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Humana: Members
built 479 days ago
The Humana Choice PPO plans all place an emphasis on health education and wellness programs, and include preventive screening benefits, routine physical exams, and immunizations. All members receive a free membership in the SilverSneakers(R) Fitness Program, which is a specially designed exercise program that features low-impact group aerobics, seated exercise classes and free gym membership at participating health clubs.
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Humana will establish a fund of $3.5 million that will be divided pro rata among the class members that submit valid claims. The amount will be determined by the total dollar value of claims and the number of class members that have submitted claims. In order to obtain compensation, providers must submit a claim form with an estimate of the total billed charges, before the Jan. 13, 2007, deadline. As part of the settlement, doctors of chiropractic will be permitted to assign 100 or 50 percent of the recovery to the American Chiropractic Association (ACA), if they wish to do so.
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Humana ... explains what actually happened during the incident in question: "...during a 1987 telephone conversation, she [Dr. Peeno] was asked by a hospital doctor whether the member's plan covered heart transplants. Since the member's employer had not purchased heart transplant coverage, she correctly answered 'no.' The member was discharged from the hospital and lived at least another two years. He was no longer covered by Humana after March of 1988."
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Pretax earnings from Humana's commercial segment rose slightly to $54.4 million in the fourth quarter, compared with $53.9 million a year ago. Commercial segment medical membership grew by 167,800, or 5 percent, to 3.45 million at the end of 2007. Nearly 96,000 of the membership increase stemmed from an acquisition completed in the fourth quarter.
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Humana fell $2.86 to $78.98 at 4:02 p.m. in New York Stock Exchange composite trading after earlier touching $76.30. Last year, Humana climbed 36 percent, the strongest performance in the six-member S&P 500 Managed Health Care Index, which posted a 16 percent gain.
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Humana and UnitedHealth said benefits will remain the same and there will be no interruption in members' health care coverage. Humana said it will fund the deal with cash and debt, and doesn't expect the transaction to impact 2008 earnings guidance.
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