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Plan Materials

Want to learn more about a specific plan? Here you'll find all the details about your Health Net coverage choices to find the plan that fits your needs. Check back during Open Enrollment for additional materials, which begins November 1, 2020.

All documents are in PDF format.

Materials & Forms


Enrollment Tools

Individual & Family Plans (IFP) Enrollment Applications – Effective January 1, 2022

Ambetter HMO
Ambetter HSP
Ambetter EPO
Ambetter PPO

2022 Disclosures

Ambetter PPO

Dental and Vision

Plan Overviews

Summary of Benefits and Coverage (SBC)

Looking for a Summary of Benefits and Coverage for a specific plan? Use our SBC Search Tool

Summary of Dental Benefits and Coverage (SDBC)

Plan Contract and Evidence of Coverage/Policies

Evidence of Coverage for Ambetter HMO Plans (off Marketplace)

Evidence of Coverage for HSP Ambetter Plans (off Marketplace)

Policies for EPO Ambetter One Plans (off Marketplace)

Policies for PPO Plans (off Marketplace)

Policies for Ambetter PPO Plans (off Marketplace)

Other Documents

Health insurance companies and group health plans are required to make available a uniform glossary of health coverage and medical terms commonly used in plan documents. The Uniform Glossary is meant to help the consumer understand some of the most common language used in health insurance documents. Please log in to request a hardcopy of the document by mail.