Company Information

mportant Phone Numbers:

Billing & Enrollment: 800-992-2551 (for billing, premium, and new enrollment issues)

Customer Service: 800-457-4708 (for all types of member inquiries)

Application Fax: 877-889-9936

Agent Support:

When contacting Humana’s Agent Support, please be sure to provide the MGA name and account number, your first and last name, your contact information, and the reason you’re calling.

Phone: 800-309-3163

  • Option 1: Certification/Recertification Questions
  • Option 3: Enrollment Questions
  • Option 4: Check Status of Enrollment
  • Option 6: Order Sales
  • Option 7: Commissions

Email: agentsupport@humana.com

Hours: Monday through Friday from 8 a.m. to 9 p.m. EST

To Check the Status of a Client:

In order to check the status of a client, email agentRSOS@humana.com. An email can contain either Medicare or Individual based concerns about a member’s policy. policy. Do not send Medicare and individual concerns in the same email. We recommend you use the following template for these emails.

Standard subject heading: [Member Last Name], [Member First Name] [Medicare OR Humana Individual]

Body text: Should include the information below.

  • Agent Name (required)
  • Agent SAN (required)
  • Member ID # (required)
  • Member Name in question (required)
  • Reference # (if applicable)
  • Summary of issue (required)

Certification

2016 Certification

Agents no longer need to send any documentation about their FFM certification to Humana. Humana will capture their certification from a file issued by CMS. Right now the file is made available every three weeks, so agents will need to be patient. Humana will notify agents we’ve received their FFM certification information from CMS via email.

Products:

  • Medicare Advantage
  • Part D

Certification Start Date:

  • 2016 MAPD Recertification: Live (July 21, 2015)
  • 2016 MAPD Initial Certification: Live (August 3, 2015)
  • 2016 PDP Initial Certification and Recertification: Live (August 11, 2015)

Is AHIP Required?

Yes

What is the Cost of AHIP?

If agents complete AHIP certification through the Humana Agent Portal, it costs $125. This is a discount of $50 off the standard $175 fee.

Can AHIP Be Used for Compliance Credit?

Yes

Does Carrier Reimburse for AHIP?

Yes. Humana will reimburse for 2016 AHIP certification if agents do both of the following:

  • Complete AHIP and Humana Recertification courses through the Humana
    Agent Portal
  • Successfully enroll 10 MA OR 40 PDP with January 1, 2016 effective
    members*

*Members must be accredited with CMS by March 4, 2016.

MAPD Initial Certification Online Delegated Pre-Work:

  • AHIP Training and Test
  • Ethics and Compliance
  • Humana Products and Processes

Note: The AHIP courses must be taken before starting the Humana modules.

MAPD Recertification Compliance/Product Modules:

  • AHIP course (includes Fraud, Waste, and Abuse and CMS General Compliance training)
  • Code of Ethics
  • Safeguarding Protected Information (PI)
  • Humana Product Information

Note: The AHIP courses must be taken before starting the Humana modules. Agents who have completed the MAPD initial certification or recertification are not required to complete the PDP-only training.

PDP-Only Certification:

  • AHIP course (includes Fraud, Waste, and Abuse and CMS General Compliance training)
  • Code of Ethics
  • Safeguarding Protected Information (PI)
  • Humana Product Information

Note: The AHIP courses must be taken before starting the Humana modules. Agents who have completed the MAPD initial certification or recertification are not required to complete the PDP-only training.

Is Face-to-Face Training Required?

Face-to-Face training is required for NEW AGENTS ONLY. New agents must attend a one-day face-to-face Medicare Advantage classroom training session after they complete the online Delegated Pre-work.

Will Certifying for 2016 Allow Me to Sell 2015 Products?

Yes

Are Additional Steps Required for Those Certifying for the First Time Versus Those Who Are Recertifying?

Yes. Agents certifying with Humana for the first-time must complete the online Delegated MAPD Pre-work courses and attend a one-day face-to-face Medicare Advantage classroom training session.

Those who are recertifying will only be required to open and read modules 4 and 5. However, it is strongly recommended agents review all five modules since agents will be tested on all five modules.

How Do I Retrieve My Username and Password?

Click on the “Contact Agent Support” link located in the “Agent Sign In” box. Then, click on the “Forgot your username?” or “Forgot your password?” links located under the username and password text fields in the green banner.

If you continue to experience technical problems, you can contact Humana’s Agent Support Unit (ASU) at agentsupport@humana.com or 800-309-3163. They can be reached Monday through Friday from 8 a.m. to 9 p.m. EST.

Who Do I Contact at Carrier to Confirm Certification?

You can contact Humana’s Agent Support Unit (ASU) at agentsupport@humana.com or 800-309-3163. They can be reached Monday through Friday from 8 a.m. 9 p.m. EST.

Certification Web Link:

https://www.humana.com/agent/

Navigation to Certification Portal and Training Courses:

1) Go to https://www.humana.com/agent/.

2) Enter your username and password and click “Sign In.”

3) Click the “Education tab” or the “Agent Education” link.

4) Scroll down to the “MarketPoint Learning Portal” section and click the “MarketPoint Learning Point.”

5) Click the “My Assignments” link.

6) Locate the title of the assignment you must take, and click the “Enroll” link next to it.

7) Click the “Enrollment Complete — Return to Home Page” link.

8) Look for the assignment under your “Current Enrollments” section, and click “GO” to launch the desired course.

9) Begin the course by clicking the link to the first module. When you complete an open module, click the “Return” button. Then, select the next module.

Note: You must complete the modules in order.

Submitting Business

Announcements:

The new version of iMAPA for iPads is NOW AVAILABLE for download in Apple’s App Store. Make sure you update your software to iOS 9, so that you can access this excellent application!

Important Information:

  • All enrollment applications should be submitted within 24 HOURS of obtaining the beneficiary signature. Agents can fax the app or use the special Humana UPS overnight account. ALL enrollment applications must be received within three days of the signature date to meet CMS processing guidelines.
    • Agents not adhering to this requirement will be notified 95% of the time .
    • Agents not consistently meeting this regulation will be subject to corrective action.
  • All face-to-face meetings with Medicare beneficiaries require a Scope of Appointment (SOA) IN ADVANCE of the meeting.
    • Humana will accept either a paper SOA form or an agent can use the Interactive Voice Response (IVR) system.
    • In cases where a Medicare beneficiary is seeking a “next day” appointment, please use the IVR system to obtain the SOA in advance.
  • Do not destroy, replace, or rewrite (etc.) any application unless someone in the Humana Enrollment Department specifically tells you to do so. If given these type of instructions, document when and who gave you the instructions.
  • Applications should first be sent directly to Humana (not MGA).

Reminders for Applications:

  • A full enrollment application should be used. When in doubt, use the FULL Enrollment Application.
  • Abbreviated enrollment forms can only be used when the beneficiary is already a Humana member and the contract number is NOT changing.
  • Use black ink – print clearly and legibly on paper applications
  • Double check that the agent SAN number is written clearly on page 7 of the paper application.
  • Use the correct Group ID and Benefit Numbers on page 7 of the paper application job aid.
  • Use the correct Plan Option on page 1 of the paper application. This is shown on the Summary of Benefits.
  • Double check for the most common errors that cause applications to be “pending”
    • Invalid birth date
    • Sex type not selected
    • P.O. Box listed as the address or address incorrect for service area
    • Member signature missing
    • Invalid Medicare ID
  • Do not rewrite paper applications that are signed by a beneficiary and “received” by an agent/Humana in the MAPA/FastApp.

How to Submit Business with Humana:

Paper Applications

  • Fax: 877-889-9936 (preferred method)
    • Please include completed application and SOA
    • SOA must be agreed to and documented either by IVR (866-945-4471) or on paper prior to the appointment taking place, unless it is not feasible.
    • The form must be a CMS-approved form. DO NOT modify (shrink or enlarge) the Humana form in any way.
    • Delegate HFPP Enrollment Fax: 800-589-9309
  • Overnight Mail:
    • Humana Medicare Enrollment
      2432 Fortune Dr.
      Lexington, KY 40509
    • Humana has established an easy-to-use UPS Overnight Account Process that you can begin using today. Effective December 1, all labels must be created from https://cvshipping.ups.com.
      • Use the UPS letter size package to ship enrollments to Humana (ACS).
      • If you have several enrollment applications ready, please ship more than one enrollment application in each overnight shipment.

Online Enrollments

  • MAPA – Medicare Advantage Paperless Application for laptop computers
    • Usable with a digital signature pad or electronic signature process (an auto-generated email to the client)
    • Does not require live internet connectivity—applications can be sent to Humana later in the day from home or the office
  • iMAPA – Medicare Advantage Paperless Application for iPads
    • Usable with a digital signature pad or electronic signature process (an auto-generated email to the client)
    • Does not require live internet connectivity—applications can be sent to Humana later in the day from home or the office
  • FastAPP – Electronic method through the Agent Portal
    • Requires internet connectivity
    • The member must have an email address so that enrollment can be verified. Please be aware that the email address provided during the FastAPP method CANNOT be the agent’s email address. It must be the enrollee’s email address in order to be a compliant enrollment. For more information, please click here.

Commissions

Agent Certification Needed to Maintain Commissions

The Centers for Medicare and Medicaid Services (CMS) requires that agents certify on a yearly basis in order to represent and enroll beneficiaries in Medicare Advantage (MA) and Prescription Drug Plans (PDP). In addition, CMS has recently revised regulation linking annual certification testing to an agent’s ability to receive renewal commissions.

Humana is extending a special invitation to any agent who has enrolled Medicare members with Humana and has let their certification lapse to recertify so that they may retain their renewal commissions. This special recertification is open for agents. Agents must have a passing score of 85 percent.

General Information:

Commissions are paid twice each month (on the 15th and the last day of the month). They are based on the enrollments entered into the system that have passed compliance credits for licensing, appointment, and certification. They do not include enrollments that have a PENDING status. Chargebacks will occur for any enrollment that is NOT confirmed by CMS as an eligible member.

Initial enrollments (first-time eligibles for Medicare and any beneficiary moving from original Medicare)

  • First installment will be disbursed at enrollment submission.
  • Second installment will be disbursed upon CMS Validation.
  • Commissions for members who disenroll within their first three effective months will result in a full chargeback of commissions.
  • Commission for members who disenroll after the first three effective months will be charged back on a prorated basis.
  • All agents must be certified to receive commission payments.

Supplies

How to Order Supplies for Humana:

Agents can order supplies in Humana’s Marketing Resource Center. For help navigating the site, download the Quick Start User Guide for Humana’s Marketing Resource Center.

Here is the link you can use to order materials:http://printandfulfillment.adp.com/HumanaDelegatedAgents/AgentOffice.aspx. Your username and password are your SAN #.

Items available for you to order:

  • Enrollment Book, which includes:
    • Scope of Appointment
    • Verification form
    • Business reply envelope
    • Full Application
    • Carbonless receipt
  • Combined Enrollment Book-Pilot, which states only:
    • Summary of Benefits
    • Plan Rating
    • Benefit at a Glance
  • SNP forms-SNP plans only
  • PFFS Leaflet -PFFS plans only
  • Other items that can be ordered separately:
    • POPs
    • Flyers
    • Apps
    • SOAs
    • Sales Presentations
    • Physician Finder Tool

Contact for Inquiries Regarding Ordering Supplies:

For help ordering supplies, you can contact Humana’s Agent Support team at 800-309-3163 or agentsupport@humana.com. They are available Monday through Friday from 8 a.m. to 9 p.m. EST.

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