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Rate Update

Health Net reports a statewide average increase of 3.3% for PPO plans and a decrease of -0.2% for HMO and HSP plans.

Product Update

Health Net is reconfiguring their product portfolios to better align with the marketplace. Their Full HMO, WholeCare, SmartCare, and Salud HMO networks are removing HMO Gold $50 and adding a new metal level plan, HMO Silver $40. They are also adding a Bronze plan to their CommunityCare network, CommunityCare HMO Bronze $45.

All HSP plans will remain, but Health Net will discontinue EPO plans, Gold 80 EPO 1300/20 and Silver 70 EPO 2000/20.

EnhancedCare PPO is a new limited PPO network with plans designed after their Full Network PPO Value and HSA plans. The addition of CommunityCare Bronze $45 and EnhancedCare PPO plans in Regions 15 and 16 suggests that Health Net is targeting their growth and retention efforts in Los Angeles, giving consumers a diversified product offering and more price points.  EnhancedCare PPOs will be available on and off-exchange in Q1. Both CommunityCare HMO and EnhancedCare PPO plans include Teladoc at $0 copay for non-HDHP plans; standard rates apply for HDHP plans.

Health Net is also launching a new Full Network Silver PPO HSA statewide in December 2017.  All PPO HSA plans in Q4 will be renamed “HDHP,” or “high deductible health plan” in Q1 2018.

Underwriting Update

Health Net is rolling out several underwriting promotions. Please click here for their underwriting promotions and t-table comparisons of active plans in Q1 2018.

Their new promotion, ID Card Express for New Sales, guarantees that if a group does not receive their ID cards 10 days after their status has been “active,” Health Net will pay the group $250. A few things to note:

  • “Active status” is not when Underwriting approves final rates; rather, it is the date when Health Net’s Membership Team activates the group.
  • Health Net’s Underwriting and Membership departments will pay close attention to turnaround times (TAT). Health Net will initiate payment if they do not meet their TAT.
  • This promotion is subject to clean and complete applications.
  • Click here to learn about ID Card Express for New Sales.
Enhanced Choice Active Plans/Promos in Q1 2018 EnhancedCare PPO Choice
Full HMO, WholeCare, SmartCare, Salud
x Platinum $10, $20 x
x Gold $30, $40 x
x Silver $40 (new) x
CommunityCare HMO
x Gold $5 x
x Silver $20 x
x Bronze $45 (new) x
x All HSP Plans x
Full Network PPO
x Full Network PPO Platinum
x Full Network PPO Gold
x Full Network PPO Silver
x Full Network PPO Bronze x
x Full Network PPO Gold Value
x Full Network PPO Silver Value
x Full Network PPO Bronze HDHP  x
x Full Network Silver HDHP (new)
EnhancedCare PPO (new)
EnhancedCare PPO Gold Value x
EnhancedCare PPO Silver Value x
EnhancedCare PPO Silver HDHP x
EnhancedCare PPO Bronze HDHP x
35% Relaxed Promotion for Groups 6+ (Dec. 1 – 15; and Jan. 1 – 15) x
Prior Carrier Bill in Liue of DE-9C for Groups 6+ ( Dec. 1 – Jan. 15) x
No DE-9C or Prior Carrier Bill for Groups 10+ (Dec. 1 – Jan. 15) x
x ID Card Express for New Sales for All Small Groups ( Dec. – Jan. Effective Dates) x