PayerIQ
Production
Back to universe
Tier 2TNNational

Humana

Active pursuit — access summits + value dossier

Composite
61.9
Rank
#106
Members
34.9M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
56
+14.0
Lives
20%
81
+16.2
Geography
20%
100
+20.0
Restrictions
15%
10
+1.5
Relationship
10%
46
+4.6
Financials
10%
56
+5.6
Composite Score61.9
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 14.0 + 16.2 + 20.0 + 1.5 + 4.6 + 5.6 = 61.9
Intelligence

Qualitative intelligence

Members
34.9M
Drug spend
$11.7B
Formulary
3-tier
PA / RA level
Low
Biosimilar policy
Preferred biosimilar policy
Avg reimbursement
94 days
Strategic notes

Data-sharing agreement pending legal review; delay contracting until finalized

Peer set

Closest peers in National

MetroPlus Health Plan
KY · Tier 2
62.0
+0.1
WellCare Health Plans
CO · Tier 2
61.8
-0.1
Independence Blue Cross Managed Care
NE · Tier 2
62.1
+0.2
Dean Health Plan
CA · Tier 2
61.6
-0.3
Humana Insurance
NC · Tier 2
61.1
-0.8
Playbook · Tier 2

Engagement timeline

Week 1
Senior medical director engagement
Week 3
Formulary review submission
Quarterly
Account QBR + utilization review