Humana 2015 Annual Report Download - page 17

9
Group Segment Products
This segment is comprised of products sold to employer groups including medical and supplemental benefit plans
as well as health and wellness products as described in the discussion that follows. The following table presents our
premiums and services revenue for the Group segment by product for the year ended December 31, 2015:
Group
Segment
Premiums and
Services Revenue
Percent of
Consolidated
Premiums and
Services Revenue
(dollars in millions)
External Revenue:
Premiums:
Fully-insured commercial group $ 5,493 10.2%
Group specialty 1,055 2.0%
Military services 21 —%
Total premiums 6,569 12.2%
Services 698 1.3%
Total premiums and services revenue $ 7,267 13.5%
Intersegment services revenue:
Wellness $ 93 n/a
Total intersegment services revenue $ 93
n/a – not applicable
Group Commercial Coverage
Our commercial products sold to employer groups include a broad spectrum of major medical benefits with multiple
in-network coinsurance levels and annual deductible choices that employers of all sizes can offer to their employees
on either a fully-insured, through HMO, PPO, or POS plans, or self-funded basis. Our plans integrate clinical programs,
plan designs, communication tools, and spending accounts. We participate in the Federal Employee Health Benefits
Program, or FEHBP, primarily with our HMO offering in certain markets. FEHBP is the government’s health insurance
program for Federal employees, retirees, former employees, family members, and spouses. As with our individual
commercial products, the employer group offerings include HumanaVitality®, our wellness and loyalty reward program.
Our administrative services only, or ASO, products are offered to employers who self-insure their employee health
plans. We receive fees to provide administrative services which generally include the processing of claims, offering
access to our provider networks and clinical programs, and responding to customer service inquiries from members of
self-funded employers. These products may include all of the same benefit and product design characteristics of our
fully-insured HMO, PPO, or POS products described previously. Under ASO contracts, self-funded employers generally
retain the risk of financing substantially all of the cost of health benefits. However, more than half of our ASO customers
purchase stop loss insurance coverage from us to cover catastrophic claims or to limit aggregate annual costs.
As with individual commercial policies, employers can customize their offerings with optional benefits such as
dental, vision, life, and a portfolio of voluntary benefit products.
Military Services
Under our TRICARE South Region contract with the United States Department of Defense, or DoD, we provide
administrative services to arrange health care services for the dependents of active duty military personnel and for
retired military personnel and their dependents. We have participated in the TRICARE program since 1996 under
contracts with the DoD. On April 1, 2012, we began delivering services under our current TRICARE South Region
contract that the Defense Health Agency, or DHA (formerly known as the TRICARE Management Activity), awarded
to us on February 25, 2011. Under the current contract, we provide administrative services while the federal government