RBG Health Net Updates

Rates:
4th quarter rates are available, RBG is ready to help you quote!

SBG HMO/HSP Rate Pass for Q4 2017!
Health Net is pleased to announce that through December 15, 2017, they are delivering a rate pass for all HMO/HSP medical plans to meet the need for new sales and to provide continued value for the future. The rates for Q3 will be sticking around for Q4!

Renewing groups with HMO/HSP plans will enjoy a lower overall renewal rate for 2017 with their cumulative rate changes for this year based on a three-quarter average rather than four. All new HMO/HSP business sold during October-December will receive Q3 rates.

Additionally, Health Net’s PPO/EPO insurance medical plan rates were given a 0.0% quarterly increase. While this is not a rate pass per se, you will find that most of the PPO/EPO Q4 rates are identical to Q3 rates.
 
Reduced Participation Promotion
Through 11.15.17, take advantage of Health Net’s reduced participation promotion

PPO Offering is Expanded

Health Net is expanding the off exchange PPO offering effective 12/01/2017. Five new plans are designed to better align with the marketplace. One plan, a full network Silver PPO HSA, will be available in all regions. The additional four plans (Gold Value, Silver Value, Silver HSA, and a Bronze HSA) will be offered in Health Net’s new PPO network, EnhancedCare. This network is a subset of Health Net’s full network and is available only in Regions 15 and 16.

  • Deductible waived for the PCP visit, however deductible does apply for specialist visit
  • Integrated medical and pharmacy deductibles and deductible is waived for generics
  • Pharmacy copays apply after deductible is met for s pecialty drugs

Advanced Choice Pharmacy Network
Health Net’s first tailored pharmacy network, which connects members to CVS, Walmart, Costco, Safeway, Vons, and other pharmacies. Walgreens is excluded.

Advanced Choice will be paired with a select number of California Small Business Group (SBG) plans and Individual & Family Plans (IFP). The effective dates are staggered as follows:


EnhancedCare PPO is Health Net’s newest medical plan innovation, which will be intr duced to you for your 2018 sales and renewals.

Members who have used a Walgreens pharmacy at any time in the past 12 months will receive a letter about the change 60 days in advance of the end of the year if they have an individual and family plan. Group members will receive the letter 60 days in advance of their employer’s renewal date. The first letters mail late July to members of groups renewing October 1. Sample member letter

Employer renewal packets for Q4 renewals will also highlight the change. Health Net is emphasizing that members continue to have access to CVS, Walmart, Costco, Safeway, Vons, and other pharmacies, and that only Walgreens is excluded.

Clear instructions on how to find a pharmacy will also be included in both member and group communications.

Effective October 1, to find a pharmacy in the Advanced Choice network:
Go to www.healthnet.com and choose Members, then Member Plan Information.

Under Select Your Plan Type, choose Group Plan.
Select Find a Pharmacy (at the bottom of the page).
Click on Advanced Choice Pharmacy Network.