Small Group Health Plans
Health Net provides a range of relevant, affordable health plan solutions for your small employer groups – backed by expert business support for you, your clients and all of our members.
With strategic provider partnerships, we provide valuable tailored network solutions for small employer groups, in addition to our nationally recognized, full-network HMO options.
We have also pioneered innovations in the area of proactive health care – offering unique wellness services like Decision Power® Health & Wellness tools with most of our plans.
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.
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.
Health Net was an early pioneer in the creation of tailored networks that give California employers the value they want by delivering affordability without compromise. Now we're delivering even more as we continue to build on our tailored network strength by delivering our new benefit-rich statewide WholeCare network and plans.
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.
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.
- See Tailored Networks information (above) on this page.
- Full Network
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 plans make it possible to get what's really important when it comes to benefits – comprehensive coverage, plan choice and low, predictable copayments. Plan members and insureds also have access to participating SIMNSA1 providers in Mexico.
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.
1A network of physicians contracting with SistemasMedicos Nacionales, S.A. de C. V. (SIMNSA) has been selected to provide services to Health Net Salud HMO y Mas members. Family members residing in Mexico cannot receive plan benefits when visiting California providers, except for emergencies or urgently needed care, which are covered worldwide.
Our preferred provider organization (PPO) members have access to an expansive network of both local and out-of-state providers. They'll also have coverage for a wide range of medical services – and specialist visits require no referral.
- No referrals required for in-network specialists.
- Freedom to choose in-network or out-of-network providers.
- Large network.
- Wide range of covered services.
- No claims to file when you visit an in-network provider.
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)
Health Net has created EZ Access HSA 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 for Life® Health Savings Account (HSA) from Bank of America.1
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.
- 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.
1HSA administration services are provided by Bank of America, N.A. Investments in HSAs are not FDIC insured, may lose value and are not bank guaranteed. The HSA custodian, Bank of America, N.A., is not a registered broker dealer. Promotional materials describing The HSA for Life have been approved and authorized by Bank of America.
What is a Health Savings Account (HSA)?
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.
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 www.mhn.com for more information about our EAP or MHN's other products – including carve-out behavioral health plans and workplace wellness solutions.
With both PPO and DHMO insurance plans, Health Net offers large networks of qualified dentists and substantial savings on in-network dental services.
A variety of eye care benefits, including discounts on eyewear and member services hours designed around members' busy schedules.
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.
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.
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.
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.