Select POS Maximum Allowable Amount (MAA) Mailing

California Brokers – SBG/LG Amendment to EOCs – Maximum Allowable Amount Update

Effective September 15, 2016

Approximately 7,000 members will receive the following letter/amendment.

Maximum Allowable Amount is the amount on which Health Net bases its reimbursement for Covered Services and Supplies received from an Out-of-Network Provider, which may be less than the amount billed for those services and supplies. Health Net calculates Maximum Allowable Amount as the lesser of the amount billed by the Out-of-Network Provider or the amount determined as set forth herein. Maximum Allowable Amount is not the amount that Health Net pays for a Covered Service; the actual payment will be reduced by applicable Coinsurance, Copayments, Deductibles and other applicable amounts set forth in this Evidence of Coverage.

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Arizona Large Group New Sale HSA Broker Bonus Program Continues!

The chance for cash rewards has been extended through the end of 2016! The more HSA business you sell, the more you earn. It’s that simple!

What’s new?

  • You must sell new HSA 101+ group plans with effective dates of 4/1/16 – 12/31/16

What continues?

  • 75% of the group must enroll into an HSA medical plan
  • You earn a $50 bonus for each member enrolled in a newly sold HSA plan

For more details about this bonus program and how it can boost your potential to generate cash rewards, contact your Health Net sales consultant today!

Special Enrollment Periods (SEPs): What You Need to Know

Western Region Brokers

Special Enrollment Period content has been added to the Broker and Employer ACA Reform Guide portals for IFP/SBG/Large. There you will find effective date determination and documentation on the following topics:

  • Life Changing Qualifying Events (QEs) – Mini Open Enrollment
  • Loss of Minimum Essential Coverage (MEC)
  • Additional Qualifying Events

We’re here for you
For more details on this and any other ACA-related topic, please log onto the Health Care Reform Guide at

Extension on the Relaxed Participation Requirements for California Small Group!

California Brokers

Hiring tips that ensure successHealth Net is extending its’ relaxed participation requirements for California Small Group sales for month of December. Groups of 5+ can have a participation rate as low as 25%!

Click here to check out the full details.

For more information, please contact your Health Net Representative.

December 2015 Renewals and Plan Closures for Small Business Groups

California Small Business Group Plans


broker_hubIt’s time. The mass migration to ACA-compliant plans is set for December 1, 2015, as small business groups renew following the extra year of transitional relief. Along with this change comes Small Group 2.0! Clients renewing December 1 are the first to have access to our new simplified Small Group 2.0 portfolio!

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51–100 Transition – or Not – to SBG

Working TogetherJanuary 1, 2016, is the date the Affordable Care Act provision redefining “small group” as 2–100 employees is slated to take effect. Whether or not that reclassification actually happens is a topic hotly debated. Either way, you and your clients can count on Health Net.

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Special Enrollment Period Extended to Off-Exchange Plans

SEPCalifornia Individual & Family Plans: Tax Season SEP Extended to Off-Exchange Plans

The tax season Special Enrollment Period we told you about in early March has been extended, in California, to off-exchange plans. This means your clients can apply directly through Health Net of California, Inc. or Health Net Life Insurance Company (Health Net). Clients can enroll through April 30, 2015.

The tax season Special Enrollment Period (SEP) is a limited enrollment opportunity for consumers who did not realize there was a tax penalty in 2014 or learned they may face a penalty in 2015. This SEP runs through April 30, 2015.

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Marketplace Update: Tax Season SEP

Western Region Brokers

The state and federally facilitated marketplaces are offering a Special Enrollment Period (SEP) for people who did not know or understand that there is a tax penalty for not having health insurance. In California, the SEP began February 23, 2015, and continues through April 30, 2015. In states like Arizona where the marketplace is federally facilitated, the SEP is March 15, 2015, through April 30, 2015.

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51–100 Choice Portfolio Renewals are Coming Soon!

Sharing her ideas with the teamThe new 51–100 Choice portfolio from Health Net has set the market on fire! Featuring competitive plan flexibility and pricing structure, this first-on-the-market offering is giving employers numerous plan choices tailored to groups of 51–100 eligible employees. As promised, renewals for this outstanding sales solution will be available Thursday, 5/22/14, starting with 8/1/14 renewal effective date.

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