Humana sends out various types of letters relating to a producer’s contract and appointment status. Whether it’s an appointment termination, a contract termination, or an appointment fee reimbursement request, we’re here to help you understand exactly what each means and how it could affect your business.
Each year, Humana applies the Minimum Business Production (MBP) standards found in the appendix of the PPP. The appendix states:
“Should an Agent fail to meet at least one of these Minimum Business Production standards and choose not to reimburse Humana for all renewal appointment fees paid by Humana on their behalf, the Agent’s contract will be either terminated or placed in an inactive status under an Inactive Status Amendment.”
The producers identified as not having fulfilled the MBP standards after 12 months (from contract date) may receive a reimbursement request. As indicated in the letter, producers will have 45 days from the letter date to submit payment. If the payment is not received in a timely manner, the producer will be placed in an inactive status.
No solicitation or negotiation of new business is allowed while a producer is in inactive status. It is important to note that commission payments will cease immediately when a producer is put in inactive status. The inactive status will allow for continued renewals from non-Medicare products.
If a producer misses the 45-day window to reimburse Humana for their appointment fees, they may still submit payment in check form but will need to re-contract through the Producer Onboarding tool after the payment is processed.
Reimbursement checks can be made payable to Humana and mailed to:
Humana Attn: Finance—Agency Management
1100 Employers Blvd.
Green Bay, WI 54344
Minimum Business Requirements Humana outlines minimum business requirements in the appendix of our Producer Partnership Plan (PPP). (See Minimum Production Standards)
Producers identified as not fulfilling the minimum business requirements will be invoiced for any renewal appointment fees paid by Humana in the Appointment Fee Reimbursement (AFR) process.
As part of cost-reducing efforts, Humana periodically reviews Agent’s production to ensure we are maintaining an efficient distribution channel.
If the review finds the producer has no in-force business for longer than 12 months, they may be notified either by email or letter of a change in their overall contracting status (pending termination). Partners should also receive a listing prior to the termination. If, after the termination date, Agents wish to re-establish their Humana Producer Contract, they should contact their upline for assistance.
Please note that Humana may seek reimbursement for appointment fees that it incurs when any terminated appointments are re-established.
Reminder: Humana has no requirements for the Principle Officers to be contracted if they are not producing.
Look for “Humana Appointment Notification” in email subject line agents receive.
Humana periodically reviews state appointments, and we are required to notify producers per state regulations if we terminate appointments for lack of production. Appointment changes do not impact current books of business or the Agent’s state license status, and the Humana Producer Contract remains active. No action on the producer’s part is needed to maintain the appointments required for the current or future business. As long as the producer is properly licensed in the state where they are selling and maintains an active Producer Contract, Humana will automatically appoint them for the specific appointment that is necessary.
Sample Appointment Notification:
For the state of West Virginia, the following appointment(s) are terminated; however, if you do sell, solicit, negotiate, be a writing agent, agent of record or in any manner or capacity represent these entities, you will be automatically re-appointed as long as you are properly licensed in the state and have an active producer contract at the time:
HUMANA INSURANCE COMPANY
This appointment termination is in accordance to your Humana Producer Contract. State regulations require that we notify you to return or destroy all copies of confidential information immediately for HUMANA INSURANCE COMPANY for the state of WEST VIRGINIA. If at any point you become re-appointed for this legal entity, you will regain access to these materials.
Every now and then Humana will send a contract amendment notice showing a list of state agents can conduct business in. Occasionally, there will be states agents can conduct business but not appear. This is because Humana does not require an appointment in this state.
This is an amendment of your Humana Producer Contract (“Contract”) pursuant to Section 15.13(A) of the Contract.
WHEREAS, the Company desires to restrict Producer’s authorization to Sell Products in states that require appointment to those Products offered or insured by the legal entities in the states listed in this Amendment;
NOW, THEREFORE, the Company hereby amends the Contract as follows: