Frequently Asked Questions
In our continued commitment to support you as you serve your clients, we've1 provided answers to your most important questions.
This page will be updated periodically so please bookmark it, as well as our member FAQ page.
1 Health Net of California, Inc., and Health Net Life Insurance Company (Health Net)
Time to enroll and renew for 2023
Our 2023 portfolio is focused on working to keep you and your clients happy and satisfied with our most popular HMO and PPO plans, including subsidized* and non-subsidized plans for financial help.
The portfolio simplifies business with matching plan and network names: Ambetter HMO and Ambetter PPO.
| Plan Name | Highlights | Network Name |
|---|---|---|
| Ambetter HMO |
|
2022: CommunityCare HMO 2023: Ambetter HMO |
| Ambetter PPO |
|
2022: EnhancedCare PPO (HNL) 2023: Ambetter PPO (Health Net of California, Inc.) |
*Financial help can be used only on plans purchased through Covered California. Coverage available only to residents of California who meet Covered California eligibility requirements.
Ambetter HSP, Ambetter EPO and Off-Exchange Full-Network PPO will close:
| Plan Name | Highlights |
|---|---|
| Ambetter HSP plans | Ambetter HSP plans will close and members will automatically be enrolled to a new plan as follows:
|
| Ambetter EPO (HNL) and Off-Exchange Full-Network PPO(HNL) | These plans will close. Members will need to choose a new plan during Open Enrollment. |
We're delivering everything you and your clients need in 2023
We're continuing value: What your clients love about their coverage and services stays!
- My Health Pays program
- Convenient, affordable prescriptions
- Behavioral health and wellness programs
- Care convenience: telehealth, walk-in clinics, 24/7 nurse advice
We're offering stability
- 1.4% average premium rate increase for HMO plans
- 2.1% average premium rate increase from our Health Net Life Insurance Company PPO plans to our new Health Net of California, Inc. Ambetter PPO plans
We're supporting your 2023 business
- Competitive compensation program: earn bonuses and commissions for new enrollments and renewals
- Easy-to-sell and renew products and plans positioned for long-term growth
- We're still competitive in Bronze! Our Bronze PPO rates will invigorate your book of business2
- Take another look at our competitive Silver HMO rates in Southern California – delivering even more value3
Your dedicated Account Executive is standing by to assist with regional rate details and strategies for your clients – including how the Inflation Reduction Act's extended subsidies can help keep them covered.
2 Lowest cost Bronze PPO 2023 rates in Sacramento, Northeast Los Angeles, Southwest Los Angeles, Inland, Orange, San Diego regions -- based on 9/8/22 DMHC rate filing comparisons with Blue Shield of California. Lowest cost Bronze PPO 2023 rates in Inland Empire based on 9/8/22 DMHC rate filing comparisons with all carriers.
3 Improved rate positions as compared to 2022, based on 9/8/22 DMHC rate filings, for an individual aged 40 years, in East Los Angeles, Inland Empire, and Orange County regions.
- On Exchange PPO "renewals" and the remaining HSP renewals are scheduled to be sent by Covered California on 12/15 to Health Net. Once enrollment is received, an invoice is triggered and sent to the member the following day. Health Net is not able to send invoices or collect the binder payment until the 834 enrollment is received from Covered California.
- All members enrolled into the new Ambetter PPO HNCA product are considered "new" enrollments and are required to make a binder payment to effectuate coverage. Binder payments are due on the last day of the first month of coverage, 1/31. Binder payments must be made to effectuate coverage. If a member needs to seek services on 1/1, they must make their binder payment first.
- If a member is already enrolled in autopay, the auto-payment will draft their binder payment on their scheduled date. If their auto-payment is scheduled before the renewal is received by Health Net, then it will not draft until January. If a member needs to seek services earlier than their auto-payment date, they should manually make their binder payment. Members with auto-payments scheduled on the 15th or 16th will likely need to make a manual binder payment.
- If manual binder payments are made, the binder payment will not pull on the auto-payment date because there will be no amount due.
- Members can call the call center to make a payment or set up auto-payment.
- ID cards will be sent within 10 days of the binder payment effectuation. Members can continue to use the same ID number or log into the member portal to download a new ID card. If there is a subscriber flip (dependent becomes the subscriber) then they will be assigned a new ID number.
Don't forget! Please remind your clients to make their January binder payments.
| Important Dates | Details |
|---|---|
| September 28, 2022 | Health Net mailed Ambetter HSP plan closure letters to impacted members. |
| October 15, 2022 | Health Net mails 2023 Ambetter HMO renewal letters and Health Net Ambetter PPO informational letters. |
| October 18, 2022 | Covered California early renewal begins. |
| November 1, 2022 | Enrollment for 2023 opens in California. Go to myhealthnetca.com for materials. |
| December 31, 2022 | Last day to enroll in new plan through Covered California or directly through Health Net to take effect on January 1, 2023. Your clients need to confirm information and income with Covered California to get tax credits in 2023. |
| January 31, 2023 | Last day to choose a new plan to take effect on February 1. Enrollment for 2023 closes in California. If eligible, clients may use a Special Enrollment Period to make changes after this date. |
You can find plan information located on the Plan Materials page for your clients who need coverage. Materials include applications for the current year.
To check the status of an application, log in to your broker account; then select Eligibility, Status & Activity at the top of the page. Then select Application Status. Enter the application status type, date range and any optional fields you are looking for, and click Search.
Note: You will only be able to view status of applications that are linked to your broker ID. If you think that a client is not linked to your account, please contact Broker Sales and Service at brokers@healthnet.com for assistance.
Off-Exchange
Ambetter from Health Net may require proof of permanent residency prior to enrollment on off-exchange Individual & Family plans. Please see the enrollment form for proof of permanent residency requirements. You can find enrollment forms located on the Plan Materials page.
On-Exchange
Covered CA requires members to provide an attestation for their permanent address on the enrollment application. Covered CA may also request proof of permanent residency from the member post-enrollment.
Managing my Ambetter from Health Net Book of Business
To view commission statements, log in to your broker account and select the Commission Statements link at the top of the page. Statements from the past six months are displayed on that page.
We have a dedicated staff supporting your calls and emails. If you cannot find the information you need on this website, please contact us.
To view the status of client applications for the 2022 plan year, simply visit the Eligibility, Status & Activity section within the Broker Portal. For everything else – including applications for the remainder of this plan year – please continue to consult the Book of Business section after you log in to your broker account.
To find information about your pre-members such as a new member's ID number, log in to your broker account; then select Book of Business at the top of the page. Then select from either On-Exch Pre-Members or Off-Exch Pre-Members.
To help you during the enrollment period, we'll mail you a list of your current Individual & Family Plan clients in October.
For client information throughout the year, you can view your client list online. Log in to your broker account and then select Book of Business at the top of the page.
View your:
- Active Member List
- Canceled Member List
- On-Exchange Pre-Members
- Off-Exchange Pre-Members
Supporting a client who is a Health Net member
Log in to your broker account to locate your client's member ID. Your client's status will determine where to go.
Active Member
Select Book of Business at the top of the page. Your Active members will be listed.
Pre-Member
Select Book of Business at the top of the page. Then select either On-Exch Pre-Members or Off-Exch Pre-Members.
Member ID numbers start with either an R or a U, depending on when the member enrolled.
Once members pay their first month's premium, they will receive a member ID card in the mail. If they are active and have not received an ID card yet, members can order one or print a temporary one through the member portal.
Note: If the member is accessing their online account for the first time, they will need to register, and will need their member ID number to do so. Please see "Where do I find a member's ID number?" to assist them with obtaining their number.
There are several ways to pay, including online and automatic bill pay, by phone, with cash through MoneyGram, and by mail. For all the details, go to Pay My Bill.
There are several ways members can change their PCP.
- Members can log in to their online account. Once there, they can click Select/Change PCP.
- Or they can call the Customer Contact Center:
- On exchange members: 1-888-926-4988
- Off-exchange members: 1-800-839-2172
For a new PCP to be effective the first day of the month, members have until the last day of the prior month to submit the request.
Example: If a member calls to request a new PCP on 10/31, they can still request an effective date of 11/1. However, if a member calls on 11/1, they will be assigned a new PCP, effective 12/1.
Note: If necessary, brokers can contact Account Services to schedule a three-way call with the member to request a PCP change by phone.
We help ensure Ambetter member dependents, other than parent and stepparent dependents, who are either reaching or have reached the maximum age of 26, continue with their health care coverage. First, we alert all members with a dependent who is either reaching or has reached the age limit. These dependents may remain on their parent's health plan until December 31 of that year. We also provide information about other health plan options.
Disabled dependents who qualify can remain on family plans. They will be certified for two years. At the end of the two years, Ambetter will repeat the qualification process.
If dependents are not disabled, they have these options:
- Covered California™ plans: They can be auto-enrolled into their own plan through Covered California.
- Off-exchange plans: Their coverage under the plan will be terminated and they will need to apply for their own health coverage if they choose to do so.