2017 Small Group Updates: Kentucky

Please see below for 2017 small group info, attachments and updates for Kentucky:

Humana

Anthem

United Healthcare

Other 2017 Kentucky market updates

  • 4 Tiered composite rates are back: Anthem offering composite rates down to 2 enrolled. Humana offering composites rates for group with 10+ eligible. UHC offering composite rates for group with 10+ enrolled.
  • Anthem Pharmacy update: R90 Pharmacy network is a maintenance network that will exist in addition to the National Plus Network (National Plus with R90). The R90 Network is made up of 1,145 Kentucky pharmacies that will allow members to receive a 90-day fill at a retail pharmacy for Tier 1, 2 and 3 at a copay for each 30 day supply. National Plus Network will continue to apply to all plans in 2017 (consists of 65,000 pharmacies).
  • Home Delivery Choice: All small groups in 2017 will have the Home Delivery Choice; giving members the option of filling via mail or retail. They must notify Express Scripts (ESI) of their choice before their third fill each year. Members will receive education material, see attachment: Home Delivery Plus Marketing Piece
  • Carriers will no longer write a husband and wife company.

Reminders

Participation:

  • Anthem: 50% of the net eligible
  • Humana: suggests 50% of the net eligible but not enforced
  • UHC: 50% of the total eligible

Dual Option:

  • Anthem: 5 enrolled for two plans with at least 2 enrolling in the 2nd plan. 10 enrolled for triple option with at least 2 enrolling in the other plans.
  • Humana: 5 enrolled for two plans with at least 1 enrolled in the 2nd plan.10 enrolled for triple option with at least 1 enrolled in the other plans
  • UHC: No requirements in the multi choice package. Small groups are allowed to offer as many plans as needed with not requirement of membership in a particular plan.

 

Please note that all new business should be submitted to your Agentlink representative rather than the carrier directly. Questions? Email tanya@agent-link.net.

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