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PRISM - Health Net is Now Available Through Claremont!

Why Choose Health Net?
Lowest rates in the market – Affordable options without compromising quality.
Robust PPO network – Competes with major carriers like Anthem and Blue Shield.
Flexible HMO options – Networks to fit nearly every group statewide and every budget.
Simplified underwriting – Only 25% participation required for groups with 5+ enrolling. No DE9C or prior carrier bill needed.
Easy-to-sell benefits – $0 deductible HMO plans + four years of rate stability.
Nationwide coverage – Cigna network access for out-of-state employees + state plurality rules for group qualification.

Start Including Health Net in Your Quotes Today!
Need guidance on networks, plan designs, or have questions? We’re here to help!

Call us at 800.696.4543 | Email us at info@claremontcompanies.com.

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Individual Family Eligibility & Enrollment

What if an individual does not have a SSN?

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If the individual is not a U.S. citizen or U.S. national, the application asks whether the individual has satisfactory immigration status.  The application also asks for immigration document information including document type, ID number (in most cases this will be the Alien Registration Number), country of issuance, expiration date, and name as it appears on the document.

If eligibility is based on total household income how can a child be on Medi-Cal and a parent on a Covered California health plan?

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There are different Medi-Cal income eligibility thresholds for different populations.  See the chart on page 11 of the Eligibility for Individuals and Families participant guide.

Are out-of-state students eligible to enroll in Covered California?

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Out-of-state students are eligible if they are a resident of California; a U.S. citizen, national or lawfully present in the U.S.; and not incarcerated.

What does lawfully present mean?

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See page 12/13 of the Eligibility for Individuals and Families  participant guide:

See also page 27 of the individuals and families application has a list of acceptable immigration statuses.

Why would an individual enroll in the exchange if their income is greater than 400% of the FPL and thus the individual would be paying the full cost?

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Covered California’s individual market offers access to a variety of health insurance plans with standardized plan designs that could meet the consumer’s needs and makes shopping for coverage more convenient.

If an individual has an accident and did not elect insurance during the open enrollment period, will there be an “emergency” late enrollment allowed even if an added penalty or cost is added to the individual premium?

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No.

From the date of the qualifying event, e.g. child birth, how long does the policy holder have to notify Covered California?

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Consumers have 60 calendar days from the date of the qualifying event to take advantage of the special enrollment period.

In our library, you’ll find carrier forms, applications, enrollment kits, broker bonuses, marketing resources, and more (video tutorial). However, not all carrier forms are available online.

If you don’t find what you are looking for, contact our team for help at 800.696.4543 or materialsrequest@claremontcompanies.com.