Large Group Plan Offerings

Health Net PPO plans make it easy for you and your employees to have choices for health care providers. The plans have a wide range of products and medical services for you to gain and maintain good health.

PPO plan features include:

• Access to thousands of doctors, hospitals and pharmacies in our PPO Network – one of the largest in California.
• Option to visit providers outside the preferred network (pay a higher amount).
• No need to choose a primary care physician (PCP).
• No referrals needed to see an in-network specialist.
• No claims to file to see an in-network provider.

What's a Preferred Provider Organization (PPO) plan?

PPO plans are health care plans attached to a large network of medical providers. Employees can choose to visit any of the thousands of doctors, hospitals or pharmacies in our PPO Network – one of the largest in California. They can also visit providers outside the preferred network and pay a slightly higher amount.

PPO members don't need to choose a primary care physician (PCP) or be referred if they want to see an in-network specialist. Plus, there are no claims to file if visiting an in-network provider.

Health reimbursement arrangements (HRA) and health saving accounts (HSA) offer other ways to pay for medical costs. HRAs let you pay for some or all of the medical costs of your employees. HSAs help cover costs that fall under a plan’s deductible. Both are backed by large medical and pharmacy networks.

What is a health savings account (HSA)?

As an employer, the more health benefits and value you can offer your employees the better. One option, a health savings account (HSA), lets employees set aside a part of their pre-tax income to an interest-bearing account. The account can be used to pay for medical bills and medications. Any member that has an HSA-compatible, high-deductible health plan can add to an HSA. Benefits include:

• Savings stay with the member even if he or she changes jobs.
• No time limit on using funds.
• Deposits are free of employer and employee payroll taxes.
• Low premiums.
• No referrals.
• Combined medical and pharmacy deductible.
• Tax-free deposits.
• Rollover savings.
• Earning interest on the HSA.

HRA and HSA compatible plans

Health reimbursement arrangements (HRAs) are designed to act as full health benefits solutions. They let you to pay for either some or all medical costs of your employees. Health savings accounts (HSAs) are meant to help cover costs that fall under the deductible of a health insurance plan.

Whether you're looking for a regular PPO (HRA-compatible) or HSA-compatible plans, you're in the right spot. Both are backed by large medical and pharmacy networks that match our competitors.

HSA-compatible PPO plans

These are low-premium, high deductible PPO plans. Choosing this type of plan will give your employees access to broad benefits and our statewide PPO network. These plans also have the tax-saving potential of an HSA, which adds even more value for your employees to benefit from.

Account management system

Health Net offers a proven resource for both HSA and health reimbursement arrangement (HRA) health plans through HealthEquity. HealthEquity is a financial account administrator. It provides expertise in finance and account management.

HealthEquity presents a whole new level of ease, service and choice for you and your employees. They offer easy-to-use tools and a wide range of helpful resources. You and those you employ can make the most of this streamlined account management system. Best of all, it's championed by Health Net at no added cost.

The HSA/HRA way

Our HSA/HRA products are a chance for you to offer smart and savvy health plans to your employees. By doing this, you'll help them to build health savings. They will also benefit from useful tax savings. And it means the people you employ will be able to have a record of their claims and what to pay or not pay. Other benefits include:

• Savings on premiums.
• Tax-free deposits into an HSA account.
• Savings rollover year after year. This allows for future medical spending.
• Employer deposits to medical spending account.
• Savings build fast.

The HealthEquity customer service team and website are valued resources. Your employees can expect:

• Free HealthEquity phone support any time.
• Online account access via a link from HealthNet.com (post log-in). They can get claim, balance and transaction information.
• Free investment options on the HealthEquity Investment Platform.

Please contact your broker or Health Net sales agent for more information. Or, visit the HealthEquity website.

Health Net has many budget-friendly HMO plan designs for businesses of all sizes. All plans are tied to our HMO provider network, giving you and your employees access to thousands of doctors and pharmacies across the state.

What’s a health maintenance organization (HMO)?

Health maintenance organization (HMO) plans require its members to choose a primary care physician (PCP) from a network of providers. Members pay a fixed monthly fee, and their PCP directs all health care services which include referrals and consents. This is great for employees who want one doctor to manage all their medical care and costs.

Health Net full network HMO plans

Our HMOs come in at pricing options that allow you to choose the right one to fit your budget. All plans are tied to our HMO provider network, giving you and your employees access to thousands of doctors and pharmacies across the state.

If you select an HMO plan, your employees can count on basic, inpatient and emergency services. Many plans include:

• Office visits.
• Preventive care.
• Hospital stays.
• X-ray and lab services.
• Prenatal and postnatal services, including newborn care office visits.
• Mental health services and more.

Note: Copays may vary by plan.

Elect Open Access (EOA) is an HMO plan for the savvy shopper. Our EOA plans combine HMO predictability with set copayments. It has lifetime benefits and a PCP to manage all your care.

With an EOA, you and your employees can enjoy the freedom to visit any doctor within our PPO provider network of doctors and specialist. Choose between two tiers of benefits – HMO or PPO – whenever you need to see a doctor. No referrals needed for certain professional services.

Note: Members who visit a PPO provider will have a slightly higher copay per visit.

EOA products are also found in our ExcelCare Network. ExcelCare is part of our Full Network HMO. (see Tailored network HMO plans below). The ExcelCare Network is offered in these counties:

• Kern
• Los Angeles
• Orange
• Riverside
• San Bernardino
• San Diego
• San Francisco
• Santa Clara
• Stanislaus
• Ventura

For more information on EOA plans, call your broker or Health Net sales agent.

Health Net is a driving force in tailored network strategies. We're known for our ability to look closely at key provider partners who share our same passion for offering high quality and low-cost products. The result – we find more ways to build network solutions that match the many health care needs for you and your employees.

SmartCare

SmartCare HMO is a network of trusted, high-quality provider groups and hospitals. With easy to use benefits, predictable costs and a quality network, SmartCare is an attractive, whole-health option for your employees.

SmartCare is offered in 23 counties across California.

ExcelCare

Our ExcelCare tailored network combines the best of our HMO and Elect Open Access (EOA) plans with a cost-saving provider network. It’s a select subset of the quality providers in our Full Network HMO. The ExcelCare network is designed as a valued health plan that provides you with the same quality coverage as our other plans.

Salud HMO y Más

Salud HMO y Más addresses the needs of Southern California. It gives members access to a quality group of doctors and hospitals where they live or work.

One more great reason to choose Health Net – Scripps Health in San Diego has been added to the current group of providers within Salud HMO y Más, including access to 13 Scripps HealthExpress Clinics for same day care for minor ailments and injuries.

Members also have flexible crossborder access to SIMNSA's network providers in northern Mexico through all Salud y Más medical groups.