Frequently Asked Questions
We know your time is valuable. In our continued commitment to do our part to support you as you serve your clients, we’ve provided answers to many of the common questions we receive daily.
(Note: The page will be updated periodically so bookmark it for one-click access. Also, feel free to visit and bookmark the member FAQ page as a reference while you support your clients.)
Enrolling (or renewing) a client as Health Net member
Members enrolled directly through Health Net
Health Net will automatically renew members into their existing Health Net plan. Note Members who no longer qualify for enrollment on a Minimum Coverage plan will be automatically enrolled onto a 2021 Bronze 60 plan.
Members enrolled through Covered California
Members signed up through Covered California should confirm their renewal/enrollment for 2021 on the Covered California website. Covered California will confirm the final determination on the member’s health coverage. We encourage you to stress with your clients the importance of confirming health coverage. Health Net must cancel any members for whom we do not receive an 834 file from Covered California.
If members currently receive APTC and/or state premium assistance, or are on a plan with cost-share reductions, they will lose that financial assistance unless they validate their income directly with Covered California. Members can call Covered California at 1-800-300-1506 or go to www.CoveredCA.com.
Financial help for your clients
Financial help is available again in 2021 to those who qualify. If you believe that your off-exchange clients qualify in 2021 for the federal advanced premium tax credit (APTC) and/or California’s premium assistance they can apply for the same Health Net plan through Covered California. With the exception of our regular PPO plans, all other plans – CommunityCare HMO, EnhancedCare PPO, PureCare HSP and PureCare One EPO – are available on-exchange in select counties.
Please make sure their enrollment is submitted with broker information. Covered California provides Health Net with the necessary data to assign broker of record and pay commissions. Enrollments received without broker data will not be eligible for commission.
California tax penalty
For your clients who do not have minimum essential health coverage, the California tax penalty remains in place and, at this time, has no end date.Learn more about exemptions and the penalty.
Benefit Changes for 2021
Please refer to the following benefit change inserts that were included in the member renewal letter.
- CommunityCare HMO Platinum 90, Silver 73 and Silver 94 (PDF)
- CommunityCare HMO Gold 80 (PDF)
- CommunityCare HMO Silver 70 and Silver 70 Off-Exchange (PDF)
- CommunityCare HMO Silver 87 (PDF)
- CommunityCare HMO Silver $0 Cost Share (PDF)
PureCare One HSP
- PureCare One HSP Bronze 60 (PDF)
- PureCare One HSP Bronze $0 Cost Share (PDF)
- PureCare One HSP Minimum Coverage (PDF)
- EnhancedCare PPO Platinum 90 (PDF)
- EnhancedCare PPO Gold 80 (PDF)
- EnhancedCare PPO Silver 70 and Silver 70 Off-Exchange (PDF)
- EnhancedCare PPO Silver 73 (PDF)
- EnhancedCare PPO Silver 87 (PDF)
- EnhancedCare PPO Silver 94 (PDF)
- EnhancedCare PPO Bronze 60 (PDF)
- EnhancedCare PPO Bronze 60 $0 Cost Share (PDF)
- EnhancedCare PPO Bronze 60 HDHP (PDF)
- EnhancedCare PPO Minimum Coverage (PDF)
- EnhancedCare PPO Gold Value (PDF)
- EnhancedCare PPO Silver Value (PDF)
PureCare One EPO
- PureCare One EPO Platinum 90, Silver 73 and Silver 94 (PDF)
- PureCare One EPO Gold 80 (PDF)
- PureCare One EPO Silver 70 and Silver 70 Off-Exchange (PDF)
- PureCare One EPO Silver 87 (PDF)
- PureCare One EPO Bronze 60 (PDF)
- PureCare One EPO Bronze $0 Cost Share (PDF)
- PureCare One EPO Minimum Coverage (PDF)
|October 1, 2020||Covered CA early renewal begins.|
|October 21, 2020||Health Net mails renewal letters to all of our members.|
|November 1, 2020||Enrollment for 2021 officially opens in California. Go to Plan Materialsfor sales materials.|
|December 15, 2020||Last day to enroll in new health coverage for a January 1, 2021, effective date. This is also the deadline for consumers to verify information and income with Covered California in order to qualify for tax credits in 2021.|
|January 31, 2021||Last day to enroll in new health coverage for a February 1, 2021 effective date. Enrollment for 2021 closes in California. If eligible, consumers may enroll with a SEP 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 Services at firstname.lastname@example.org for assistance.
Health Net requires proof of permanent residency prior to enrollment on off-exchange Individual & Family PPO and EnhancedCare PPO plans. Please see the enrollment form for proof of permanent residency requirements. You can find enrollment forms located on the Plan Materials page.
Managing my Health Net Book of Business
To view 2019 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 understand your time is valuable. We have a dedicated staff supporting your calls and emails. If you cannot find the information you need on this website, please contact us.
Note: During open enrollment, we’ve extended our hours, including Saturdays. Our team is available to you Monday through Friday, 9:00 a.m. to 6:00 p.m., and on Saturdays, 9:00 a.m. to 2:00 p.m.
To view the status of client applications for the 2020 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 of the Broker Portal for your broker account. (Note: Our technical team is working on an update to consolidate the 2020 information into the Book of Business section and simplify things for you.)
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 mailed a list of your current Individual & Family Plan clients in September 2019.
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.
- 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.
Select Book of Business at the top of the page. Your Active members will be listed.
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. All new members effective in 2018 and later have a member ID number that begins with a U.
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 Health Net member 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, Health Net 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: They will be termed and will need to apply for their own health coverage if they choose to do so.