Product Portfolio

Health Maintenance Organization

With Health Maintenance Organization (HMO) plans, members choose a primary care physician (PCP) from our network of providers and pay a fixed monthly fee. Their PCP will then oversee all health care related services, including referrals and authorizations. HMOs are ideal for employees who would like one doctor to coordinate all their medical care at predictable costs.

If you select an HMO plan, your employees can depend on basic, inpatient, and emergency services. Many plans include office visits, hospitalization, X-ray and lab services, prenatal and postnatal services, mental health services and more. Copays may vary according to plan.

Health Net HMO Plans

We know HMOs! Health Net has a variety of plan designs for businesses of all sizes. Our Full Network HMO gives you and your employees access to thousands of physicians and pharmacies across the state.

If you select an HMO plan, your employees can depend on basic, inpatient, and emergency services. Many plans include office visits, hospitalization, X-ray and lab services, prenatal and postnatal services, mental health services and more. Copays vary according to plan.

Elect Open Access (EOA) Plans

Elect Open Access (EOA) is an HMO plan with set copays, unlimited lifetime benefits, and a primary doctor to coordinate all of your care. However, an EOA also offers the flexibility of seeing any provider within Health Net's PPO provider network without needing a referral. For this added convenience, members who visit a PPO provider will have slightly higher copays per visit.

EOA products are also available with our ExcelCare Network, a subset of our full HMO network (see Tailored Network HMO plans below), available in Kern, Los Angeles, Orange, Riverside, San Bernardino, San Diego, San Francisco, Santa Clara, Stanislaus and Ventura counties. For more information on EOA plans, call your broker or Health Net representative.

Point-of-Service (POS) Plans

A POS plan combines aspects from both HMO and PPO plans, offering more freedom than a traditional HMO. Members choose a primary care physician from our network of providers, but our POS also offers limited coverage for members who choose to see an out-of-network provider.

Health Net POS is a two-tiered point-of-service plan. Members have the option to use benefits at an HMO benefit level or PPO benefit level whenever they need care. HMO benefits include primary care physician, referral to see a specialist, predictable payments and no claim paperwork. PPO benefits include the option to see any doctor or specialist in the Health Net network without a referral, payment of deductible and coinsurance and possibly filing claim forms.

Contact a Representative to Get a Quote

Highlights

• Basic, inpatient and emergency services
• Preventive care
• X-Ray and Lab Procedures
• Prenatal, postnatal and newborn care office visits
• Mental health services

Preferred Provider Organization Insurance Plans

Preferred Provider Organization (PPO) plans are health care plans contracted with a network of medical providers. PPO members have the option to select one of these preferred providers and only pay their deductible and office visit copay, or select an out-of-network provider and pay a slightly higher amount. PPO members also do not need to choose a primary care physician (PCP) and do not need referrals when going to a specialist.

To enroll in a PPO, contact a Health Net Sales Representative or your Broker

Learn More About Our PPO Plans

Our PPO members have access to an expansive network of both local and out-of-state providers. They'll also have coverage for a wide range of medical services – and specialist visits require no referral.

Highlights

• No referrals required for in-network specialists
• Freedom to choose in-network or out-of-network providers
• Large network
• Wide range of covered services
• No claims to file when you visit an in-network provider

HSA/HRA for Large Groups

Want to provide a consumer-directed care program for your employees while you both save money? Sign up for an HRA or HSA-compatible insurance plan.

What is a Health Savings Account?

A Health Savings Account (HSA) allows members to set aside a portion of their pre-tax income to an interest-bearing account used for qualified medical expenses and medications. Anyone enrolled in a high-deductible health plan can contribute to an HSA. Benefits include: The money stays with the member, even if they change jobs; No time limit on using funds; Contributions are free of FICA and FUTA taxes.

To enroll in an HSA, contact a Health Net Sales Representative or your Broker

Integrated HSA/HRA

Health Net delivers integrated solutions for both health savings account (HSA) and health reimbursement account (HRA) health plans through HealthEquity, a proven expert in financial arrangement integration and administration.

The addition of account integration provides a whole new level of service, convenience and choice for you and your employees. With HealthEquity's easy-to-use tools and comprehensive resources, you and your employees can take full advantage of this streamlined account administration facilitated by Health Net – at no additional cost.

HSA/HRA advantages

The HSA/HRA product offering is an opportunity for you to offer consumer-directed plans to your employees, empowering them to build health savings and benefit from significant tax savings. It also means employees will be able to have a record of their claims and what to pay or not pay.

Benefits of HSA/HRA products:

• Employees can typically save on insurance premiums.
• Savings can be deposited tax-free into an HSA account.
• Savings roll over year after year allowing for future medical spending.
• Employer contributions to medical spending account.
• Savings build fast.

The HealthEquity customer service and website have strong reputations for excellence. Your employees' experience with the integrated product will include:

• 24/7/365 toll-free HealthEquity telephone support.
• Online account access via a link from HealthNet.com (post log-in) for claim, balance and transaction information.
• Free investment options (trades and transactions) on the HealthEquity Investment Platform.

Please contact your broker or Health Net sales consultant for more information on integrated accounts. Or go to the HealthEquity website.

EZ ACCESS HSA Plans

Health Net has created EZ Access HSA plans for groups. This easy-to-use program accommodates members by allowing them to control their personal health savings account (HSA) and receive low monthly premiums, while you benefit through potential tax savings. Members have the option to use any financial institution of their choice, or to open an HSA in one of our EZ Access HSA plans through Bank of America.

We offer the coverage your employees need at the price you want.

Accessibility

Members have 24/7 access to their online account, including online bill pay, expense tracking, and investments tracking. A Bank of America HSA Visa debit card makes paying medical expenses easier and more convenient.

Member Benefits

• Low premiums
• No referrals
• Combined medical and pharmacy deductible
• Tax-free contributions
• Investible rollover savings
• HSA funds earn interest