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Humana debuts PPO plans for small businesses

Humana Inc. is offering a new line of Preferred Provider Organization (PPO) health insurance plans designed for small businesses.


plans feature a four-tier pharmacy benefit and preventive care coverage.

HumanaPPO plans encourage members to seek care within a specific network of preferred providers, while allowing them to visit out-of-network providers if they so choose. Humana launched the plans in Wisconsin where the HMO's small business division is located. The division serves more than 1.4 million members in more than 20 states and sells products and services underwritten by Humana's Employers Health Insurance Co. Humana, headquartered in Louisville, Ky., plans to sell HumanaPPO to businesses that employ between two and 99 people.

HumanaPPO plans feature a four-tier pharmacy benefit and preventive care coverage, including immunizations, mammographies, and Pap smears. The pharmacy benefit allows members to choose between generic or brand name drugs, with the amount members have to pay varying by tier. After a doctor writes a prescription for a member, there is no need to obtain further authorization to fill the prescription, except for a few selected drugs, such as those used in gene therapy and some self-administered injectable drugs — not including insulin or epinephrine.

Business owners have told HMOs that the rising cost of health insurance is a major concern for them, says Todd Zacharias, the chief financial officer for Humana's small business division. "We've designed a solution that's responsibly priced and yet preserves choice for plans members," he says.

HumanaPPO members can check claims, review benefits, and locate doctors online at Humana's Web site.

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