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Health Net Plans Discontinue Out-of-State Coverage

Health Net Plans Discontinue Out-of-State Coverage

Health Net Plans Discontinue Out-of-State Coverage, Covered California for Small Business,

Starting in April 2016, Out-of-State (OOS) coverage will no longer be available for Health Net plans through Covered California for Small Business. The good news — Covered California will continue to accept new groups with Health Net OOS members through March effective dates; and groups that renew in April or thereafter can take advantage of OOS coverage with Blue Shield of California.

Groups New to Covered California for Small Business with OOS Employees

Effective Dates: February and March
Health Net plans that cover OOS employees can be purchased.

Effective Dates: April and Thereafter
Health Net plans in up to two contiguous metal tiers can be purchased, however OOS employees will enroll in the Blue Shield Bronze PPO plan* and access care through the BlueCard Program.

Groups Currently with Covered California for Small Business Health Net OOS Coverage

Renewal Dates: February and March
OOS employees can remain enrolled in their current Health Net plan until the group’s next renewal, at which time they will migrate to the Blue Shield Bronze PPO plan* and access care through the BlueCard Program.

Renewal Dates: April and Thereafter
Groups will receive a notice in their renewal stating Health Net OOS coverage is no longer available. OOS employees will enroll in the Blue Shield Bronze PPO plan* and access care through the BlueCard Program.

Recommendations to Augment Coverage for Groups with OOS Employees

  • To increase benefit levels, supplement the Blue Shield Bronze PPO plan* with disability, accident, life, critical illness and hospitalization coverage.
  • To provide more choices for employees, pending participation requirements, offer Blue Shield higher tier plans alongside the Covered California for Small Business lower tier plans.

Notify your affected groups about the Health Net cut-off and recommend the best options to your clients.

 

Questions? Need assistance?
Contact the small group experts at 800.696.4543 or info@claremontcompanies.com.

 

*Enrollment in the Blue Shield of California Bronze plan through Covered California for Small Business is permitted even if the employer has selected Silver, Gold or Platinum plans for their coverage tier.

 

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