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Large Group Plans

Health Plans

Health Net continues to define affordable health plan solutions for your large employer groups. We provide a range of low-cost benefit solutions through our Enhanced Choice and Starting Line-Up portfolios, designed to keep employees healthy and companies going strong!

Strong networks, better value

Through our strategic provider partnerships, we offer our most popular tailored networks and products for large employers, including: SmartCare, Salud, ExcelCare, HSA-compatible PPO, PPO, along with full-network HMO options.

Lower costs, making choices easy

We know that for large groups, affordability is a top priority, and that's why we continue to develop low-cost plan choices that are easy for you to offer, and make it easy for consumers and employers to afford.

Wellness and preventive services keep employees healthy

All our plans provide wellness, preventive and behavioral health services and programs – valued benefits that support our members’ health and well-being.

Check out our Enhanced Choice and Starting Line-Up portfolios!

Affordable, simple – the right solutions! Our Enhanced Choice and Starting Line-Up portfolios deliver the right price points for maximum value and accessibility, as well as for sustainable cost savings! Visit the forms and brochures section of our website for detailed sales tools.

Health Net is recognized as a driving force in tailored network strategies.

This stems from our ability to look more closely at key provider partners who share the same commitment to offering quality, affordable products. The result – We discover more opportunities to build network solutions that match the varying needs of our customers.

CanopyCare HMO – San Francisco Bay Area

Health Net CanopyCare HMO offers convenience and affordability to large groups in the San Francisco Bay Area. With its broad array of benefit design options, CanopyCare HMO offers employees access to care at five prominent medical groups with 5,000+ physicians, 22 contracted hospitals, and 48 urgent care centers.

Learn more about CanopyCare HMO

SmartCare

Through our strategic partnerships with expert community providers, we're able to offer a number of smart, cost-saving solutions, including the Health Net SmartCare Network. Available in select Southern and Northern California counties.

Learn more about SmartCare

Salud

Salud con Health Net is a system of health care designed to specifically address the cultural preferences of the Hispanic community. Members enjoy a health care experience that's affordable, local and culturally competent.

Learn more about Salud plans

ExcelCare Network

Health Net's ExcelCare Network combines all the best benefits from our HMO and Elect Open Access (EOA) plans with a select network of affordable and quality providers. The ExcelCare Network was designed to be a cost-effective health plan that offers quality coverage. Available in select Northern and Southern California counties.

Learn more about ExcelCare Network

With health maintenance organization (HMO) plans, members choose a primary care physician (PCP) from our network of providers and pay a fixed monthly fee. Their PCP then oversees all health care related services, including referrals and authorizations. HMOs are ideal for employees who would like one doctor to coordinate all their medical care at predictable costs.

If your clients select an HMO plan, their employees can depend on basic, inpatient and emergency services. Many plans include office visits, hospitalization, X-ray and lab services, prenatal and postnatal services, mental health services, and more. Copayments may vary according to plan.

What makes Salud different?

  • Designed for members of the Hispanic community, Salud offers access to affordable, local, culturally competent health care.
  • Quality medical professionals who understand the cultural preferences and health concerns of Latinos.
  • The ability to offer cost-savings to employers without giving up quality for employees.

And when Salud is paired alongside another Health Net plan, it's a combination that's perfectly matched for a diverse workforce.

Salud HMO y Mas

Salud HMO y Mas plans offer some of the lowest copayments around, making it easy to use preventive care benefits to stay healthy and well. Most offer:

  • Low, fixed copayments for many services.
  • Coordinated care through a primary care physician.
  • Emergency services covered worldwide.

plans are the best of both worlds – coordinated care through a primary care physician and freedom to see specialists without a referral. Most offer:

  • Access to in-network doctors and hospitals no matter where the member lives.
  • Fixed copayments for many services.
  • Specialist visits without a referral.
  • Emergency services covered worldwide.

Salud Mexico

Salud Mexico plans give members and their enrolled dependents access to medical care through participating SIMNSA1 providers in Tijuana, Rosarito, Mexicali, and Tecate without a referral.

  • Eligible members must live or work within 50 miles of either side of the California-Mexico border.
  • The SIMNSA treating physician will coordinate all care in Mexico.
  • SIMNSA is the only Mexican health plan regulated by the California Department of Managed Health Care (DMHC).

Broker & Employer Materials

1 A network of physicians contracting with Sistemas Medicos Nacionales, S.A. de C.V. (SIMNSA) has been selected to provide services in Mexico.

We know consumers who choose PPO are looking for greater flexibility and choice in their health care benefits. We offer a wide range of traditional PPO and HSA/HRA PPO plans supported by extensive medical and pharmacy networks. Our PPO product offering is comparable to our competitors, including:

  • Network strength: Our Health Net PPO network is one of the largest in California. The out-of-state First Health network – a nationally recognized PPO – is available in all 50 states, Washington, D.C. and Puerto Rico.
  • HSA/HRA, important product offerings for large business: Our health plan PPO products are offered with HSA/HRA account options via the employer group's choice or accounts administered by HealthEquity.
  • Travel program: Wherever our PPO members go, we have them covered. Health Net PPO members and their covered dependents have access to quality health care while traveling. Members are covered for urgent care and emergency services received from licensed providers or treatment centers anywhere in the world.

Flex Net Managed Indemnity Plans

Flex Net is a managed indemnity plan that combines both traditional fee-for-service coverage and managed care. Members pay a set percentage of the doctor's or other provider's allowable fee for each service performed, plus there are review processes so that expenditures and utilization can be managed efficiently.

What are the basics?

With this point-of-service plan, members can choose between our preferred provider organization (PPO) and out-of-network benefit levels every time they need care.

  • Flex Net is a managed indemnity, or fee-for-service, insurance product.
  • It allows members the freedom to seek covered services from any licensed provider.

How does it work?

  • Without a referral, members call any licensed physician or specialist.
  • Costs will be higher and members may need claim forms for certain services.
  • Flex Net generally provides coverage for members who live outside the Health Net service area and cannot enroll in one of Health Net's core medical plans such as HMO or PPO.
  • Flex Net also provides coverage for eligible California-based retirees who reside outside the Health Net service area.
  • With out-of-network coverage, members generally pay a deductible and coinsurance.

What are the benefits?

  • Flex Net plans offer basic, inpatient and emergency services.
  • Deductibles, coinsurance and other services may vary by plan.

The following benefits are common to Flex Net plans:

  • Coverage for physician office visits (after a calendar year deductible is satisfied)
  • Coverage for hospital service visits (after a calendar year deductible is satisfied)
  • Coverage for emergency room service (in addition to the calendar year deductible)

A Health Savings Account (HSA) allows members to set aside a portion of their pre-tax income to an interest-bearing account used for qualified medical expenses and medications. Anyone enrolled in a high-deductible health plan can contribute to an HSA. Benefits include: The money stays with the member, even if they change jobs; no time limit on using funds; and contributions are free of FICA and FUTA taxes.

A Health Reimbursement Arrangement (HRA) is a employer sponsored plan. An employer sets allowances for employees who can then use that money to be reimbursed for medical expenses.

Learn more about integrated HSA/HRA

Health Net delivers the right solutions to clients who are looking for greater flexibility and choice in their consumer-directed health care benefits. Our Self-Funding product and fully funded high deductible health plan PPO products are offered with integrated account options through HealthEquity, a proven expert in financial arrangement integration and administration.

The addition of account integration provides a whole new level of service, convenience and choice for employer groups and employees alike. By utilizing HealthEquity's easy-to-use tools and comprehensive resources, clients can maximize health savings and experience high levels of excellence in customer service.

HSA/HRA advantages

The HSA/HRA product offering creates selling opportunities that can generate increased client satisfaction and return business, including:

  • Helping clients realize short- and long-term savings opportunities through their health care benefits.
  • Confirming how clients can empower employees to build health savings and take advantage of significant tax savings.

For more information, contact your Health Net sales consultant, or go to the HealthEquity website for sales materials.

Find enrollment forms and HSA/HRA integrated benefit grids here:

Health Net has created HSA-compatible plans for groups. This easy-to-use program accommodates members by allowing them to control their personal health savings account (HSA) and receive low monthly premiums, while employers benefit through potential tax savings. Members have the option to use any financial institution of their choice, or to open an HSA in one of our HSA-compatible plans through Bank of America.

Accessibility

Members have 24/7 access to their online account, including online bill pay, expense tracking and investments tracking. A Bank of America HSA Visa debit card makes paying medical expenses easier and more convenient.

Member benefits

  • Low premiums
  • No referrals
  • Combined medical and pharmacy deductible
  • Tax-free contributions
  • Investible rollover savings
  • HSA funds earn interest

Above is general information only. For more details on the tax advantages of an HSA, please consult with a professional tax advisor.

Large Group Forms and Brochures

Supplemental Coverage

Beyond outstanding health insurance, Health Net offers a variety of complementary supplemental plans – helping you deliver a comprehensive benefits solution for your employer groups.

View our Forms and Brochures pages to view/download a variety of detailed supplemental plan materials.

Employee Assistance Programs

When employees live better, companies work better. That's why an Employee Assistance Program (EAP) from a company with extensive behavioral health experience is a key component of any company's benefit package.

Through MHN, our behavioral health subsidiary, we offer expert, innovative EAP solutions for groups of all sizes, with clinical support as well as work and life services for members and organizational development, management consultation, crisis management, and workplace trainings for employers.

Clients may select a standard EAP, add enhanced services, or craft a customized suite of services just right for their employees.

Visit MHN website for more information about our EAP or MHN's other products – including carve-out behavioral health plans and workplace wellness solutions.

Dental Plans

With both PPO and DHMO insurance plans, Health Net offers large networks of qualified dentists and substantial savings on in-network dental services.

More on Health Net Dental

Vision Plans

A variety of eye care benefits, including discounts on eyewear and member services hours designed around members' busy schedules.

Chiropractic Care

Members receive affordable coverage by in-network chiropractors – with no referrals needed. In California, our SmartCare plans include chiropractic services as value-added benefits many Californians want.

Acupuncture

Considered traditional Chinese medicine, this homeopathic approach to wellness has been practiced for centuries, and it can be added to any existing Health Net plan. In California, our SmartCare plans include acupuncture services as value-added benefits many Californians want.

Learn more about acupuncture

Group Term Life

Health Net Life Insurance Company, a Health Net affiliate, offers a full range of optional life benefits designed with different lives and different life insurance needs in mind. Products like Group Term Life, Accidental Death and Dismemberment, Supplemental Group Term Life Insurance, and Dependent Life Insurance.

AD&D

Accidental Death and Dismemberment (AD&D) benefits are usually included along with the group life policy. Health Net Life Insurance Company does not offer Accidental Death and Dismemberment benefits on a stand-alone basis.

It Pays to Bundle!: Get Multi-Product Discounts

When your clients add Dental, Vision or Life to the quote, they get added affordability. That's because we're giving up to 2% combined savings on the medical premium. This program is available to groups of at least 51 employees, up to a maximum of 1,000 enrolled members. The savings on medical premiums:

  • Dental – 1.0%
  • Vision – 0.5%
  • Life – 0.5%
Last Updated: 10/22/2021