More Value for Your Large Group Clients

Update from Larry Tallman: Western Region Brokers

With a new year out in front of us, I want to take a moment to tell you about some exciting benefits changes taking place in our Large Group regions. We’ve designed these updates to create more value for you and your clients, making this the perfect time to take a fresh look at Health Net!

All updates are effective as of January 1, 2016.

West Region

New federal rule
Health and Human Services Department (HHS) Notice of Benefit of Payment Parameters (NBPP) – Annual Cost Sharing / Out-of-Pocket (OOP) Limits Rules

This is a federal rule affecting Health Net’s western region states (Arizona, California, Oregon and Washington). The rule mandates that out-of-pocket (OOP) limits applicable to single coverage also apply to individuals covered in a family policy. In other words, the OOP limit for individual coverage applies to all enrollees, regardless of enrollment in family coverage.

Health Net has identified plans in our portfolios impacted by this mandate and made the necessary updates to comply with these regulations.



  • Three new High Deductible Health Plans have been added to both Oregon and Washington Large Group standard plan portfolios. These plans have a 0% coinsurance for contracted providers once the deductible has been met.
  • Our High Deductible Health Plans in Oregon have been updated to include chiropractic, acupuncture, naturopathic and massage therapy benefits to the core medical plans, giving members more ways to protect their health.
  • We’ve updated our Oregon Large Group product portfolios to include state legislative updates regarding telemedical services. (These services include a growing variety of applications and services using two-way video, email, smart phones, wireless tools and other forms of telecommunications technology.)



Enhanced Health Savings Account (HSA) and Wellness Program

HSAs offer employees a way to help control their own health care costs. And when paired with a wellness program, employees can feel more confident about their health care decisions. Our Enhanced HSA and Wellness Program is now available to a larger population of new groups 101-299, and boosts plan value with the following features:

  • Healthy Returns program – For qualified groups of 101+, Health Net will issue a renewal premium credit based on the group’s year-end claims experience.
  • Renewal rate cap – For qualified new groups enrolled in any of the Enhanced HSA Program HSA plans, Health Net will cap their first year renewal rate for the HSA plan.
  • Funding for wellness programs – Wellness options are good for people and good for business. To help employers enrolled in the new Enhanced HSA, Health Net will provide funding and support for various wellness programs.



Refreshed Enhanced Choice and Starting Line-Up portfolios

We understand that for large groups, choice and affordability are top priorities. Both our Enhanced Choice and Starting Line-Up portfolios continue to offer our current suite of products and tailored networks plans:

  • SmartCare
  • Salud
  • ExcelCare
  • HSA-compatible PPO • HMO
  • EOA
  • PPO

Plus, plans in these portfolios come with core essentials to complement medical coverage, including: chiropractic, dental, vision, employee assistance program and life coverage.

Enhanced Choice refresh – To help you generate more sales to groups 101-500, we’ve made our popular and proven Enhanced Choice more robust with new marketable plan choices, including:

  • Greater choice of low-cost plans for employer groups.
  • More dental and vision options (more information coming soon!)
  • Our ExcelCare tailored network is now tied to HMO plans in the portfolio.


Starting Line-Up – We’ve streamlined our attractive Starting Line-Up portfolio for 2016 to include our most affordable plan solutions for employer groups.

Have you heard about our SmartCare expansion?

New for 2016, Health Net has introduced the SmartCare portfolio of plans and popular tailored network into 14 new counties. This expansion takes SmartCare from seven Southern and Northern California counties to 21 statewide. And this means more opportunities for you to hit the ground running in 2016 with SmartCare’s whole-health option, predictable costs and user-friendly plan designs.


We’re here to support your sales with marketing materials for each offering. Go to > select your region > Forms and Brochures > Large Group to view and download these materials.

We remain committed to the health and success of your business. Join us as we continue to define our place in the future of health care. Health Net is providing the way forward! As always, if you have any questions or would like more information, please call me or your contact your local sales consultant.


Larry Tallman
Chief Sales Officer, Western Region
Large Group and Major Accounts
(818) 676-6543

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