Commercial HCR Overview Alignment Template

Understanding Humanas basic commercial pharmacy products provides a platform for success in future, more specific training for new hires
to the Pharmacy Benefits Team. Most new team members come from other departments within the organization and have little or no
pharmacy exposure. Others come from outside of the organization and have no knowledge of Humanas pharmacy products. Without this
knowledge, a new hire may become lost or frustrated when learning future content, and may need re-training. This course will provide new
employees with the foundation knowledge of Humanas commercial pharmacy product, and will be delivered face-to-face during the first week
of hire.

Terminal Objective: Define basic pharmacy terms and basic Humana terminology and acronyms
Enabling Objectives Assessment Idea
Absorb Activity Do Activity
Connect Activity
Knowledge
check:
Define basic
Pick one
pharmacy benefits
questions
terms such as
Choose the best
brand, generic,
definition for the
deductible,
Provide job aids
term presented
maximum out of
Quiz activity (pick
Presentation
(HCR Appendix, Hum-opocket, and high
one/matching list
and reading
Pedia and Glossarydeductible health
questions) and
(Explore HumAcronyms List and
plan.
crossword puzzle
o-Pedia)
Terminology)
Define basic
Matching list
question- Match
Humana terms and
the Humana
acronyms such as
term/acronym with
Rx3, Rx4, Rx5, DED
its definition
and MOP.

Terminal Objective: List and describe each pharmacy plan offered by Humana and define how the tier levels are
grouped in each product
Enabling Objectives
Assessment Idea
Absorb
Do Activity
Connect Activity
Activity
Knowledge check:
Explain the
Presentation Case study
Discussion compare your
Sequence
difference between
Decide which plan
suggestion with other
question

List
the
each of the copay
would be best for
students and explain why
copay plans on a
plans (Rx3, Rx4, and
an employer based you chose this plan
scale ranging from
Rx5).
on given criteria

Define the tier

groupings of each
pharmacy product.

Describe clearly how

a plan with a
pharmacy deductible
functions differently
than a plan without a
deductible.

Compare and contrast

the catastrophic plan
design, aggregate high
deductible health plan
design, and embedded

most cost effective

for the member, to
most cost effective
for the insurer
Knowledge check:
Matching list
questions For
each plan, match
the tier level with its
description
Knowledge check:
Sequence
question Put
descriptions of paid
claims outcomes in
chronological order
on labeled timeline
(Ex member pays
100% of claim cost
would be sequenced
on the deductible
phase portion of the
timeline)

Group activity &

discussion create a
chart and list the
similarities and

Quiz (Sequence
question)
Presentation

During the presentation, fill in the definitions of

the tier groupings on a worksheet. Use this as a
job aid.
Do: Quiz (Matching list questions)

Presentation
and Humana
Video (How
do
deductibles
and copays
work?)

Quiz (Sequence
question)

Presentation
and Humana
Video (What
are HDHPs?)

Discussion describe the

type of plan you
participated in with your
past employer (or parents)

Group activity & discussion create a chart

and list the similarities and differences between
the three plan designs

high deductible health

plan design.

differences between the

three plan designs

Terminal Objective: Identify each of the plans offered on a benefits spreadsheet.

Enabling
Assessment Idea
Absorb Activity
Do Activity
Connect Activity
Objectives
Activity (Scavenger
Locate the
Hunt) Learner will chose
sections of a
a plan on the benefits
benefits
Activity (Scavenger Hunt) Learner will chose a
plan on the benefits spreadsheet, and find the
spreadsheet that spreadsheet, and list the
Reading
following:
following:
are relevant to
(benefits
Plan type

Plan
type
pharmacy.
spreadsheet)
Copays/coinsurance
Copays/coinsurance
Identify the
and
presentation
Deductible amount
Deductible amount (if any)
separate plans
(if any)
Maximum out of pocket amount
outlined on a
Maximum out of
benefits
pocket amount
spreadsheet.