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Power Wellness Products

Power Wellness Products

Health Net's Power Wellness products are ideal for those employers ready to take the next step toward employee wellness. Power Wellness products provide employers with the tools and programs they need to implement a comprehensive employee wellness program. Key features include Health Net's Wellness Toolkit to help employers get started, program reporting to track results, and wellness consultation from our experienced health promotion team to support employers as they develop effective ongoing wellness initiatives. Additional services include integrated financial incentives for employees who meet wellness goals and onsite biometric screenings.

Key Features:


Wellness Toolkit for Employers
  • Tip sheets and resource guides offer a roadmap for planning, implementing, and evaluating the success of your wellness program.
  • Customizable surveys, flyers, emails and posters make program promotion easy.

Integration with Decision Power Programs
  • Power Wellness products are designed to help employers get the most value out of Decision Power tools and programs.
  • All Power Wellness products integrate core features of Health Net's Decision Power programs to meet your organization's unique needs.

Integrated Financial Incentives
  • Integrated financial incentives help employers who are ready to invest in the wellbeing of their employees boost their engagement rates. Talk to your account manager about the incentive design that's right for you.

Wellness Reporting
  • Reporting on your population's unique health risks and program engagement metrics allows you to demonstrate results and refine your wellness programs over time. Talk to your account manager to learn more.

Wellness Consultation
  • Our experienced team of wellness consultants can help you maximize your organization's wellness initiatives by assisting with:
    • Strategic planning.
    • Establishing meaningful goals and objectives for your program.
    • Support for promotion and implementation.
    • Reporting on your key program outcomes.


Power Wellness Product Menu

Power Wellness Start-Up Package (Health Assessment Package)
Take advantage of the Power Wellness Start-Up package. This package offers all of the tools you need to get your wellness program up and running. We'll help you leverage Health Net's convenient, online Health Risk Questionnaire to increase your employees' awareness of their personal health status and long-term health risks. With adequate participation, we'll also help you better understand the health and wellness of your workforce.

Key Features:


  • Wellness Toolkit for Employers
  • Customizable flyers, posters and emails to promote your campaign
  • Wellness reporting provided by one of our experienced wellness consultants for those groups who achieve a minimum of 50 HRQ completions (minimum thresholds apply to protect member privacy)
  • Convenient, integrated financial incentive buy-up option available for HRQ completion

Power Wellness Screenings Package (Biometrics Screening Package)
Are you ready to take your wellness program to the next level? Then look into the Power Wellness Screenings package. The Screenings package adds onsite biometric screening services, provided for your employees at your worksite, to your wellness initiative.

Key Features:


  • Onsite biometric screening services (Per participant and minimum participation fees apply.)
    • Healthy Heart screening package includes the following
      • Accurate fingerstick testing for total cholesterol (TC), HDL, TC/HDL ratio, and glucose
      • Blood pressure and pulse
      • Body mass index (BMI)
      • Identification of out of normal range values and counseling throughout the screening process
  • Screening data upload to each member's online Health Risk Questionnaire
  • Wellness Toolkit for employers
  • Customizable flyers, posters and emails to promote your biometric screening campaign
  • Wellness reporting provided by one of our experienced wellness consultants for those groups who achieve a minimum of 50 participants in their biometric screening event and 50 HRQ completions (minimum thresholds apply to protect member privacy)
  • Convenient, integrated financial incentive buy-up option available for completion of biometric screening and HRQ


Power Wellness Connect Package (Primary Care Physician (PCP) Engagement Package)
Sometimes people need a little incentive to do the right thing for their health. The Power Wellness Connect package offers a convenient, integrated incentive program - a gift card (you choose the value) for employees who complete the HRQ and visit their PCP to share the results.

Key Features:


  • Convenient, integrated incentive for completing the HRQ and sharing results during a preventive care visit
  • Wellness Toolkit for employers
  • Customizable flyers, posters and emails to promote your wellness campaign
  • Wellness reporting provided by one of our experienced wellness consultants for those groups who achieve a minimum of 50 HRQ completions (minimum thresholds apply to protect member privacy)

Contact your account manager for details and cost information.

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General Purpose
Health Net's National Medical Policies (the "Policies") are developed to assist Health Net in administering plan benefits and determining whether a particular procedure, drug, service, or supply is medically necessary. The Policies are based upon a review of the available clinical information including clinical outcome studies in the peer-reviewed published medical literature, regulatory status of the drug or device, evidence-based guidelines of governmental bodies, and evidence-based guidelines and positions of select national health professional organizations. Coverage determinations are made on a case-by-case basis and are subject to all of the terms, conditions, limitations, and exclusions of the Member's contract, including medical necessity requirements. Health Net may use the Policies to determine whether, under the facts and circumstances of a particular case, the proposed procedure, drug, service, or supply is medically necessary. The conclusion that a procedure, drug, service, or supply is medically necessary does not constitute coverage. The Member's contract defines which procedure, drug, service, or supply is covered, excluded, limited, or subject to dollar caps. The policy provides for clearly written, reasonable and current criteria that have been approved by Health Net's National Medical Advisory Council (MAC). The clinical criteria and medical policies provide guidelines for determining the medical necessity criteria for specific procedures, equipment and services. In order to be eligible, all services must be medically necessary and otherwise defined in the Member's benefits contract as described in this "Important Notice" disclaimer. In all cases, final benefit determinations are based on the applicable contract language. To the extent there are any conflicts between medical policy guidelines and applicable contract language, the contract language prevails. Medical policy is not intended to override the policy that defines the Member's benefits, nor is it intended to dictate to providers how to practice medicine.


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The date of posting is not the effective date of the Policy. The Policy is effective as of the date determined by Health Net. All policies are subject to applicable legal and regulatory mandates and requirements for prior notification. If there is a discrepancy between the policy effective date and legal mandates and regulatory requirements, the requirements of law and regulation shall govern. In some states, prior notice or posting on the website is required before a policy is deemed effective. For information regarding the effective dates of Policies, contact your provider representative. The Policies do not include definitions. All terms are defined by Health Net. For information regarding the definitions of terms used in the Policies, contact your provider representative.


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Health Net reserves the right to amend the Policies without notice to providers or Members. In some states, prior notice or website posting is required before an amendment is deemed effective.


No Medical Advice.
The Policies do not constitute medical advice. Health Net does not provide or recommend treatment to Members. Members should consult with their treating physician in connection with diagnosis and treatment decisions.


No Authorization or Guarantee of Coverage.
The Policies do not constitute authorization or guarantee of coverage of any particular procedure, drug, service, or supply. Members and providers should refer to the Member contract to determine if exclusions, limitations and dollar caps apply to a particular procedure, drug, service, or supply.


Policy Limitation: Member's Contract Controls Coverage Determinations.
Statutory Notice to Members: The materials provided to you are guidelines used by this plan to authorize, modify or deny care for persons with similar illnesses or conditions. Specific care and treatment may vary depending on individual need and the benefits covered under your contract. The determination of coverage for a particular procedure, drug, service, or supply is not based upon the Policies, but rather is subject to the facts of the individual clinical case, terms and conditions of the Member's contract, and requirements of applicable laws and regulations. The contract language contains specific terms and conditions, including pre-existing conditions, limitations, exclusions, benefit maximums, eligibility, and other relevant terms and conditions of coverage. In the event the Member's contract (also known as the benefit contract, coverage document, or evidence of coverage) conflicts with the Policies, the Member's contract shall govern. The Policies do not replace or amend the Member contract.


Policy Limitation: Legal and Regulatory Mandates and Requirements
The determinations of coverage for a particular procedure, drug, service, or supply is subject to applicable legal and regulatory mandates and requirements. If there is a discrepancy between the Policies and legal mandates and regulatory requirements, the requirements of law and regulation shall govern.


Reconstructive Surgery
California Health and Safety Code 1367.63 requires health care service plans to cover reconstructive surgery. "Reconstructive surgery" means surgery performed to correct or repair abnormal structures of the body caused by congenital defects, developmental abnormalities, trauma, infection, tumors, or disease to do either of the following:


1. To improve function; or
2. To create a normal appearance, to the extent possible.


Reconstructive surgery does not mean "cosmetic surgery," which is surgery performed to alter or reshape normal structures of the body in order to improve appearance.


Requests for reconstructive surgery may be denied, if the proposed procedure offers only a minimal improvement in the appearance of the enrollee, in accordance with the standard of care as practiced by physicians specializing in reconstructive surgery.


Reconstructive Surgery after Mastectomy
California Health and Safety Code 1367.6 requires treatment for breast cancer to cover prosthetic devices or reconstructive surgery to restore and achieve symmetry for the patient incident to a mastectomy. Coverage for prosthetic devices and reconstructive surgery shall be subject to the copayment, or deductible and coinsurance conditions, that are applicable to the mastectomy and all other terms and conditions applicable to other benefits. "Mastectomy" means the removal of all or part of the breast for medically necessary reasons, as determined by a licensed physician and surgeon.


Policy Limitations: Medicare and Medicaid
Policies specifically developed to assist Health Net in administering Medicare or Medicaid plan benefits and determining coverage for a particular procedure, drug, service, or supply for Medicare or Medicaid Members shall not be construed to apply to any other Health Net plans and Members. The Policies shall not be interpreted to limit the benefits afforded Medicare and Medicaid Members by law and regulation.

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