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PRISM - Stop, Do Not Quote Health Net
Health Net Is Exiting the California Group Market
Health Net will no longer offer small or large group coverage in CA. In-force groups terminate February 28, 2027. Your Claremont team is ready to help find alternatives. Call 800.696.4543 or email quotes@claremontcompanies.com.
Health Net announced today that it will exit the commercial group health market in California to focus on Medi-Cal, Medicare, and IFP/Covered California. This affects all small group and large group medical plans. Dental, vision, and EGWP plans are also included, and Health Net will send separate communications on those.
What we know today (updated 9/3)
In-force group coverage will end February 28, 2027, or as otherwise permitted by contract and regulation. Each group will receive its specific end date in a formal notice mailed by Health Net.
Employer notices are going out by USPS on 9/1. Please expect calls from your clients in the coming days.
Groups may renew before February 28, 2027, but the renewed policy will still end on that date. Groups may also terminate early to move to new coverage, with timely notice per their Health Net agreement.
Health Net is NOT accepting any new business (updated 9/3 from the original Health Net message).
Commissions on active policies are not expected to change through termination.
Health Net’s claims and customer service teams will continue to support members and groups through the transition.
Health Net Notices for Brokers and Employers
Below are examples of the notices and FAQs being sent by Health Net:
We are standing by to help you move every affected group to a new carrier with as little disruption to networks and benefits as possible. We can identify replacement plans that best match your client’s current network and benefit design, quote across our carrier portfolio for 10/1 and later effective dates, and pull census and invoice information for any group where Claremont is the GA of record.
Contact your Regional Sales Manager or reach us at 800.696.4543 or info@claremontcompanies.com to get started. We will share more from Health Net as we receive it.
Low rates in the market – Affordable plans without sacrificing quality.
Robust PPO network – Competes directly with major carriers like Anthem and Blue Shield.
$0 HMO plans – Broad statewide access tailored to fit any group or budget.
Simplified underwriting – Works alongside other carriers, with only 25% participation required for groups with 4+ enrolling. No DE9C or prior carrier bill needed.
Easy-to-sell benefits – $0 deductible HMO plans, choose from 61 plan options, and five years of rate stability.
Nationwide coverage – Cigna network access for out-of-state employees and state plurality rules for group qualification.
Learn more about Health Net’s versatile health plans, ancillary coverage, wellness programs, and value-added services.
Join Health Net’s Q4-2026 Small Group Updates Webinar
Hear the latest from Health Net’s leadership team, including Q4-2026 small group rate and benefit updates, underwriting promotions, and healthcare cost drivers & market trends.
Date & Time
Thursday, July 23, 2026
1:00 p.m. – 2:00 p.m. PT
Learn more about Health Net’s competitive and stable pricing, value-added programs, flexible guidelines, and other key updates for the quarter.
Get practical insights to stay ahead of market changes, refine your strategy, and better support your clients.
Health Net Advantages
Lowest rates in the market – Affordable plans without sacrificing quality.
Robust PPO network – Competes directly with major carriers like Anthem and Blue Shield.
$0 HMO plans – Broad statewide access tailored to fit any group or budget.
Simplified underwriting – Works alongside other carriers, with only 25% participation required for groups with 4+ enrolling. No DE9C or prior carrier bill needed.
Easy-to-sell benefits – $0 deductible HMO plans, choose from 61 plan options, and five years of rate stability.
Nationwide coverage – Cigna network access for out-of-state employees and state plurality rules for group qualification.
Learn more about Health Net’s versatile health plans, ancillary coverage, wellness programs, and value-added services.
Health Net has clarified the participation requirement language used in recertification notices for groups with only one enrolled employee — so if your group received one of these recently, here’s what it actually means.
The requirement, clarified: For groups where only the owner is currently enrolled, Health Net requires that the group have at least one eligible W-2 employee — someone who is not an owner or spouse of an owner. That employee does not need to enroll in coverage to satisfy the requirement; they simply need to be eligible and on payroll. A group where the owner is the only enrolled participant can remain qualified for small group coverage as long as this condition is met.
Why we’re sharing this: Some recent recertification notices used language that could be read as requiring the eligible employee to enroll, rather than simply exist. Health Net has confirmed the correct standard and is updating notice language going forward to reduce confusion.
What this means for your groups: If a client receives a recertification notice, there’s no need to enroll an additional employee to maintain eligibility — just confirm they have at least one eligible W-2 employee who isn’t an owner or spouse of an owner on payroll.
Why Brokers Choose Health Net? Flexibility that fits most clients:
Enhanced Choice — 4+ Enrolling Employees
Mix and match any HMO and PPO plans — no network restrictions
No DE9C, payroll records, prior carrier bill, or ownership documents required
No waivers needed for groups with 10 or more enrolled
4–9 enrolled: only 25% participation required (employees on another carrier don’t count against the threshold)
10+ enrolled: zero participation requirement, no waivers when not paired with Life or Employer-paid Dental/Vision
Flexible Underwriting — Startups & PEOs
Works for startups of any size — even groups of one — with just two weeks of payroll
Mix and match from all 61 Health Net plans
Can be written alongside any carrier, with no limit on the number of carriers as long as participation is met
Groups of 1–3 enrolling require 70% participation; PEO subgroups accepted with a quarterly wage report or two weeks of payroll
Household employers accepted with a DE9C or DE-1HW
Health Net covers a wide range of group situations — from lean startups to established employers with complex carrier arrangements. If you have a group that’s been tough to place, it’s worth the conversation.
Questions? Reach out to your Claremont team for a full Health Net overview and quoting support.
Health Net Advantages
Attractive rates – Affordable plans without sacrificing quality.
Robust PPO network – Competes directly with major carriers like Anthem and Blue Shield.
$0 HMO plans – Broad statewide access tailored to fit any group or budget.
Simplified underwriting – Works alongside other carriers, with only 25% participation required for groups with 4+ enrolling. No DE9C or prior carrier bill needed.
Easy-to-sell benefits – $0 deductible HMO plans, choose from 61 plan options, and five years of rate stability.
Nationwide coverage – Cigna network access for out-of-state employees and state plurality rules for group qualification.
Learn more about Health Net’s versatile health plans, ancillary coverage, wellness programs, and value-added services.
A benefit your clients’ employees will actually notice — and use. Plus a few reminders on why Health Net remains a strong option in today’s market.
Core Wellness Program — Up to $100/year per member
$50 — Complete the RealAge Test
$25 — PCP Self-Attestation or Health Coaching Call
$25 — Participate in two programs: Monthly Wellness Challenges, Eat Right Now, or Craving to Quit
2026 Bonus Campaigns — Up to $100 More
Campaign
Activity
Timeframe
Reward
Start Strong
RealAge Test
2/1–3/31
$25 Amazon
Grocery Giveaway
RealAge Test
8/1–9/30
$25 Instacart
Coaching
Enroll + Complete One Call
Year-round
$25 Amazon
Eat Right Now
Enroll in Program
Year-round
$25 Amazon
Craving to Quit
Enroll in Program
Year-round
$25 Amazon
Broker Talking Points
Gift cards resonate with employees — easy to explain at open enrollment
Drives benefit utilization, which employers care about at renewal
$0 deductibles + wellness rewards = a compelling package to present
Full wellness program scope includes mental health, Teladoc, Active&Fit discounts, and more
Supporting Sharecare flyers available — contact our office for materials
Don’t Miss: Health Net Small Group Wellness Webinar
Health Net is hosting a broker webinar covering the full range of no-cost wellness programs available to Small Group employers and their members.
Date: May 28, 2026
Time: 10:00 a.m. Pacific
Presenter: Lora Maloof-Miller, Health Net Program Manager for Wellness & Quality Improvement
$0 deductibles on all HMO plans — the only carrier in the market offering this
No participation requirements for groups of 10+ enrolling
Competitive pricing with a broad network, including all Sutter facilities
Why Brokers Choose Health Net? Flexibility that fits most clients:
Enhanced Choice — 4+ Enrolling Employees
Mix and match any HMO and PPO plans — no network restrictions
No DE9C, payroll records, prior carrier bill, or ownership documents required
No waivers needed for groups with 10 or more enrolled
4–9 enrolled: only 25% participation required (employees on another carrier don’t count against the threshold)
10+ enrolled: zero participation requirement, no waivers when not paired with Life or Employer-paid Dental/Vision
Flexible Underwriting — Startups & PEOs
Works for startups of any size — even groups of one — with just two weeks of payroll
Mix and match from all 61 Health Net plans
Can be written alongside any carrier, with no limit on the number of carriers as long as participation is met
Groups of 1–3 enrolling require 70% participation; PEO subgroups accepted with a quarterly wage report or two weeks of payroll
Household employers accepted with a DE9C or DE-1HW
Health Net covers a wide range of group situations — from lean startups to established employers with complex carrier arrangements. If you have a group that’s been tough to place, it’s worth the conversation.
Questions? Reach out to your Claremont team for a full Health Net overview and quoting support.
Health Net Advantages
Lowest rates in the market – Affordable plans without sacrificing quality.
Robust PPO network – Competes directly with major carriers like Anthem and Blue Shield.
$0 HMO plans – Broad statewide access tailored to fit any group or budget.
Simplified underwriting – Works alongside other carriers, with only 25% participation required for groups with 4+ enrolling. No DE9C or prior carrier bill needed.
Easy-to-sell benefits – $0 deductible HMO plans, choose from 61 plan options, and five years of rate stability.
Nationwide coverage – Cigna network access for out-of-state employees and state plurality rules for group qualification.
Learn more about Health Net’s versatile health plans, ancillary coverage, wellness programs, and value-added services.
Competitive rates get attention, but Health Net’s underwriting flexibility might be the real reason to bring this solution to your clients.
If Health Net hasn’t been top of mind for your groups, it’s worth a second look. Beyond competitive pricing, Health Net matches the major carriers on network breadth — so disruption risk is low. Out-of-state employees plug into the Cigna network for solid coverage, and $0 deductible HMO plans mean first-dollar benefits from day one.
The story gets even better when you look at their Simplified Underwriting Program. Relaxed paperwork requirements make placement faster and easier — two tracks cover nearly every group scenario you’ll encounter.
Enhanced Choice — 4+ Enrolling Employees
Mix and match any HMO and PPO plans — no network restrictions
No DE9C, payroll records, prior carrier bill, or ownership documents required
No waivers needed for groups with 10 or more enrolled
4–9 enrolled: only 25% participation required (employees on another carrier don’t count against the threshold)
10+ enrolled: zero participation requirement, no waivers when not paired with Life or Employer-paid Dental/Vision
Flexible Underwriting — Startups & PEOs
Works for startups of any size — even groups of one — with just two weeks of payroll
Mix and match from all 61 Health Net plans
Can be written alongside any carrier, with no limit on the number of carriers as long as participation is met
Groups of 1–3 enrolling require 70% participation; PEO subgroups accepted with a quarterly wage report or two weeks of payroll
Household employers accepted with a DE9C or DE-1HW
Health Net covers a wide range of group situations — from lean startups to established employers with complex carrier arrangements. If you have a group that’s been tough to place, it’s worth the conversation.
Questions? Reach out to your Claremont team for a full Health Net overview and quoting support.
Health Net Advantages
Lowest rates in the market – Affordable plans without sacrificing quality.
Robust PPO network – Competes directly with major carriers like Anthem and Blue Shield.
$0 HMO plans – Broad statewide access tailored to fit any group or budget.
Simplified underwriting – Works alongside other carriers, with only 25% participation required for groups with 4+ enrolling. No DE9C or prior carrier bill needed.
Easy-to-sell benefits – $0 deductible HMO plans, choose from 61 plan options, and five years of rate stability.
Nationwide coverage – Cigna network access for out-of-state employees and state plurality rules for group qualification.
Learn more about Health Net’s versatile health plans, ancillary coverage, wellness programs, and value-added services.
Get practical insights to stay ahead of market changes, refine your strategy, and better support your clients.
Health Net Advantages
Lowest rates in the market – Affordable plans without sacrificing quality.
Robust PPO network – Competes directly with major carriers like Anthem and Blue Shield.
$0 HMO plans – Broad statewide access tailored to fit any group or budget.
Simplified underwriting – Works alongside other carriers, with only 25% participation required for groups with 4+ enrolling. No DE9C or prior carrier bill needed.
Easy-to-sell benefits – $0 deductible HMO plans, choose from 61 plan options, and five years of rate stability.
Nationwide coverage – Cigna network access for out-of-state employees and state plurality rules for group qualification.
Learn more about Health Net’s versatile health plans, ancillary coverage, wellness programs, and value-added services.
Hosted by Crystal Given and Ryan Bradley, with Guest Speaker Dr. Todd May.
Health Net Advantages
Lowest rates in the market – Affordable plans without sacrificing quality.
Robust PPO network – Competes directly with major carriers like Anthem and Blue Shield.
$0 HMO plans – Broad statewide access tailored to fit any group or budget.
Simplified underwriting – Works alongside other carriers, with only 25% participation required for groups with 4+ enrolling. No DE9C or prior carrier bill needed.
Easy-to-sell benefits – $0 deductible HMO plans, choose from 61 plans options, and five years of rate stability.
Nationwide coverage – Cigna network access for out-of-state employees and state plurality rules for group qualification.
Learn more about Health Net’s versatile health plans, ancillary coverage, wellness programs, and value-added services.
Stay informed with the latest industry insights from Health Net’s Executive Sales Team. Don’t miss the next session in the Health Net Market Insights Webinar Series, hosted by Commercial Officer Alyson Stone.
This quarter’s agenda features timely updates and market expertise, including:
Regulatory and Legislative Updates – Jason Gabhart, Government Affairs Advocate
Gain valuable knowledge to help you navigate evolving market trends, strengthen your strategy, and better serve your clients.
Health Net Advantages
Lowest rates in the market – Affordable plans without sacrificing quality.
Robust PPO network – Competes directly with major carriers like Anthem and Blue Shield.
$0 HMO plans – Broad statewide access tailored to fit any group or budget.
Simplified underwriting – Works alongside other carriers, with only 25% participation required for groups with 4+ enrolling. No DE9C or prior carrier bill needed.
Easy-to-sell benefits – $0 deductible HMO plans, choose from 61 plans options, and five years of rate stability.
Nationwide coverage – Cigna network access for out-of-state employees and state plurality rules for group qualification.
Learn more about Health Net’s versatile health plans, ancillary coverage, wellness programs, and value-added services.
Health Net announced plan and rate updates for Q2 effective dates, plus continued simplified underwriting:
Quarterly Rate Change (may vary by plan and region)
HMO: 3.9%
PPO: 3.9%
Health Net Continues to Feature Simplified Underwriting for 2026
Enhanced Choice
4+ enrolling minimum.
No DE9C, payroll, prior carrier bill or ownership documents are required.
No waivers for 10+ enrolling employees
No participation attestation
Minimum enrollment and participation
4-9 enrolling employees:
25% participation is required (coverage with another carrier does not count against the 25% participation)
For census enrollment, waiving employees may be listed on the census in lieu of providing waivers. Health Net only requires enough waivers to verify that the group meets participation.
10+ enrolling employees:
No participation requirement and no waivers (when not paired with Life or Employer paid Dental/Vision)
Flexible Underwriting
2 weeks of payroll for a Startup Group of any size (down to 1)
Household employer groups now accepted.
Mix and match any of Health Net’s 61 plans.
Health Net can be written alongside any carrier, no limit to the number of carriers if participation is met.
Standard guidelines:
70% participation for groups of 1-4 enrolling.
25% participation for groups of 5-100 enrolling – not a promotion!
Health Net accepts PEO subgroups with a quarterly wage report or 2 weeks of payroll from the PEO.
Health Net Advantages
Lowest rates in the market – Affordable plans without sacrificing quality. Compare with Anthem and Blue Shield.
Robust PPO network – Competes directly with major carriers like Anthem and Blue Shield.
$0 Deductible HMO plans – Broad statewide access tailored to fit any group or budget.
Simplified underwriting – Works alongside other carriers, with only 25% participation required for groups with 5+ enrolling. No DE9C or prior carrier bill needed.
Easy-to-sell benefits – $0 deductible HMO plans and four years of rate stability.
Nationwide coverage – Cigna network access for out-of-state employees and state plurality rules for group qualification.
Learn more about Health Net’s versatile health plans, ancillary coverage, wellness programs, and value-added services.
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