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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.
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Login To PrismNo. In California, only age, family size, location and plan design can be used to determine rates.
The “Cadillac Tax” is an excise tax on high-cost health plans. Starting in 2020 an excise tax of 40% will be assessed on the cost of coverage for health plans that exceed a certain annual limit ($10,200 for individual coverage and $27,500 for self and spouse or family coverage).
No. The metal tiers (Platinum, Gold, Silver, Bronze) are determined by the Actuarial Value of the plan, which is independent of the provider network.
Yes, carriers are all applying similar small group definition rules regarding both “non spouse W-2s” (sometimes referred to as “common law employee”) and 1099s. Check with the individual carriers for their exact rules.
Carriers are required to notify consumers with these policies that they have a grandfathered plan and disclose if they are grandfathered in all materials describing plan benefits.
If in doubt, contact the carrier.
No. Grandfathered plans are those that were in existence on March 23, 2010 and haven’t been changed in ways that substantially cut benefits or increased costs.
Covered California (individual exchange and Covered California for Small Business) is available in all counties. Not every plan is available in each county.
Any plans in Covered California that are also offered by the carrier outside of Covered California have to have the same benefits and premium rates.
There are HSA-qualified high deductible health plans (HDHPs) available in Covered California’s individual exchange. For example, the Blue Shield of California Bronze 60 HSA Plan.
Preventive health benefits with no cost-sharing does not apply to grandfathered plans.