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Commercial Broker Certification


Commercial Plan Brokers

Please note: If you would also like to sell our Medicare products, you must be trained, tested and certified as well as contracted prior to selling your first piece of Medicare business. Please visit our Medicare Producer Training & Certification Center to learn more about becoming a Medicare contracted and certified broker, or call our Medicare Broker Services Unit at 1-800-708-7646.

Appointed brokers
To update your Address, Phone Number, Name (Only applicable if you have no TIN/SSN or License number change) to enroll/change your EFT or do a Web Registration, you will need to set up a Contract Account (please refer to the Self-service contract management portal section below).

Become contracted
How to contract with Health Net of California Inc. and Health Net Life Insurance Company:

We invite you to represent Health Net for your Individual & Family and Employer Group business. With Health Net products, you have a vast portfolio of quality benefit offerings to present to your clients – big and small.

In order to contract with us, you will need to have written or assumed your first piece of Health Net business. Using our online quoting engines for Individual and Small Group commercial business or working directly with a Health Net Commercial Sales Representative, you can obtain the plan information and rates you need for your clients.

Upon writing or assuming your first Health Net group or individual contract, you will need to complete, the following documentation through our Broker Self Service Web Tool.

  • Health Net of California, Inc. and Health Net Life Insurance Company Agent/Broker Agreement
  • Web registration
  • Direct Deposit Verification form
  • Online W-9 form
  • Proof of Errors & Omissions (E&O) insurance coverage

Self-service contract management portal

Both new and existing brokers need to create a Contract Account using our Broker Self Service Web Tool. If you are already contracted as a Health Net broker you can use this page to:

  • Update your name (only applicable if you have no TIN/SSN or license number changes)
  • Update your address/phone/fax number
  • Enroll in EFT or change bank accounts
  • Complete a web registration

Please note: Your HealthNet.com website account access is separate from this online broker registration process and needs to be accessed separately.

Start a new online Contracting Account with Health Net
Broker Contracting Account User Guide (pdf)

Create a Health Net Contract Account

Log in page, after Broker Contracting Account is created.

Broker Contracting Account Log In

When completing your online contracting documents, please ensure that:

  • The name on the Agreement, license and W-9 form match exactly.
  • If paid to a corporation, the corporation’s tax identification number is provided.
  • If paid to an individual, the individual’s Social Security number or tax number is provided.
  • You have a current and active license with the appropriate lines of authority, of Accident/Health and Life.

Commissions
Each Agent/Broker must be contracted with Health Net of California, Inc. and Health Net Life Insurance Company in order to receive a commission payment. Commissions cannot be paid prior to the effective date of the Agent/Broker Agreement.

If you have additional questions or need further assistance on how to become a Commercial Broker, please contact the Health Net Broker Services unit at 1 800 448 4411, option 4.

Code of Conduct
To know more about the Code of Business Conduct and Ethics Integrity Hotline, click here.

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Important Notice

General Purpose
Health Net's National Medical Policies (the "Policies") are developed to assist Health Net in administering plan benefits and determining whether a particular procedure, drug, service, or supply is medically necessary. The Policies are based upon a review of the available clinical information including clinical outcome studies in the peer-reviewed published medical literature, regulatory status of the drug or device, evidence-based guidelines of governmental bodies, and evidence-based guidelines and positions of select national health professional organizations. Coverage determinations are made on a case-by-case basis and are subject to all of the terms, conditions, limitations, and exclusions of the Member's contract, including medical necessity requirements. Health Net may use the Policies to determine whether, under the facts and circumstances of a particular case, the proposed procedure, drug, service, or supply is medically necessary. The conclusion that a procedure, drug, service, or supply is medically necessary does not constitute coverage. The Member's contract defines which procedure, drug, service, or supply is covered, excluded, limited, or subject to dollar caps. The policy provides for clearly written, reasonable and current criteria that have been approved by Health Net's National Medical Advisory Council (MAC). The clinical criteria and medical policies provide guidelines for determining the medical necessity criteria for specific procedures, equipment and services. In order to be eligible, all services must be medically necessary and otherwise defined in the Member's benefits contract as described in this "Important Notice" disclaimer. In all cases, final benefit determinations are based on the applicable contract language. To the extent there are any conflicts between medical policy guidelines and applicable contract language, the contract language prevails. Medical policy is not intended to override the policy that defines the Member's benefits, nor is it intended to dictate to providers how to practice medicine.


Policy Effective Date and Defined Terms.
The date of posting is not the effective date of the Policy. The Policy is effective as of the date determined by Health Net. All policies are subject to applicable legal and regulatory mandates and requirements for prior notification. If there is a discrepancy between the policy effective date and legal mandates and regulatory requirements, the requirements of law and regulation shall govern. In some states, prior notice or posting on the website is required before a policy is deemed effective. For information regarding the effective dates of Policies, contact your provider representative. The Policies do not include definitions. All terms are defined by Health Net. For information regarding the definitions of terms used in the Policies, contact your provider representative.


Policy Amendment without Notice.
Health Net reserves the right to amend the Policies without notice to providers or Members. In some states, prior notice or website posting is required before an amendment is deemed effective.


No Medical Advice.
The Policies do not constitute medical advice. Health Net does not provide or recommend treatment to Members. Members should consult with their treating physician in connection with diagnosis and treatment decisions.


No Authorization or Guarantee of Coverage.
The Policies do not constitute authorization or guarantee of coverage of any particular procedure, drug, service, or supply. Members and providers should refer to the Member contract to determine if exclusions, limitations and dollar caps apply to a particular procedure, drug, service, or supply.


Policy Limitation: Member's Contract Controls Coverage Determinations.
Statutory Notice to Members: The materials provided to you are guidelines used by this plan to authorize, modify or deny care for persons with similar illnesses or conditions. Specific care and treatment may vary depending on individual need and the benefits covered under your contract. The determination of coverage for a particular procedure, drug, service, or supply is not based upon the Policies, but rather is subject to the facts of the individual clinical case, terms and conditions of the Member's contract, and requirements of applicable laws and regulations. The contract language contains specific terms and conditions, including pre-existing conditions, limitations, exclusions, benefit maximums, eligibility, and other relevant terms and conditions of coverage. In the event the Member's contract (also known as the benefit contract, coverage document, or evidence of coverage) conflicts with the Policies, the Member's contract shall govern. The Policies do not replace or amend the Member contract.


Policy Limitation: Legal and Regulatory Mandates and Requirements
The determinations of coverage for a particular procedure, drug, service, or supply is subject to applicable legal and regulatory mandates and requirements. If there is a discrepancy between the Policies and legal mandates and regulatory requirements, the requirements of law and regulation shall govern.


Reconstructive Surgery
California Health and Safety Code 1367.63 requires health care service plans to cover reconstructive surgery. "Reconstructive surgery" means surgery performed to correct or repair abnormal structures of the body caused by congenital defects, developmental abnormalities, trauma, infection, tumors, or disease to do either of the following:


1. To improve function; or
2. To create a normal appearance, to the extent possible.


Reconstructive surgery does not mean "cosmetic surgery," which is surgery performed to alter or reshape normal structures of the body in order to improve appearance.


Requests for reconstructive surgery may be denied, if the proposed procedure offers only a minimal improvement in the appearance of the enrollee, in accordance with the standard of care as practiced by physicians specializing in reconstructive surgery.


Reconstructive Surgery after Mastectomy
California Health and Safety Code 1367.6 requires treatment for breast cancer to cover prosthetic devices or reconstructive surgery to restore and achieve symmetry for the patient incident to a mastectomy. Coverage for prosthetic devices and reconstructive surgery shall be subject to the copayment, or deductible and coinsurance conditions, that are applicable to the mastectomy and all other terms and conditions applicable to other benefits. "Mastectomy" means the removal of all or part of the breast for medically necessary reasons, as determined by a licensed physician and surgeon.


Policy Limitations: Medicare and Medicaid
Policies specifically developed to assist Health Net in administering Medicare or Medicaid plan benefits and determining coverage for a particular procedure, drug, service, or supply for Medicare or Medicaid Members shall not be construed to apply to any other Health Net plans and Members. The Policies shall not be interpreted to limit the benefits afforded Medicare and Medicaid Members by law and regulation.

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