Revised Prior Authorization Requirements for OR Commercial Members

We regularly review the Prior Authorization List (PAL) to ensure we deliver the right balance of value and stability to our members. As a valued employer group with Health Net, we want you to be aware of PAL changes that may affect your employees’ health care coverage.

 

We have revised our commercial (EPO, POS, CommunityCare, and PPO) PAL requirements, effective January 1, 2017. Continue reading

Oregon/Washington Drug List Changes for Q4 2016

Health Net’s Drug Lists are updated quarterly and available online.

 

This update includes information for all Commercial formularies/drug lists, except as otherwise noted.

  • The Essential Rx Drug List (EDL) is an ACA compliant formulary utilized by Commercial members (IFP, Small and Large Group members).
  • The Aon Active Health Exchange Drug List is used by groups/members who sign up under the Aon Hewitt private exchange.

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Select Number of Small Group Plan Members Invited to Take an HRQ, Earn $50

California Small Business Groups

shutterstock_11696662_Social Media and Your BusinessAt Health Net, we want our members — your employees — to use their benefits, in order to be their healthiest! We’re reaching out to a select number of small group plan members who we feel will gain the most value, with an invitation to take a Health Risk Questionnaire (HRQ) and visit their doctor—and sweetening the deal with a $50 gift certificate. Continue reading

Revised Prior Authorization Requirements

Revised Prior Authorization Requirements for Health Net Health Plan of Oregon, Inc. Commercial Members

At Health Net Health Plan of Oregon, Inc. (Health Net), we regularly review the Prior Authorization List (PAL). As a valued employer group with Health Net, we want you to be aware of PAL changes that may affect your employees’ health care coverage.

Effective July 1, 2016, we have revised our commercial [EPO, POS, CommunityCare, and PPO] PAL requirements. Significant changes to the list are indicated below. Please click here to view a complete copy of the new July 1, 2016, PAL requirements.

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

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

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For more details on this and any other ACA-related topic, please log onto the Health Care Reform Guide at www.healthnet.com/employer/reformguide .

Probationary Period Update – CA SB1034

California’s Limit on Waiting Periods (Probationary Periods) – CA SB1034 Signed into Law

As you may know, Governor Brown signed CA SB1034 into law on Friday, August 15, 2014. CA SB1034 repeals California’s stricter 60-day limit on waiting periods (in accordance with AB1083) and allows employers to follow the federal ACA’s 90-day waiting period limitation. CA SB1034 also prohibits insurers and health plans from imposing waiting periods, although the insurer or health plan may administer waiting period on behalf of the employer (as long as the employer’s waiting period does not exceed the ACA’s 90-day limit).

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Revised Prior Authorization Requirements

For Oregon Members and Employees

 

Revised Prior Authorization Requirements for Health Net Health Plan of Oregon, Inc. Commercial Members


At Health Net Health Plan of Oregon, Inc. (Health Net), we regularly review the Prior Authorization List (PAL) to ensure our members receive safe and appropriate medical care. As a valued employer group with Health Net, we want you to be aware of PAL changes that may affect your employee’s health care coverage.

Effective January 1, 2014, we have revised our commercial [EPO, Point of Service (POS), CommunityCare and PPO] PAL requirements. Significant changes to the list are indicated below. For a complete copy of the PAL requirements, please log in to our website at www.healthnet.com, click on Preauthorizations under My Coverage > Prior Authorization List, or call 1-888-802-7001.

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Salud: Solutions for Hispanic Employees

At Health Net, we focus on ways to support you with a combination of unique health care solutions that make it possible to meet the needs of your employees.

 

Salud HMO y Más – a Latino-focused health solution – is specifically designed for members of the Hispanic community who are looking for access to budget-friendly, community-based, culturally competent health care. Continue reading

Four Things You Should Know About Health Care Reform

As a business owner, you’ve undoubtedly paid close attention to the coverage regarding the Affordable Care Act (ACA). However, with all the debate and discussion around health care reform and its long list of regulatory provisions, it can be difficult to keep track of what’s already been implemented and what’s coming down the road. With the next major phase of changes gearing up for January 1, 2014, it’s a good time for a refresher on some of the basic requirements you may have as an employer. Continue reading