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Small Business Group Plans – California

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2020 – HMO – Summary of Benefits

Full Network HMO

Full Network HMO Platinum $10

English 2.6MB   03/19/20


Full Network HMO Platinum $10 + NF

English 2.6MB   03/19/20


Full Network HMO Platinum $20

English 2.6MB   03/19/20


Full Network HMO Platinum $20 + INF

English 2.6MB   03/19/20


Full Network HMO Platinum $30

English 2.6MB   03/19/20


Full Network HMO Platinum $30 + INF

English 2.6MB   03/19/20


Full Network HMO Gold $30

English 2.6MB   03/19/20


Full Network HMO Gold $30 + INF

English 2.6MB   03/19/20


Full Network HMO Gold $35

English 2.6MB   03/19/20


Full Network HMO Gold $35+INF

English 2.6MB   03/19/20


Full Network HMO Gold $40

English 2.6MB   03/19/20


Full Network HMO Gold $40 + INF

English 2.6MB   03/19/20


Full Network HMO Gold $50

English 2.6MB   03/19/20


Full Network HMO Gold $50 + INF

English 2.6MB   03/19/20


Full Network HMO Silver $50

English 2.6MB   03/19/20


Full Network HMO Silver $50 + INF

English 2.6MB   03/19/20


SmartCare HMO

SmartCare HMO Platinum $10

English 2.6MB   03/19/20


SmartCare HMO Platinum $10 + INF

English 2.6MB   03/19/20


SmartCare HMO Platinum $20

English 2.6MB   03/19/20


SmartCare HMO Platinum $20 + INF

English 2.6MB   03/19/20


SmartCare HMO Platinum $30

English 2.6MB   03/19/20


SmartCare HMO Platinum $30 +INF

English 2.6MB   03/19/20


SmartCare HMO Gold $30

English 2.6MB   03/19/20


SmartCare HMO Gold $30 + INF

English 2.6MB   03/19/20


SmartCare HMO Gold $35

English 2.6MB   03/19/20


SmartCare HMO Gold $35 + INF

English 2.6MB   03/19/20


SmartCare HMO Gold $40

English 2.6MB   03/19/20


SmartCare HMO Gold $40 + INF

English 2.6MB   03/19/20


SmartCare HMO Gold $50

English 2.6MB   03/19/20


SmartCare HMO Gold $50 + INF

English 2.6MB   03/19/20


SmartCare HMO Silver $50

English 2.6MB   03/19/20


SmartCare HMO Silver $50 + INF

English 2.6MB   03/19/20


WholeCare HMO

WholeCare HMO Platinum $10

English 2.6MB   03/19/20


WholeCare HMO Platinum $10 + INF

English 2.6MB   03/19/20


WholeCare HMO Platinum $20

English 2.6MB   03/19/20


WholeCare HMO Platinum $20 + INF

English 2.6MB   03/19/20


WholeCare HMO Platinum $30

English 2.6MB   03/19/20


WholeCare HMO Platinum $30 + INF

English 2.6MB   03/19/20


WholeCare HMO Gold $30

English 2.6MB   03/19/20


WholeCare HMO Gold $30 + INF

English 2.6MB   03/19/20


WholeCare HMO Gold $35

English 2.6MB   03/19/20


WholeCare HMO Gold $35 + INF

English 2.6MB   03/19/20


WholeCare HMO Gold $40

English 2.6MB   03/19/20


WholeCare HMO Gold $40 + INF

English 2.6MB   03/19/20


WholeCare HMO Gold $50

English 2.7MB   03/19/20


WholeCare HMO Gold $50 + INF

English 2.7MB   03/19/20


WholeCare HMO Silver $50

English 2.6MB   03/19/20


WholeCare HMO Silver $50 + INF

English 2.7MB   03/19/20


2020 – Salud HMO y Mas – SUMMARY OF BENEFITS


Salud HMO y Mas Gold $30

English 2.1MB   03/19/20


Salud HMO y Mas Gold $30 + INF

English 2.1MB   03/19/20


Salud HMO y Mas Gold $35

English 2.1MB   03/19/20


Salud HMO y Mas Gold $35 + INF

English 2.1MB   03/19/20


Salud HMO y Mas Gold $40

English 2.1MB   03/19/20


Salud HMO y Mas Gold $40+ INF

English 2.1MB   03/19/20


Salud HMO y Mas Gold $50

English 2.1MB   03/19/20


Salud HMO y Mas Gold $50 + INF

English 2.1MB   03/19/20


Salud HMO y Mas Platinum $10

English 2.1MB   03/19/20


Salud HMO y Mas Platinum $10 + INF

English 2.1MB   03/19/20


Salud HMO y Mas Platinum $20

English 2.1MB   03/19/20


Salud HMO y Mas Platinum $20 + INF

English 2.1MB   03/19/20


Salud HMO y Mas Platinum $30

English 2.1MB   03/19/20


Salud HMO y Mas Platinum $30 + INF

English 2.1MB   03/19/20


Salud HMO y Mas Silver $50

English 2.1MB   03/19/20


Salud HMO y Mas Silver $50 + INF

English 2.1MB   03/19/20


2020 – PPO – Summary of Benefits

Summary of Benefits
Plans for new and renewing groups effective 1/1/20.

EnhancedCare PPO

Bronze 60 HDHP PPO 5600/20% + Child Dental Alt

English 2.1MB   01/15/20


Bronze 60 HDHP PPO 5600/20% + Child Dental Alt INF

English 2.1MB   01/15/20


EnhancedCare Gold 80 PPO 500/20 + Child Dental Alt

English 2MB   01/15/20


EnhancedCare Gold 80 PPO 500/20 + Child Dental Alt INF

English 2MB   01/15/20


EnhancedCare Gold 80 PPO 0/30 + Child Dental Alt

English 2MB   01/15/20


EnhancedCare Gold 80 PPO 0/30 + Child Dental Alt INF

English 2MB   01/15/20


EnhancedCare Gold 80 PPO 1000/30 + Child Dental Alt

English 2MB   01/15/20


EnhancedCare Gold 80 PPO 1000/30 + Child Dental Alt INF

English 2MB   01/15/20


EnhancedCare Gold 80 Value PPO 750/15 + Child Dental Alt

English 2MB   01/15/20


EnhancedCare Gold 80 Value PPO 750/15 + Child Dental Alt +INF

English 2MB   01/15/20


EnhancedCare Platinum 90 PPO 250/15 + Child Dental Alt

English 2MB   01/15/20


EnhancedCare Platinum 90 PPO 250/15 + Child Dental Alt INF

English 2MB   01/15/20


EnhancedCare Silver 70 Value PPO 1700/50 + Child Dental Alt

English 2.1MB   01/15/20


EnhancedCare Silver 70 Value PPO 1700/50 + Child Dental Alt INF

English 2MB   01/15/20


EnhancedCare Silver 70 PPO 2250/55 + Child Dental Alt

English 2.1MB   01/15/20


EnhancedCare Silver 70 PPO 2250/55 + Child Dental Alt INF

English 2.1MB   01/15/20


EnhancedCare Silver 70 HDHP PPO 1400/40% + Child Dental Alt

English 2MB   01/15/20


EnhancedCare Silver 70 HDHP PPO 1400/40% + Child Dental Alt INF

English 2MB   01/15/20


Full Network PPO

Bronze 60 PPO 6300/65 + Child Dental

English 2MB   02/27/20


Bronze 60 PPO 6300/65 + Child Dental INF

English 2MB   02/27/20


Bronze 60 HDHP PPO 5600/20% + Child Dental Alt

English 2MB   02/27/20


Bronze 60 HDHP PPO 5600/20% + Child Dental Alt INF

English 2MB   02/27/20


Gold 80 PPO 500/20 + Child Dental Alt

English 2MB   02/27/20


Gold 80 PPO 500/20 + Child Dental Alt INF

English 2MB   02/27/20


Gold 80 PPO 250/25 + Child Dental

English 2.1MB   02/27/20


Gold 80 PPO 250/25 + Child Dental INF

English 2MB   02/27/20


Gold 80 PPO 0/30 + Child Dental Alt

English 2MB   02/27/20


Gold 80 PPO 0/30 + Child Dental Alt INF

English 2MB   02/27/20


Gold 80 PPO 1000/30 + Child Dental Alt

English 2MB   02/27/20


Gold 80 PPO 1000/30 + Child Dental Alt INF

English 2MB   02/27/20


Gold 80 Value PPO 750/15 + Child Dental Alt

English 2MB   02/27/20


Gold 80 Value PPO 750/15 + Child Dental Alt INF

English 2MB   02/27/20


Platinum 90 PPO 0/15 + Child Dental

English 2MB   02/27/20


Platinum 90 PPO 0/15 + Child Dental INF

English 2MB   02/27/20


Platinum 90 PPO 250/15 + Child Dental Alt

English 2MB   02/27/20


Platinum 90 PPO 250/15 + Child Dental Alt INF

English 2MB   02/27/20


Silver 70 PPO 2250/50 + Child Dental

English 2MB   02/27/20


Silver 70 PPO 2250/50 + Child Dental INF

English 2MB   02/27/20


Silver 70 PPO 2250/55 + Child Dental Alt

English 2.1MB   02/27/20


Silver 70 PPO 2250/55 + Child Dental Alt INF

English 2.1MB   02/27/20


Silver 70 HDHP PPO 1400/40% + Child Dental Alt

English 2MB   02/27/20


Silver 70 HDHP PPO 1400/40% + Child Dental AltINF

English 2MB   02/27/20


Silver 70 Value PPO 1700/50 + Child Dental Alt

English 2MB   02/27/20


Silver 70 Value PPO 1700/50 + Child Dental Alt INF

English 2MB   02/27/20


2019 – Plan Overviews / Summary of Benefits

Plan Overviews
Plans for new and renewing groups effective 1/1/19.

EnhancedCare PPO

Platinum 90 250/15 + Child Dental Alt (ENG) 2.2MB   12/09/19

Gold 80 1000/30 + Child Dental Alt (ENG) 2.2MB   12/09/19

Gold Value (ENG) 2.3MB   12/09/19

Silver 70 2000/55 + Child Dental Alt (ENG) 2.2MB   12/09/19

Silver Value (ENG) 2.2MB   12/09/19

Silver 70 HDHP 1350/40 + Child Dental Alt (ENG) 2.2MB   12/09/19

Bronze 60 HDHP 5600/15 + Child Dental Alt (ENG) 2.2MB   12/09/19


PPO

Platinum 90 0/15 + Child Dental (ENG) 2.2MB   12/09/19

Platinum 90 0/15 + Child Dental (SPN) 2.2MB   12/08/19

Platinum 250/15 + Child Dental Alt (ENG) 2.2MB   12/09/19

Platinum 250/15 + Child Dental Alt (SPN) 2.6MB   12/08/19

Gold 80 0/30 + Child Dental (ENG) 2.2MB   12/09/19

Gold 80 0/30 + Child Dental (SPN) 2.3MB   01/14/19

Gold 80 Value 750/10 + Child Dental Alt (ENG) 2.2MB   12/09/19

Gold 80 Value 750/10 + Child Dental Alt (SPN) 2.6MB   12/08/19

Gold 80 1000/30 + Child Dental Alt (ENG) 2.2MB   12/09/19

Gold 80 1000/30 + Child Dental Alt (SPN) 2.6MB   12/08/19

Silver 70 2000/45 + Child Dental (ENG) 2.2MB   12/09/19

Silver 70 2000/45 + Child Dental (SPN) 2.2MB   12/08/19

Silver 70 2000/55 + Child Dental Alt (ENG) 2.2MB   12/09/19

Silver 70 2000/55 + Child Dental Alt (SPN) 2.2MB   12/08/19

Silver 70 Value 1700/30 + Child Dental Alt (ENG) 2.2MB   12/09/19

Silver 70 Value 1700/30 + Child Dental Alt (SPN) 2.2MB   12/08/19

Silver 70 HDHP 1350/40 + Child Dental Alt (ENG) 2.2MB   12/09/19

Silver 70 HDHP 1350/40 + Child Dental Alt (SPN) 2.2MB   12/08/19

Bronze 60 6300/75 + Child Dental (ENG) 2.2MB   12/09/19

Bronze 60 6300/75 + Child Dental (SPN) 2.3MB   01/14/19

Bronze 60 HDHP 5600/15 + Child Dental Alt (ENG) 2.3MB   12/09/19

Bronze 60 HDHP 5600/15 + Child Dental Alt (SPN) 2.3MB   01/14/19


PureCare HSP

Platinum 90 0/15 + Child Dental (ENG) 525kB   12/09/19

Platinum 90 0/15 + Child Dental (SPN) 541kB   02/26/19

Platinum 90 0/15 + Child Dental (CHI) 799kB   12/10/19

Gold 80 0/30 + Child Dental (ENG) 528kB   12/09/19

Gold 80 0/30 + Child Dental (SPN) 541kB   02/26/19

Gold 80 0/30 + Child Dental (CHI) 773kB   12/10/19

Silver 70 2000/45 + Child Dental (ENG) 526kB   12/09/19

Silver 70 2000/45 + Child Dental (SPN) 541kB   02/26/19

Silver 70 2000/45 + Child Dental (CHI) 775kB   12/10/19

Bronze 60 6300/75 + Child Dental (ENG) 534kB   12/09/19

Bronze 60 6300/75 + Child Dental (SPN) 542kB   02/26/19

Bronze 60 6300/75 + Child Dental (CHI) 783kB   12/10/19


HMO

Platinum 10 (ENG) 515kB   12/09/19

Platinum 10 (SPN) 525kB   02/26/19

Platinum 10 (CHI) 727kB   12/10/19

Platinum 20 (ENG) 516kB   12/09/19

Platinum 20 (SPN) 525kB   02/26/19

Platinum 20 (CHI) 728kB   12/10/19

Platinum 30 (ENG) 471kB   12/09/19

Platinum 30 (SPN) 470kB   02/26/19

Platinum 30 (CHI) 671kB   12/10/19

Gold 30 (ENG) 517kB   12/09/19

Gold 30 (SPN) 525kB   02/26/19

Gold 30 (CHI) 712kB   12/10/19

Gold 35 (ENG) 463kB   12/09/19

Gold 35 (SPN) 470kB   02/26/19

Gold 35 (CHI) 671kB   12/10/19

Gold 40 (ENG) 543kB   12/09/19

Gold 40 (SPN) 524kB   02/26/19

Gold 40 (CHI) 728kB   12/10/19

Silver 50 (ENG) 516kB   12/09/19

Silver 50 (SPN) 524kB   02/26/19

Silver 50 (CHI) 729kB   12/10/19


WholeCare HMO

Platinum 10 (ENG) 549kB   12/09/19

Platinum 10 (SPN) 3.9MB   12/08/19

Platinum 10 (CHI) 790kB   12/10/19

Platinum 20 (ENG) 552kB   12/09/19

Platinum 20 (SPN) 3.9MB   12/08/19

Platinum 20 (CHI) 790kB   12/10/19

Platinum 30 (ENG) 505kB   12/09/19

Platinum 30 (SPN) 3MB   12/08/19

Platinum 30 (CHI) 769kB   12/10/19

Gold 30 (ENG) 549kB   12/09/19

Gold 30 (SPN) 3.9MB   12/08/19

Gold 30 (CHI) 720kB   12/10/19

Gold 35 (ENG) 485kB   12/09/19

Gold 35 (SPN) 6.3MB   12/08/19

Gold 35 (CHI) 739kB   12/10/19

Gold 40 (ENG) 551kB   12/09/19

Gold 40 (SPN) 3.7MB   12/08/19

Gold 40 (CHI) 790kB   12/10/19

Silver 50 (ENG) 550kB   12/09/19

Silver 50 (SPN) 528kB   02/28/19

Silver 50 (CHI) 791kB   12/10/19


SmartCare HMO

Platinum 10 (ENG) 528kB   12/09/19

Platinum 10 (SPN) 4.3MB   12/08/19

Platinum 10 (CHI) 790kB   12/10/19

Platinum 20 (ENG) 529kB   12/09/19

Platinum 20 (SPN) 3.9MB   12/08/19

Platinum 20 (CHI) 790kB   12/10/19

Platinum 30 (ENG) 484kB   12/09/19

Platinum 30 (SPN) 2.9MB   12/08/19

Platinum 30 (CHI) 768kB   12/10/19

Gold 30 (ENG) 523kB   12/09/19

Gold 30 (SPN) 4.3MB   12/08/19

Gold 30 (CHI) 791kB   12/10/19

Gold 35 (ENG) 491kB   12/09/19

Gold 35 (SPN) 3MB   12/08/19

Gold 35 (CHI) 741kB   12/10/19

Gold 40 (ENG) 557kB   12/09/19

Gold 40 (SPN) 3.9MB   12/08/19

Gold 40 (CHI) 791kB   12/10/19

Silver 50 (ENG) 557kB   12/09/19

Silver 50 (SPN) 3.9MB   12/08/19

Silver 50 (CHI) 791kB   12/10/19


Salud HMO y Más

Platinum 10 (ENG) 557kB   12/09/19

Platinum 10 (SPN) 4.3MB   12/08/19

Platinum 10 (CHI) 739kB   12/10/19

Platinum 20 (ENG) 557kB   12/09/19

Platinum 20 (SPN) 3.8MB   12/08/19

Platinum 20 (CHI) 740kB   12/10/19

Platinum 30 (ENG) 2.3MB   12/09/19

Platinum 30 (SPN) 2.9MB   12/08/19

Platinum 30 (CHI) 705kB   12/10/19

Gold 30 (ENG) 556kB   12/09/19

Gold 30 (SPN) 3.9MB   12/08/19

Gold 30 (CHI) 740kB   12/10/19

Gold 35 (ENG) 2.3MB   12/09/19

Gold 35 (SPN) 2.9MB   12/08/19

Gold 35 (CHI) 703kB   12/10/19

Gold 40 (ENG) 545kB   12/09/19

Gold 40 (SPN) 4.3MB   12/08/19

Gold 40 (CHI) 738kB   12/10/19

Silver 50 (ENG) 557kB   12/09/19

Silver 50 (SPN) 3.8MB   12/08/19

Silver 50 (CHI) 743kB   12/10/19


CommunityCare HMO

Gold 5 (ENG) 547kB   12/09/19

Gold 5 (SPN) 538kB   05/02/19

Gold 5 (CHI) 939kB   12/10/19

Silver 20 (ENG) 545kB   12/09/19

Silver 20 (SPN) 527kB   12/09/19

Silver 20 (CHI) 784kB   12/10/19

Bronze 45 (ENG) 545kB   12/09/19

Bronze 45 (SPN) 536kB   05/02/19

Bronze 45 (CHI) 776kB   12/10/19


Summary of Benefits

Enhanced Care PPO

Platinum 90 250/15 3.2MB   01/07/19

Platinum 90 250/15 w/inf 3.2MB   01/07/19

Gold 80 1000/30 3.1MB   01/07/19

Gold 80 1000/30 w/inf 3.1MB   01/07/19

Gold Value 3.2MB   01/07/19

Gold Value w/inf 3.2MB   01/07/19

Silver 70 2000/55 3.2MB   01/08/19

Silver 70 2000/55 w/inf 3.2MB   01/07/19

Silver Value 3.2MB   01/08/19

Silver Value w/inf 3.2MB   01/08/19

Silver 70 HDHP 1350/40 3.2MB   01/08/19

Silver 70 HDHP 1350/40 w/inf 3.2MB   01/08/19

Bronze 60 HDHP 5600/15 3.1MB   01/07/19

Bronze 60 HDHP 5600/15 w/inf 3.1MB   01/07/19


PPO

Platinum 90 0/15 3.1MB   01/08/19

Platinum 90 0/15 w/inf 3.1MB   01/08/19

Platinum 90 250/15 3.1MB   01/08/19

Platinum 90 250/15 w/inf 3.1MB   01/08/19

Gold 80 0/30 3.1MB   01/08/19

Gold 80 0/30 w/inf 3.1MB   01/08/19

Gold 80 1000/30 3.1MB   01/08/19

Gold 80 1000/30 w/inf 3.1MB   01/08/19

Gold 80 Value 750/10 3.1MB   01/08/19

Gold 80 Value 750/10 w/inf 3.1MB   01/08/19

Silver 70 2000/45 3.1MB   01/08/19

Silver 70 2000/45 w/inf 3.1MB   01/08/19

Silver 70 2000/55 3.2MB   01/08/19

Silver 70 2000/55 w/inf 3.2MB   01/08/19

Silver 70 Value 1700/30 3.1MB   01/08/19

Silver 70 Value 1700/30 w/inf 3.1MB   01/08/19

Silver 70 HDHP 1350/40 3.1MB   01/08/19

Silver 70 HDHP 1350/40 w/inf 3.1MB   01/08/19

Bronze 60 6300/75 3.1MB   01/08/19

Bronze 60 6300/75 w/inf 3.1MB   01/08/19

Bronze 60 HDHP 5600/15 3.1MB   01/08/19

Bronze 60 HDHP 5600/15 w/inf 3.1MB   01/08/19


PureCare HSP

Platinum 90 0/15 3.5MB   01/08/19

Platinum 90 0/15 w/inf 3.5MB   01/08/19

Gold 80 0/30 2.9MB   01/08/19

Gold 80 0/30 w/inf 2.9MB   01/08/19

Silver 70 2000/45 3.5MB   01/08/19

Silver 70 2000/45 w/inf 3.5MB   01/08/19

Bronze 60 6300/75 2.9MB   01/08/19

Bronze 60 6300/75 w/inf 2.9MB   01/08/19


HMO

Platinum 10 2.1MB   01/07/19

Platinum 10 w/inf 2.1MB   01/07/19

Platinum 20 2MB   01/07/19

Platinum 20 w/inf 2.1MB   01/07/19

Platinum 30 2MB   01/07/19

Platinum 30 w/inf 2.1MB   01/07/19

Gold 30 2MB   01/07/19

Gold 30 w/inf 2.1MB   01/07/19

Gold 35 2MB   01/07/19

Gold 35 w/inf 2.1MB   01/07/19

Gold 40 2MB   01/07/19

Gold 40 w/inf 2.1MB   01/07/19

Silver 50 2MB   01/07/19

Silver 50 w/inf 2MB   01/07/19


WholeCare HMO

Platinum 10 2.1MB   01/07/19

Platinum 10 w/inf 2.1MB   01/07/19

Platinum 20 2.1MB   01/07/19

Platinum 20 w/inf 2.1MB   01/07/19

Platinum 30 2.1MB   01/07/19

Platinum 30 w/inf 2.1MB   01/07/19

Gold 30 2.1MB   01/07/19

Gold 30 w/inf 2.1MB   01/07/19

Gold 35 2.1MB   01/07/19

Gold 35 w/inf 2.1MB   01/07/19

Gold 40 2.1MB   01/07/19

Gold 40 w/inf 2.1MB   01/07/19

Silver 50 2.1MB   01/07/19

Silver 50 w/inf 3.5MB   01/07/19


SmartCare HMO

Platinum 10 2.1MB   01/07/19

Platinum 10 w/inf 2.1MB   01/07/19

Platinum 20 2.1MB   01/07/19

Platinum 20 w/inf 2.1MB   01/07/19

Platinum 30 2.1MB   01/07/19

Platinum 30 w/inf 2.1MB   01/07/19

Gold 30 2.1MB   01/07/19

Gold 30 w/inf 2.1MB   01/07/19

Gold 35 2.1MB   01/07/19

Gold 35 w/inf 2.1MB   01/07/19

Gold 40 2.1MB   01/07/19

Gold 40 w/inf 2.1MB   01/07/19

Silver 50 2.4MB   01/07/19

Silver 50 w/inf 2.4MB   01/07/19


Salud HMO y Más

Platinum 10 3.5MB   01/08/19

Platinum 10 w/inf 3.5MB   01/08/19

Platinum 20 3.5MB   01/08/19

Platinum 20 w/inf 3.5MB   01/08/19

Platinum 30 3.5MB   01/08/19

Platinum 30 w/inf 3.5MB   01/08/19

Gold 30 3.5MB   01/08/19

Gold 30 w/inf 3.6MB   01/08/19

Gold 35 2.1MB   01/08/19

Gold 35 w/inf 2.1MB   01/08/19

Gold 40 2.1MB   01/08/19

Gold 40 w/inf 2.1MB   01/08/19

Silver 50 3.5MB   01/08/19

Silver 50 w/inf 3.5MB   01/08/19


CommunityCare HMO

Gold 5 3.5MB   01/07/19

Gold 5 w/inf 3.5MB   01/07/19

Silver 20 2.1MB   01/07/19

Silver 20 w/inf 2.1MB   01/07/19

Bronze 45 3.5MB   01/07/19

Bronze 45 w/inf 3.5MB   01/07/19


Certificate of Insurance

EnhancedCare PPO

Platinum 90 250/15 + Child Dental 4.2MB   10/31/18

Platinum 90 250/15 + Child Dental w/inf 4.2MB   10/31/18

Gold 80 1000/30 + Child Dental Alt 2.9MB   10/31/18

Gold 80 1000/30 + Child Dental Alt w/inf 2.9MB   10/31/18

Gold Value 4.2MB   10/31/18

Gold Value w/inf 4.2MB   10/31/18

Silver Value 2.9MB   10/31/18

Silver Value w/inf 2.9MB   10/31/18

Silver 70 2000/55 + Child Dental Alt 2.9MB   10/31/18

Silver 70 2000/55 + Child Dental Alt w/inf 3.3MB   03/12/19

Silver 70 HDHP 1350/40 + Child Dental Alt 2.9MB   10/31/18

Silver 70 HDHP 1350/40 + Child Dental Alt w/inf 2.9MB   10/31/18

Bronze 60 HDHP 5600/15 + Child Dental Alt 4.2MB   10/31/18

Bronze 60 HDHP 5600/15 + Child Dental Alt w/inf 4.2MB   10/31/18


Plan Brochures / Product Overviews


Portfolio Plan Desktopper

January 2020 135kB   01/05/20

January 2019 298kB   12/12/19


Portfolio Guide

January 2020 1.9MB   12/12/19

January 2019 1.3MB   12/08/19


Renewal Guide

Q4 2020 Renewal Guide 3.4MB   06/21/20

Q1 2020 Renewal Guide 1.9MB   12/12/19

Q4 2019 Renewal Guide 1.9MB   12/12/19


Broker PPO Fast Facts

English 82kB   12/12/19


Member Open Enrollment PPO Brochure

English 783kB   12/12/19


Presentation Folders

Generic Folder

English 564kB   12/09/19


Open Enrollment Folder

English 231kB   12/10/19

En Español (Spanish) 1.2MB   12/10/19


Open Enrollment Product flyers
To be used as inserts with the OE Folders, may not be used as stand-alone flyers.

HMO – Open Enrollment Product flyer

English 144kB   12/10/19

En Español (Spanish) 187kB   12/10/19


PPO – Open Enrollment Product flyer

English 155kB   12/10/19

En Español (Spanish) 657kB   12/10/19


POS – Open Enrollment Product flyer

En Español (Spanish) 144kB   12/10/19

En Español (Spanish) 91kB   12/10/19


EOA – Open Enrollment Product flyer

English 1.5MB   05/20/20

En Español (Spanish) 678kB   05/20/20


Applications and Forms


Ancillary Add-On or Change Form

English 78kB   12/09/19


Enrollment and Change Applications

Top Reasons for Employee Enrollment Delays

English 653kB   12/09/19


Employee Enrollment and Change Form (2020)

English 708kB   12/12/19

En Español (Spanish) 687kB   11/18/19

Chinese (Chinese) 952kB   11/18/19

Korean (Korean) 777kB   11/18/19

Vietnamese (Vietnamese) 706kB   11/18/19

Must be completed & submitted at time of enrollment in order to enroll new employees & existing dependents. Also used for employees/dependents waiving coverage.


Employee Enrollment and Change Form (January 2019)

English 721kB   12/12/19

En Español (Spanish) 692kB   12/21/18

Chinese (Chinese) 1MB   12/10/19

Korean (Korean) 939kB   12/10/19

Vietnamese (Vietnamese) 772kB   12/10/19

Must be completed & submitted at time of enrollment in order to enroll new employees & existing dependents. Also used for employees/dependents waiving coverage.


Renewal Election and Open Enrollment Medical Plan Change Request Form

January 2020 939kB   12/12/19

January 2019 773kB   12/12/19


Group Service Agreement/Policy Applications

Group Size Attestation Form

English 504kB   12/12/19

Must be completed & signed by the Employer Group.


Application for Group Service Agreement/Policy

January 2020 639kB   10/17/19

January 2019 643kB   10/09/18

Must be completed & signed by the Employer Group and Broker at time of enrollment and submitted along with check for first month's premium and enrollment forms. For renewals, this form must be completed and signed by the Employer Group and submitted to SBG Account Management for processing.


Religious Exemption Employer Form

English 496kB   12/09/19


Transition of Care

Continuity of Care Assistance Request Form

English 2.6MB   01/24/20

En Español (Spanish) 932kB   01/24/20


Prescription Transition form

English 2.1MB   07/23/20

En Español (Spanish) 2.6MB   07/23/20


Claims

Commercial Medical Claim Form

English 1.4MB   04/23/20

En Español (Spanish) 1.2MB   04/23/20


Commercial MHN Claim Form

English 2.9MB   03/28/19


Prescription Drug Claim Form

English 661kB   01/07/20

En Español (Spanish) 654kB   01/07/20


Dental Claim Form

English 2.8MB   04/12/10


Vision Claim Form

English 84kB   04/14/10


HIPAA Disclosures

Group Health Plan HIPAA Disclosure Forms

Disclosure Directive 95kB   06/13/16


Authorization For Disclosure of PHI

English 0kB   12/31/69

En Español (Spanish) 0kB   12/31/69

Chinese (Chinese) 0kB   12/31/69

Korean (Korean) 0kB   12/31/69


Health Net Life Insurance Forms

Employee Enrollment and Change Form

English 983kB   12/10/19

En Español (Spanish) 612kB   12/10/19


Group Life Insurance Conversion Form

English 183kB   12/10/19


Evidence of Insurability Life Form

English 680kB   12/10/19


Additional Forms

Employer Group Size Verification Form

English 448kB   08/12/19


Electronic Check Form

English 54kB   08/12/19


Proof of Eligibility Statement For Sole Proprietor, Partner or Corporate Officer

English 49kB   06/03/19


Principal Business or Headquarters Address Questionnaire

English 60kB   05/09/17


Rate Guides
New to Health Net? Contact Health Net Account Management, 1-800-447-8812, option 2, for questions on standard benefit rates. Looking for CalChoice or Covered California Small Business rates? Visit the CalChoice website at https://www.calchoice.com/DownloadForms.aspx, or contact Covered California Small Business at 1-877-752-4737.
Standard

Q3 2020 – Standard Rate Guide

English 23MB   05/19/20

Rates effective July 1, 2020, to September 30, 2020


Q2 2020 – Standard Rate Guide

English 5.6MB   02/27/20

Rates effective April 1, 2020 through June 15, 2020


Q1 2020 – Standard Rate Guide

English 3.2MB   02/26/20

Rates effective January 1, 2020 through March 15, 2020


Q4 2019 – Standard Rate Guide

English 13.3MB   12/12/19

Rates effective October 1, 2019, through December 15, 2019


Q3 2019 – Standard Rate Guide

English 13.1MB   12/12/19

Rates effective July 1, 2019, through September 15, 2019


Q2 2019 – Standard Rate Guide

English 7.1MB   12/12/19

Rates effective April 1, 2019, through June 15, 2019


Q1 2019 – Standard Rate Guide

English 7.8MB   12/12/19

Rates effective January 1, 2019, through March 15, 2019


Covered California

Q1 2020 – Covered California Rate Guide

English 4MB   12/12/19

Rates effective January 1, 2020, through March 15, 2020


Q4 2019 – Covered California Rate Guide

English 4.6MB   12/12/19

Rates effective October 1, 2019, through December 15, 2019


Q3 2019 – Covered California Rate Guide

English 1.1MB   05/31/19

Rates effective July 1, 2019, through September 15, 2019


Q2 2019 – Covered California Rate Guide

English 3.5MB   12/12/19

Rates effective April 1, 2019, through June 15, 2019


Q1 2019 – Covered California Rate Guide

English 4.5MB   12/12/19

Rates effective January 1, 2019, through March 15, 2019


Cal-Choice

Q1 2020 – Cal-Choice Rate Guide

English 3.6MB   12/12/19

Rates effective January 1, 2020, through March 15, 2020


Q4 2019 – Cal-Choice Rate Guide

English 3.4MB   12/12/19

Rates effective October 1, 2019, through December 15, 2019


Q3 2019 – Cal-Choice Rate Guide

English 3.7MB   12/12/19

Rates effective July 1, 2019, through September 15, 2019


Q2 2019 – Cal-Choice Rate Guide

English 2.4MB   12/12/19

Rates effective April 1, 2019, through June 15, 2019


Q1 2019 – Cal-Choice Rate Guide

English 2.6MB   12/12/19

Rates effective January 1, 2019, through March 15, 2019


Underwriting Guidelines


Underwriting Promotions

English 471kB   04/28/20


October 2020

Enhanced Choice A

English 396kB   06/05/20


Enhanced Choice B

English 397kB   06/05/20


Dental and Vision

English 403kB   06/05/20


Health Net Life

English 398kB   06/05/20


October 2019

Enhanced Choice A

English 395kB   08/19/19


Enhanced Choice B

English 396kB   08/19/19


Dental and Vision

English 396kB   08/19/19


Health Net Life

English 397kB   08/19/19


July 2019

Enhanced Choice A

English 283kB   06/26/19


Enhanced Choice B

English 284kB   06/26/19


Dental and Vision

English 286kB   06/26/19


Health Net Life

English 284kB   06/26/19


April 2019

Enhanced Choice A

English 283kB   03/28/19


Enhanced Choice B

English 284kB   03/28/19


Dental and Vision

English 287kB   03/28/19


Health Net Life

English 284kB   03/28/19


Support Tools


Broker Portal Overview

English 3.8MB   07/15/16

Broker Portal Overview (Flip Book)


Health Care Reform Materials

Summary of Benefits and Coverage (SBC) Search Flyer

English 385kB   03/13/15

Download only


Summary of Benefits and Coverage (SBC) Instructions Sheet

English 46kB   12/12/19


Preventive Care Services Overview (ACA Non-Grandfathered Plans)

English 793kB   12/12/19

En Español (Spanish) 597kB   12/10/19


Support Tools

Heal flyer (PPO, POS and EOA plans only)

English 0kB   12/31/69

En Español (Spanish) 0kB   12/31/69

Available through your PPO insurance plan and the SELECT/ELECT 2 (PPO) tier of your SELECT (POS) or Elect Open Access health plan.


Teladoc (Telehealth) Introductory Flyer

English/Spanish 327kB   12/10/19


Teladoc (Telehealth) FAQs

English 230kB   12/10/19

En Español (Spanish) 278kB   12/10/19


Teladoc Caregiver flyer

English 2MB   12/10/19


Teladoc Caregiver FAQs

English 401kB   12/10/19


Active&Fit Direct Member Flyer

English 2MB   12/10/19

En Español (Spanish) 2MB   12/10/19


CommunityCare HMO Sell Sheet

English 1MB   12/08/19


Chiropractic Care flyer

English 102kB   12/12/19


Understanding the Continuity of Care Assistance Policy

English 3.3MB   04/23/20

Download only


How To Read Your Commission Statement

English 477kB   02/11/16

Download only


Top Reasons to Sell Health Net

English 894kB   06/08/20


Health Net Financial Strength and Stability

English 523kB   07/23/20


Health Net Beginnings Flyer – with temporary ID card

English 66kB   12/12/19

En Español (Spanish) 140kB   12/10/19


MinuteClinic Brochure

English 3MB   04/24/20


Prior-Carrier Deductible Credit Flyer

English 133kB   12/12/19


Commercial Sales Guidelines

English 272kB   12/12/19


Information for Small Business Groups

English 53kB   12/12/19


ER vs. Urgent Care

English/Spanish 222kB   12/10/19


Employer Welcome Guide

English 6MB   01/28/20


HealthNet.com Flyer

English 360kB   12/09/19

En Español (Spanish) 1.3MB   01/14/19


Uniform Glossary of Health Coverage and Medical Terms

English 117kB   07/22/16

En Español (Spanish) 138kB   07/22/16

Chinese (Chinese) 447kB   07/22/16

Navajo 230kB   07/22/16

Korean (Korean) 1.2MB   07/22/16

Health insurance companies and group health plans are required to make available a uniform glossary of health coverage and medical terms commonly used in plan documents. The Uniform Glossary is meant to help the consumer, understand some of the most common language used in health insurance documents. Please log in to request a hardcopy of the document by mail.


HSA Employer Flyer

English 142kB   10/17/19


HSA Member Brochure

English 974kB   12/10/19


Bank of America HSA Enrollment Packet

English 124kB   01/29/19


Online Support Tools

Group Administrator Registration Guide

English 995kB   01/28/20


EFT Set Up Instructions

English 1.6MB   02/20/20


Employer Online Billing and Enrollment Brochure

English 417kB   07/26/18


Health Net Mobile App How-To Guide

English 179kB   03/19/20

En Español (Spanish) 94kB   05/15/20


Flu Shot Flyer

English 551kB   12/10/19

En Español (Spanish) 600kB   12/10/19


First Health National (Out-of-State) PPO

First Health Physician Nomination Form

English 185kB   01/14/20


Broker First Health National PPO Network FAQ

English 764kB   12/10/19


Member First Health National PPO Network FAQ (for groups renewing before 1/1/2019)

English 379kB   12/10/19


Member First Health National PPO Network FAQ (for groups renewing after 1/1/2019)

English 617kB   12/10/19


Pharmacy


Essential Pharmacy Benefits Guide

English 791kB   02/21/20


Mail Order Pharmacy and Maintenance Choice® Program

English 2MB   07/08/20

En Español (Spanish) 2.1MB   07/08/20


Coverage of Blood Glucose Test Strips - For New Members

English 608kB   01/07/20


Take Medications the Right Way

English 90kB   09/30/19


Generic vs Brand-Name Drugs Information

English 90kB   01/07/20


Getting Started With Mail Order Pharmacy Kit

English 630kB   06/22/20

En Español (Spanish) 566kB   06/22/20


Supplemental Coverage


Ancillary Product Guide

English 1.8MB   01/05/20


Dental/Vision Sell Sheet

English 208kB   12/12/19


Dental Overview Flyer

English 87kB   04/13/20


Pediatric Dental and Vision

Pediatric Dental/Vision (HMO/HSP) 2.9MB   12/12/19

Pediatric Dental/Vision (PPO) 614kB   12/12/19

Pediatric Dental/Vision (EPO/EC-PPO) 622kB   12/12/19


Vision
Effective 2/1/20 Sears Optical, JC Penney Optical and Stanton Optical will no longer be in the EyeMed network.

Vision PPO FAQ

English 874kB   12/12/19


Vision Website (member)

English 147kB   12/12/19


Elite 1010-1

English 808kB   12/10/19


Preferred 1025-2

English 515kB   12/10/19


Preferred 1025-3

English 547kB   12/10/19


Preferred Value 10-3

English 504kB   12/10/19


Supreme 010-2

English 587kB   12/10/19


Exam Only

English 760kB   12/10/19


Plus 20-1

English 529kB   12/10/19


Dental

Dental Provider Search Flyer

English 554kB   12/12/19


Your Dental Website (member)

English 169kB   12/19/19


Dental Overview Flyer

English 87kB   04/13/20


DHMO

Plus (150) Plan Overview

English 1.1MB   12/12/19


Plus (150) Schedule of Benefits

English 313kB   01/23/17


Plus (225) Plan Overview

English 1.1MB   12/12/19


Plus (225) Schedule of Benefits

English 584kB   12/12/19


DPPO

Classic 4 1500

English 1.5MB   03/11/20


Classic 5 1500

English 1.5MB   03/11/20


Essential 2 1000

English 1.8MB   03/11/20


Essential 5 1500

English 1.7MB   03/11/20


Essential 6 1500

English 1.7MB   03/11/20


Health Net Life

Basic Life Insurance with AD&D

English 1.6MB   12/19/19

En Español (Spanish) 2.8MB   05/19/20

These forms are customizable to allow for the addition of benefit level.


Basic Life Insurance no AD&D

English 2.4MB   12/19/19

These forms are customizable to allow for the addition of benefit level.


Additional Forms / Brochures

Travel Guides

HMO/POS Travel Guide

English 3.7MB   10/04/19

En Español (Spanish) 2.3MB   10/04/19

Members can download claim forms at www.healthnet.com. Claim forms can also be found under the Applications and Forms section on this page.


PPO Travel Guide

English 1.4MB   12/10/19

Members can download claim forms at www.healthnet.com. Claim forms can also be found under the Applications and Forms section on this page.


Additional Materials

Understanding your Explanation of Benefits (EOB) (English/Spanish)

English 403kB   10/09/19


Out-of-Pocket Maximum Notification (PDF)

English 513kB   07/23/19


Understanding Your Billing Statement

English 270kB   04/13/20

Download only


Premium Only Plans (POP)


FlexSystem Highlights Overview

English 350kB   07/26/18


FlexSystem Premium Only Plan (POP) Information Sheet

English 1.1MB   07/26/18


Premium Only Plan Marketing Manual

English 253kB   07/26/18


Decision Power / Wellness – Member


Decision Power™ Member Brochure

English 1MB   10/01/19

En Español (Spanish) 6.5MB   10/01/19


Wellness Online

English 654kB   10/01/19

En Español (Spanish) 1.5MB   10/01/19


Wellness Incentive Member Brochure and FAQ

English 1.1MB   09/11/19

En Español (Spanish) 1.4MB   09/11/19


Healthy Discounts Member Flyer

English 680kB   10/01/19

En Español (Spanish) 682kB   10/01/19


myStrength Program Flyer

English 568kB   10/01/19

En Español (Spanish) 853kB   10/01/19


Health Coaching Program Flyer

English 537kB   10/01/19


Smoking and Tobacco Cessation

English 513kB   10/01/19

En Español (Spanish) 519kB   10/01/19


Tips to Stop Smoking

English 55kB   10/01/19

En Español (Spanish) 143kB   10/04/18


Decision Power Ready to Lose Weight?

English 511kB   10/01/19

En Español (Spanish) 514kB   10/01/19


Preventive Screening Guidelines – Web PDF only

English 312kB   06/08/20

En Español (Spanish) 429kB   12/10/19


Text4Baby Flyer - PDF Only

English 114kB   12/10/19

En Español (Spanish) 119kB   12/10/19

Promotional flyer and press releases for Health Net's new "Text4Baby" program. This new service provides the expectant mother with 3 free text messages a week, providing helpful information throughout her pregnancy and for baby's first year.


Decision Power / Wellness – Employer / Broker

Broker / Employer Materials

Decision Power Employer/Broker Toolkit

English 593kB   10/01/19


National Observances Calendar for Employers

English 1.8MB   01/29/20


Wellness Webinar flyer for Employers

English 197kB   02/04/20


Wellness Seminars Menu

English 253kB   09/13/18


Salud con Health Net


Salud HMO y Mas Service Area ZIP Codes

English 135kB   12/12/19


Member

Salud HMO y Más Brochure

Eng/Span 2.8MB   12/09/19


Provider Directories / Tailored Network Comparison Lists
Refer to County Reference Quick Guide to determine service areas in each directory.
Other reference quick guides coming soon – Northern California, Orange, Riverside, San Bernardino.

Tailored Networks Comparison Lists

Northern California 985kB   07/14/20

Central California 728kB   07/14/20

Los Angeles County 1.1MB   07/14/20

Orange County 722kB   07/14/20

Riverside County 637kB   07/14/20

San Bernardino County 661kB   07/14/20

San Diego County 732kB   07/14/20



How Soon Can I See the Doctor

English 137kB   12/10/19

En Español (Spanish) 144kB   12/10/19



ProviderSearch Information

English 1.1MB   09/11/19

En Español (Spanish) 1.2MB   12/10/19


County Reference Quick Guide

English 61kB   02/05/15


Provider Directories
If you are looking for a participating provider, please use ProviderSearch.


Information last updated 07-23-2020

Select documents in the language you desire, then click mail or email.

Looking for HealthEquity Materials?

Learn more about HealthEquity HSA/HRA Plans on the HealthEquity website.
Go to HealthEquity sales resource site

In Addition, Please See Plan Overviews for Medical Benefit Plan Overviews.

Covered California Collateral

Get fact sheets and collateral here

Need Help?

Key Contacts and Broker Support

Census Enrollment

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Important Notice

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.


Policy Effective Date and Defined Terms.
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.


Policy Amendment without Notice.
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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