Maximum Allowable Amount (MAA) Mailings

Oregon/Washington Brokers

Health Net Health Plan of Oregon, Inc. – Washington Group Contract Update

Health Net will be issuing a mailing to Washington group policyholders to inform them of updates to the Maximum Allowable Amount definition for Out-of-Network covered services. The revisions are fully described in the attached “Contract Update Endorsement” documents but are summarized here for your reference. There are two versions of the updates, one for 2015 contracts and one for 2016 contracts. The changes are effective July 15, 2016.

Continue reading

AcariaHealth™ Added as New Preferred Specialty Pharmacy Vendor

Western Region Brokers

woman reading letter iStock_000063560443_SmallAnnouncing Health Net’s new partnership with AcariaHealth™ as our preferred specialty pharmacy. AcariaHealth is a leading, full-service specialty pharmacy providing quality medications and services for chronic or complex conditions that need special handling or training. The shared goal of Health Net and AcariaHealth is to provide a seamless transition with minimal disruption for members.

Continue reading

Reminder: April 20 Webinar – Sensible Eating with Plant-Based Foods

Select healthy foods to help manage DiabetesEvidence suggests that a plant-based diet can help prevent and even reverse some of the top killer diseases in the Western world, and can be even more effective than medication and surgery. Many people switch to eating a plant-based diet because they want to lose weight, improve their heart health, stay healthy as they age, improve blood pressure or manage diabetes.

Continue reading

Form 1095B Being Mailed This Week

Western Region Brokers:  Health Net will begin mailing Form 1095B on March 24, 2016

Starting on March 24, 2016, Health Net will mail Form 1095B for tax year 2015 to the subscriber’s home address. Health Net will provide the Form 1095B to subscribers enrolled in an off-Exchange Individual and Family plan, SHOP plans, and fully insured off-exchange small or large group plans. Individuals may file their tax returns prior to receiving Form 1095B.

For more information, read the article on our Health Care Reform Guide: Minimum Essential Coverage Reporting

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

Helping Your Clients Take Charge of HMO Coverage

Special mailer to CommunityCare HMO members encourages benefit use

For California Small Business Group Brokers

CommunityCare SML006106EO00_p1For 2016, Health Net of California, Inc. (Health Net) brought CommunityCare HMO to small business group clients in Los Angeles and Orange counties. Now we’re helping employees take charge of their health by using their CommunityCare HMO coverage.

Continue reading

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.

Continue reading

New Case Submission Rules and Calendar

For California Small Business Groups

Health Net is looking to you, as our business partners, to ensure that the onboarding process for new groups is as seamless as possible.

To achieve this Health Net must receive the completed, signed, and dated submission documents by the dates set. If you are working with a General Agency (GA), then the GA may request the below information earlier in order to review the group and submit to Health Net by the submission deadlines indicated.

Continue reading