Health Plan Rates in Q3: HMO and PPO Averages Shift Upwards
In the third quarter, there's been a noticeable shift in the statewide average rate changes for health plans. The HMO plans have seen an average rate change of 1.8%, while the PPO plans have experienced a more modest average rate change of 0.4%.
New PPO Options: Health Net's Transition from CDI to DMHC
In a move to simplify its offerings, Health Net is shifting its PPO plans from the California Department of Insurance (CDI) to similar products under the Department of Managed Care (DMHC). Employer Groups are receiving notification of these changes, with reassurances of the continued availability of comparable PPO products upon renewal. Health Net remains committed to delivering quality service and diverse PPO plan options. For more information, click here.
Health Net to Partner with Cigna PPO for Out-of-State Coverage
Health Net is set to replace First Health with the Cigna PPO network for PPOs offering out-of-state coverage from November 1, 2023. The Cigna PPO network will cater to both small and large California-based employer groups, boasting over a million providers and 6,300 facilities. Members enrolled in PPO plans accessing Cigna PPO will still be considered Health Net members receiving in-network coverage level outside California. Prior to the transition, members will be notified about the change and will receive a new ID card bearing both Health Net and Cigna logos.
Elevate Your Earnings: Health Net's Incentive Program for Businesses
Health Net is introducing a special incentive program, running from July 1, 2023 through January 31, 2024, to support businesses and clients during the peak season. The initiative ensures affordable coverage for clients and allows businesses offering Health Net plans to enjoy a boosted commission rate of 6% for the lifetime of cases involving new groups of six or more subscribers.
Please note, the incentive program only covers sales made directly through Health Net and does not include CalChoice and COBRA memberships. However, general agents' sales qualify.
Additionally, Health Net is introducing flexible underwriting for startups and existing businesses. It allows for mixing and matching all networks and can be paired with any carrier, provided participation is met. For groups of 1-4 employees enrolling, a 70% participation rate is required, and for groups with 5 or more employees, only a 25% participation rate is needed. This is not a promotion but a permanent offer. Health Net also accepts PEO subgroups with a quarterly wage report or two weeks of payroll from the PEO.
For more information on the program and its guidelines, businesses should contact their Account Executives at Health Net. Please be aware that Health Net may modify or end this program at any time. For full details, click here.
Introducing Simplified Underwriting Programs
Health Net is introducing simplified Underwriting Programs that give your clients both flexibility and choice. The two packages are:
Enhanced Choice Promotion, designed for groups of 5-100 eligible employees. With a minimum of 5 active subscribers, it requires no DE9C or prior carrier bill. All eligible employees declining coverage must provide a waiver, including those enrolling with another carrier.
Sell HMO with 6 promotion, tailored for six active subscribers. It allows mixing and matching any plans from the HMO networks. No DE9C, waivers (when not paired with Life or Employer Paid Dental/Vision), participation attestation, or prior carrier bill is required.
Additionally, employees enrolled with another carrier through the same employer are now considered valid waivers for groups with a minimum of five enrolling employees. Click here for the full details.
Health Net Enhances Access to Care: Discover MinuteClinic and Babylon
Health Net offers alternative care options for its members including walk-in services at MinuteClinic, found inside CVS/pharmacy stores, and digital telehealth care through Babylon.
MinuteClinic, staffed by nurse practitioners and physician assistants, provides non-emergency treatment when regular doctors are unavailable. Babylon offers 24/7 video appointments at no extra cost for most plans, allowing members to access medical providers anytime. These alternatives ensure convenient and timely access to care.
Health Net Boosts PPO Plans with Chiropractic Options
Health Net is enhancing its PPO plans by incorporating a chiropractic buy-up rider, ensuring they align with existing HMO options.
For the full details on Health Net's official Q3 quarterly update, click here.