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Committee selects Humana option for retiree Medicare Advantage; plan includes enhanced ancillary benefits and Retiree First support
Summary
Rutherford County’s Insurance Committee approved Humana Option 3 for the county Medicare Advantage retiree plan at $220.28 per member per month, citing cost and added benefits such as dental and hearing aid allowances and a partnership opportunity with Retiree First to support beneficiaries during transition.
Rutherford County’s Insurance Committee voted May 1 to award retiree Medicare Advantage coverage to Humana (recommended Option 3, the enhanced plan) at a per‑member rate of $220.28 per month, following a public bid and multi‑factor evaluation that compared Humana with Cigna (now divested to Healthcare Services Corporation, HCSC).
Marissa Combs, the benefits consultant who led the procurement, told the committee the county ran a public bid and narrowed finalists to Humana and Cigna; Cigna’s Medicare Advantage book of business had been acquired by Healthcare Services Corporation (HCSC) effective in March, and the transaction transferred people, systems and experience, she said. "That transaction was effective in March," she said, and staff emphasized continuity of many service personnel despite the ownership change.
The committee’s recommendation favored Humana’s enhanced option because it was about $30 cheaper per member per month in the final bids and included additional plan design improvements for retirees. Notable plan design changes cited in the presentation included a dental benefit with a $250 combined maximum benefit per year, hearing aid coverage increased to $2,000 per year, prescription plan design that places some Tier 1 and Tier 2 drugs at $0 copay under Humana’s design and a higher maximum out‑of‑pocket (MOOP) that moves from $1,250 to $2,100 under Humana compared with the incumbent design. The presenter explained that while MOOP increases, other design changes and the $0 copay on many prescriptions could offset costs for many members depending on individual utilization.
Procurement staff also discussed network and pharmacy implications: carriers reported two pharmacies where continuity could be an issue (WellCare Pharmacy in Murfreesboro and Nipper RX in Charlestown, Indiana), but presenters noted providers can still bill Medicare even if not in a carrier network. The bid packet included carrier responses on network composition and drug formularies; the committee was shown aggregated claims analysis but staff said they did not have member‑level prescription impact during the meeting.
The committee discussed the option to include Retiree First, a vendor that supports Medicare Advantage enrollment and ongoing retiree service. Marissa Combs said both carriers priced an option that included Retiree First and that Humana "wholeheartedly embraced" the partner, which staff said could improve customer service and Medicare star ratings.
Risk Management recommended Humana Option 3 at $220.28 per member per month; the committee moved and approved the recommendation by roll call vote. Staff will implement the plan change, provide enrollment communications to retirees, and coordinate the transition with the carrier and any chosen retiree support partner.
