR (1-50) PPO TN NCR (51+) Indemnity TN NCR (51+) PPO
Texas	TX CR (1-50) HMO TX CR (1-50) Indemnity TX CR (1-50) POS TX CR (1-50) PPO TX NCR (51+) HMO TX NCR (51+) Indemnity TX NCR (51+) POS TX NCR (51+) PPO

“Humana” is the brand name for plans, products and services provided by one or more of the subsidiaries and affiliate companies of Humana Inc. (“Humana Entities”). Plans, products, and services are solely and only provided by one or more Humana Entities specified on the plan, product, or service contract, not Humana Inc. Not all plans, products, and services are available in each state.

Humana legal entities that offer, underwrite, administer or insure insurance products and services.

Medical Plans

Humana group medical plans are offered by Humana Medical Plan, Inc., Humana Employers Health Plan of Georgia, Inc., Humana Health Plan, Inc., Humana Health Benefit Plan of Louisiana, Inc., Humana Health Plan of Ohio, Inc., Humana Health Plans of Puerto Rico, Inc. License # 00235-0008, Humana Wisconsin Health Organization Insurance Corporation, or Humana Health Plan of Texas, Inc., or insured by Humana Health Insurance Company of Florida, Inc., Humana Health Plan, Inc., Humana Health Benefit Plan of Louisiana, Inc., Humana Insurance Company, Humana Insurance Company of Kentucky, Humana Insurance of Puerto Rico, Inc. License # 00187-0009, or administered by Humana Insurance Company or Humana Health Plan, Inc.

For Arizona Residents: Offered by Humana Health Plan, Inc. or insured by Humana Insurance Company. Administered by Humana Insurance Company.

Individual Dental and Vision Plans

Humana Individual dental and vision plans are insured or offered by Humana Insurance Company, HumanaDental Insurance Company, Humana Insurance Company of New York, The Dental Concern, Inc., CompBenefits Insurance Company, CompBenefits Company, CompBenefits Dental, Inc., Humana Employers Health Plan of Georgia, Inc. or Humana Health Benefit Plan of Louisiana, Inc. Discount plans offered by HumanaDental Insurance Company or Humana Insurance Company. For Arizona residents: Insured by Humana Insurance Company. For New Mexico residents: Insured by Humana Insurance Company. For Texas residents: Insured or offered by Humana Insurance Company, HumanaDental Insurance Company or DentiCare, Inc (d/b/a Compbenefits).

Group Dental and Vision Plans (Insurance through your employer)

Humana group dental plans are insured, offered, or administered by Humana Insurance Company, HumanaDental Insurance Company, Humana Insurance Company of New York, The Dental Concern, Inc., Humana Medical Plan of Utah, Humana Health Benefit Plan of Louisiana, Inc., CompBenefits Company, Humana Employers Health Plan of Georgia, Inc. or DentiCare, Inc. (d/b/a CompBenefits). In Arizona, group dental plans insured by Humana Insurance Company. In New Mexico, group dental plans insured by Humana Insurance Company.

Humana group vision plans are offered by Humana Insurance Company, Humana Health Benefit Plan of Louisiana, Inc., Humana Insurance Company of New York, or The Dental Concern, Inc. In Arizona, group vision plans insured by Humana Insurance Company. In New Mexico, group vision plans insured by Humana Insurance Company.

Group Life Insurance Plans (Insurance through your employer)

Humana group life plans are insured by Humana Insurance Company or Humana Insurance Company of Kentucky. In Arizona, group life plans insured by Humana Insurance Company. In New Mexico, group life plans insured by Humana Insurance Company.

Group Disability Income Insurance Plans (Insurance through your employer)

Humana group disability income plans are insured by Humana Insurance Company or Humana Insurance Company of Kentucky.

Limitations and exclusions

This communication provides a general description of certain identified insurance or non-insurance benefits provided under one or more of our health benefit plans. Our health benefit plans have exclusions and limitations and terms under which the coverage may be continued in force or discontinued. For costs and complete details of the coverage, refer to the plan document or call or write your Humana insurance agent or the company. In the event of any disagreement between this communication and the plan document, the plan document will control.

Statements in languages other than English contained in the advertisement do not necessarily reflect the exact contents of the policy written in English, because of possible linguistic differences. In the event of a dispute, the policy as written in English is considered the controlling authority.

Individual applications are subject to eligibility requirements.

Before applying for group coverage, please refer to the pre-enrollment disclosures for a description of plan provisions which may exclude, limit, reduce, modify or terminate your coverage. View plan provisions or check with your sales representative.

For group plans, please refer to your Benefit Plan Document (Certificate of Coverage/Insurance or Summary Plan Description/Administrative Services Only) for more information on the company providing your benefits.

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