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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.)

For news and updates, we will highlight them for you on the Broker News page of this website. Members will receive news relevant to them on the Member News page.

Enrolling (or renewing) a client as Health Net member

Our 2022 HMO, HSP and EnhancedCare PPO IFP health plans are now Ambetter from Health Net,1 and are available for Helath Net direct, and Covered CA 2022 enrollment and renewals. This change is in name only, and our IFP health plans will continue to offer:

  • the great benefits your clients value
  • access to the same provider networks
  • the same ID number – no changes!2

We've changed the name to better serve our members! The Ambetter name helps us draw from the national strength of Centene, our parent company, with programs and services designed to help your clients achieve better health results.

2021 Plan Name 2022 Plan Name 2022 Provider Network
CommunityCare HMO Ambetter HMO CommunityCare HMO network
PureCare One HSP Ambetter HSP PureCare HSP network
EnhancedCare PPO Ambetter PPO EnhancedCare PPO network
PureCare One EPO Ambetter EPO PureCare One EPO network
PPO1 PPO1 PPO (full network)1

1 Health Net Full Network PPO off-exchange plans are not renamed to Ambetter.
2 Your clients' ID numbers will change if they enroll onto an individual subscriber plan from a family plan.

Get ready for these important dates!
Date Event
November 1, 2021 Enrollment for 2022 officially opens in California.
December 31, 2021 Last day to enroll in new health coverage for a January 1, 2022, 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 2022.
January 31, 2022 Last day to enroll in new health coverage for a February 1, 2022 effective date. Enrollment for 2022 closes in California. If eligible, consumers may enroll with a SEP after this date.

Time to enroll and renew for 2022

Your clients can renew on the same IFP plan they have, both on- and off-exchange, for 2022!

This makes it easy to renew with us. Our 2022 portfolio of plans offers your clients:

  • Subsidized and non-subsidized plans1
  • A variety of plan and tier choices to meet their needs
  • Continued care from providers they know, and attractive networks for the price
  • Ongoing health care access via telehealth from Babylon (with $0 copay), CVS MinuteClinic® (PCP copay) and wellness/prevention programs

Plus, we help you build your 2022 business with competitive rates2:

  • Competitive Silver HMO
  • Lowest-priced Silver PPO in Sacramento, Los Angeles, Inland Empire and San Diego
  • Lowest-priced Bronze PPO in Inland Empire

 

2021 Plan Name 2022 Plan Name 2022 Provider Network
CommunityCare HMO Ambetter HMO CommunityCare HMO network
PureCare One HSP Ambetter HSP PureCare HSP network
EnhancedCare PPO Ambetter PPO EnhancedCare PPO network
PureCare One EPO Ambetter EPO PureCare One EPO network
PPO3 PPO3 PPO (full network)3

1 Premium subsidies are only available on plans purchased through Covered CA.
2 Based on the Covered California Shop and Compare tool, on 10/12/21, for an individual aged 40 years in Sacramento, Los Angeles, Inland Empire and San Diego regions.
3 Health Net Full Network PPO off-exchange plans are not be renamed to Ambetter.

Members enrolled through Covered California

Members enrolled through Covered California™ need to confirm their renewal/enrollment for 2022. Health Net must cancel any members for whom we do not receive an 834 file from Covered California. Please stress the importance of confirming health coverage with your clients.

If members currently receive APTC, or are on a plan with cost-share reductions, they will lose that financial assistance unless they validate their income directly with Covered California.

Beginning this year (2021), health insurers are required to send off-exchange members' contact information to Covered California when a health plan is closed, or coverage is terminated. However, members can opt out of having their information sent to Covered California. Therefore, an opt-out insert will be included in our off-exchange members' renewal letters. (Note that brokers cannot opt out on behalf of a 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 2022 Bronze 60 plan.

Financial help for your clients

Financial help is available again in 2022 to those who qualify. If you believe that your off-exchange clients qualify in 2022 for the federal advanced premium tax credit (APTC), they can apply for the same Health Net plan through Covered California. With the exception of our regular PPO plans, all other plans – Ambetter HMO, Ambetter PPO, Ambetter HSP and Ambetter 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.

Explore more information on Health Net's IFP health plans available through Covered California.

Changes in American Rescue Plan Act subsidies

Members with the unemployment insurance subsidy will experience decreases in their APTCs in 2022 due to the following changes:

  • The American Rescue Plan Act subsidy for unemployment insurance will no longer be in effect in January 2022.
  • In 2022, American Rescue Plan Act subsidies will no longer be prorated as they were in 2021. Instead, the subsidies will be distributed evenly over the course of the 2022 12-month period, and therefore are expected to decrease.

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. You can confirm the penalty for the 2022 tax year and learn more about exemptions.

Benefit Changes for 2022

Please refer to the following benefit change inserts that were included in the member renewal letters:

Ambetter HMO (formerly CommunityCare HMO)

Ambetter HSP (Formerly PureCare One HSP)

Ambetter PPO (Formerly EnhancedCare PPO)

Ambetter EPO (Formerly PureCare One EPO)

PPO

All other benefit change inserts

For all other plans not listed above, please see one of the following inserts:

Date Event
November 1, 2021 Enrollment for 2022 officially opens in California.
Sales materials available here.
December 31, 2021 Last day to enroll in new health coverage for a January 1, 2022, 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 2022.
January 31, 2022 Last day to enroll in new health coverage for a February 1, 2022 effective date. Enrollment for 2022 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 Sales and Service at brokers@healthnet.com for assistance.

Off-Exchange

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 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.

  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:
    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.