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Frequently Asked Questions

Ambetter HMO and Ambetter PPO plans are offered by Health Net of California, Inc.

In our continued commitment to support you as you serve your clients, we've provided answers to your most important questions.

This page will be updated periodically so please bookmark it, as well as our member FAQ page.

Time to enroll and renew for 2025

Our 2025 portfolio is focused on working to keep you and your clients happy and satisfied with our most popular HMO and PPO plans, including subsidized1 plans for financial help.

1 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.

We're delivering what you and your clients need in 2025

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
  • Access convenience: telehealth, walk-in clinics, 24/7 nurse advice

We're offering stability

  • 6.3% average premium rate increase for HMO plans
  • 6.7% average premium rate increase for PPO plans

We're supporting your 2025 business

  • Competitive compensation program: earn bonuses and commissions for eligible new enrollments and renewals.
  • Easy-to-sell and renew products and plans positioned for long-term growth.
  • In Imperial County we are offering the lowest priced HMO Bronze plan and 2nd lowest Silver and Gold plans.
  • In Kern County we are offering the lowest priced HMO Silver, Bronze and Gold plans and 2nd lowest Platinum plans.
  • In Los Angeles East we are offering the 2nd lowest priced HMO Silver and 2nd lowest PPO Bronze plans.
  • In Inland Empire we are offering the 2nd lowest priced HMO Silver and the lowest PPO Bronze plans.
  • We're still competitive in Bronze! Our Bronze PPO rates will invigorate your book of business.2
  • Take another look at our competitive Silver HMO rates in Southern California – delivering even more value.2

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 Based on the Covered California Individual Product Prices file, on 7/24/2024, for an individual aged 40 years in the respective region.

  • 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.
  • All members will receive a new ID for benefits effective January 1, 2025. Renewing members will receive a new ID card in mid-December. New members will receive an ID card within 10 days of the binder payment effectuation. Members should throw away their previous ID card and begin using the new ID card for any services or prescriptions received beginning on January 1, 2025.

Don't forget! Please remind your clients to make their January binder payments.

Important Dates Details
October 1, 2024 Covered California early renewal begins
October 15, 2024 Health Net mails 2025 Ambetter HMO and Ambetter PPO renewal letters.
November 1, 2024 Open enrollment for 2025 begins in California. Go to MyHealthNetCA for materials.
December 31, 2024 Last day to enroll in new plan to take effect on January 1, 2025.

Your clients need to confirm information and income with Covered California to get tax credits in 2025.
January 31, 2025 Last day to choose a new plan to take effect on February 1. Open enrollment for 2025 closes in California.

If eligible, clients may use a Special Enrollment Period to make changes after this date.

Ambetter from Health Net HMO and PPO plans are offered by Health Net of California, Inc. Health Net of California, Inc. is a subsidiary of Health Net, LLC and Centene Corporation. Health Net is a registered service mark of Health Net, LLC. Covered California is a registered trademark of the State of California. All other identified trademarks/service marks remain the property of their respective companies. All rights reserved.

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 upcoming 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.

  1. Members can log in to their online account. Once there, they can click Select/Change PCP.
  2. Or they can call the Customer Contact Center:

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.