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Example Of Humana's Smart Explanation Of Benefits

Humana Inc. (NYSE: HUM) recently received accolades from DALBAR, a third-party evaluator in the financial-services industry, for being one of few innovative health insurers to “buck the tradition of incomprehensible customer communications.”

DALBAR analyzed the usefulness of insurers’ Explanation of Benefits (EOBs) statements, which insurers send to customers explaining how their medical claims are processed. Out of 34 leading insurers, including the federal government’s Medicare program, 68 percent of the documents received a failing score.

Humana was one of only three insurers to receive the designation of “excellent” for the clarity, content and design of its “Smart EOB.” Humana also received special “best-in-class” recognition for its personalized member messaging, and high marks for including charts and graphics to help people understand how their benefits work, draw conclusions, and take appropriate action.

“Humana’s EOB is a leader in personalized messaging and visual creativity,” said Kathleen Whalen, managing director at DALBAR. “The company has gone above and beyond the required content to offer health tips, coupons and other imaginatively designed educational tools based on patient diagnosis, gender and age. The features are clearly designed to positively influence their members’ lives and help them manage their health.”

“We value each interaction with our members and take pride in ongoing efforts to improve each touchpoint – working to improve health literacy and member understanding,” said Bruce J. Goodman, Humana’s chief service and information officer. “Our EOBs and statements are an important part of transparency to customers, so they can understand the total cost of health care. Humana’s traditional EOB has evolved, based on the needs of our members, into a health-management tool, the Smart EOB. These are also offered electronically to our members at,” Goodman said.

About DALBAR, Inc.

DALBAR, Inc. has been a leading third-party evaluator in the financial-services industry since 1976. With offices in the U.S., Canada and London, DALBAR develops standards for – and provides research, ratings and rankings of – the many factors that influence a company’s overall customer-service experience. Such factors include print communications, public Web sites and proprietary portals, interactive voice response units, call centers, and financial-adviser services.

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