A managed care company says it is now confident enough about its medical cost forecasts that it may give some group customers refunds if the forecasts are far off the mark.
Humana Inc., Louisville, Ky., is offering the refund feature with its new SmartResults, which provides extra analytical and care management features for sponsors of self-funded plans with 300 or more employers that agree to 3-year contracts.
Humana will cap its plan administrative fees for the life of the contract, the company says.
In addition, the SmartResults plans will offer an employer the chance to choose an annual claims-cost trend target ranging from 6% to 9%, Humana says.
To qualify for the refund program, the employer must provide information Humana needs to help provide wellness and care management services and help the employer meet the cost trend goals, Humana says.
Employers that participate fully in the program and fail to meet the cost trend goals can get refunds of up to 40% of Humana’s administrative fees, Humana says.