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Important Legal Information



Privacy Information

If you would like to learn more about Health Net's privacy policies, please go to the following web links.

Health Net's Web Privacy Policy provides information about privacy over the Health Net website.

Health Net's Confidentiality Guideline describes how Health Net:

  • Protects the confidentiality of protected health information1
  • Limits access to protected health information
  • Prohibits unlawful disclosure of protected health information

Health Net's Notice of Privacy Practices describes:

  • How Health Net uses and discloses protected health information
  • Your rights as a member to access protected information and to request amendments, restrictions or an accounting of disclosures of protected health information
  • The procedures for filing a complaint

1 "Protected health information" is information about you, including demographic information, that can reasonably be used to identify you and that relates to your past, present or future physical or mental health or condition, the provision of health care to you or the payment for that care. For example, if Health Net collects a social security number in the course of business, that social security number is considered protected health information.

Web Privacy Policy

Web Privacy Policy

Web Privacy Policy (pdf)

1. Scope

This Privacy Policy ("Policy") applies to the collection, use and disclosure of information by Health Net, Inc. and its affiliated companies (collectively "Health Net") on www.healthnet.com and through mobile sites or social media (the "Website") as well as to information collected through telephone communications. This Privacy Statement does not apply to third party web sites that may be accessible through hyperlinks on this Website, which have their own privacy policies that we encourage you to review. Linking to a third party site does not mean that we endorse the site, any products or services described on the site, or any other material contained in a third party site.

This Policy explains how Health Net collects, uses, and discloses information about Health Net members or other individuals who visit the Website. Health Net also has a separate Notice of Privacy Practices that describes how we use and disclose protected health information regarding our members, including member rights with respect to such information, which is available in the Notice of Privacy Practices section (below). Neither the Notice of Privacy Practices nor this Privacy Policy apply to personal information about Health Net employees.

By using our Website in any way, such as browsing or interacting, you signify that you agree with the terms of our current Policy as posted here. If you do not agree with this Policy, you should not use our Website. Health Net may update or modify this Policy from time to time at our sole discretion by posting a new version on this Website, with the date of last update noted at the top. We encourage you to visit this area frequently to stay informed because your continued use of our Websites following the posting of changes to these terms means that you consent to such changes.

Your use of our Website is also subject to the Terms of Use.

2. Information We Collect

In general, you can visit our Website without telling us who you are or revealing personal information about yourself. You (or your personal representative) can, however, voluntarily provide personal information, which refers to:

  • Contact information (such as name, address, email address and telephone number)
  • Demographic information (such as age, date of birth, gender, marital status, ZIP code, and household composition)
  • Financial information (such as social security number, bank account information, or credit card information)
  • Health Information (such as information submitted on a health insurance enrollment application)

If you choose to interact on the Website – such as by registering, applying for products or services, submitting orders, questionnaires, surveys, or requests for information, or using mobile applications or social media platforms – Health Net will collect the personal information that you (or your personal representative) provide. We may enhance or merge the information that you provide to us directly with information from other sources, including third parties, or merge your personal information with data regarding how you use our site, for the purposes described below.

You can view your data in our system through our customer/member secure portal. To change or correct your information, please call the Customer Contact Center phone number located on the back of your ID card.

3. How We Use Your Information

We may collect, maintain, and use your personal information for the following purposes:

  • helping to establish and verify the identity and eligibility of users;
  • opening, maintaining, administering and servicing users profiles, accounts or memberships (including to confirm website transactions with you);
  • processing an application or enrollment as requested by you;
  • providing services and support to users, such as delivering web-based products or services, informing you about health or wellness programs you might be interested in provided by us or other businesses, or providing documents or other information you request (such as Explanations of Benefits (EOBs) or billing and payment information);
  • marketing our products and services to you;
  • analyzing and improving our products, services, Website, and advertising, including tailoring it to users' preferences;
  • administering surveys or promotions;
  • providing users with company updates or with information about Website functionality;
  • responding to your inquiries or other requests;
  • contacting you when necessary;
  • keeping a record of our transactions and communications;
  • maintaining the security and integrity of our systems;
  • protecting the health, safety or welfare of others; and
  • complying with legal requirements, complying with legal process, or defending our legal rights.

4. Technology Logging, Cookies, and Related Techniques

Health Net also collects certain non-personal information and aggregate information about you to help us analyze and improve the usefulness of our Website. "Non-personal information" includes information that does not directly identify you personally, but provides us with anonymous "usage data," such as the number of unique visitors we receive, what pages are visited most often, and the navigation preferences and characteristics of our visitors. Examples of such non-personal information include, but are not limited to:

  • Cookies: Cookies are pieces of information that a website transfers to a user's computer for purposes of storing information about a user's preferences, to deliver content specific to your interests, or to maximize the performance of our Website and services. Cookies do not personally identify users (such as by collecting your name or address), but they do assign a unique data element to each visitor so that the Website can recognize repeat users, track usage patterns, and better serve you when you return to the Website.
  • Browser information: Web browsers collect and store information about the type of device and operating system you are using to access our Website, as well as your device's MAC address for facilitating network communications. Accessing this information helps us to establish a secure and consistent connection to you during your visits to our website.
  • Web beacons: We may also place Web beacons in our emails to measure the effectiveness of our email campaigns by identifying the individuals who open or act upon an email message, when an email message is opened, how many times an email message is forwarded, the type of software, device, operating system and browser used to deliver the email, and any URL accessed through our email message.
  • IP Address: An Internet Protocol address is a number that automatically identifies the computer or machine you have used to access the Internet. The IP address enables our server identify your geographic location and to send you the webpages that you want to visit, and it may disclose the server owned by your Internet Service Provider.

At this time, we do not honor "do not track" signals from a web site browser. However, you may refuse or delete cookies. If you have your browser set to private browsing, or refuse or delete cookies, you may not be able to take full advantage of the Website.

5. Data Sharing and Storage

Health Net will not sell your personal information to any other third party for their own use unless we disclose this to you at the time the information is collected and obtain your consent. We do not currently share your personal information with any outside third parties in order for them to market directly to you.

Health Net may disclose your personal information to third parties for the following reasons:

  • We may use unaffiliated companies such as agents or contractors ("Third Parties") to help us maintain and operate our Websites, to provide you with services that you have requested, or for other reasons related to the operation of our business (including the information uses listed above). In the event we provide personal information to these Third Parties, they are restricted from using this data in any way other than to provide the required services for us.
  • We reserve the right to release your personal information if required to do so by law, search warrant, subpoena, court order, upon request of government authorities, or as reasonably necessary to protect Health Net, the individuals that Health Net serves, or the public.
  • We may provide your personal information to affiliated entities or third parties in connection with the actual or prospective sale or transfer of some or all of a business to which you submitted your information, or in the event of a corporate change. We may share your personal information with Health Net affiliated companies and subsidiaries for marketing reasons.

We may also disclose to third parties (or allow third parties to compile) your non-personal information from the cookies, Web beacons, or other technologies on our Website for purposes including but not limited to measuring site activity and providing a better user experience.

Your personal information and non-personal information may be stored in Health Net databases, affiliated company or subsidiary databases, or databases managed by third party service providers, which are located within and outside of the United States. Your information will be automatically transferred to these databases for storage and maintenance. These databases may be located in countries where privacy rules differ and may be less stringent than those of the country in which you reside.

6. Social Media Platforms

Our Websites' web pages may embed plugs-ins, widgets, or other apps of various social media platforms, such as Facebook, Twitter, and YouTube. An example of such a plug-in is Facebook's "Like" button. When you encounter those embedded objects, your internet browser may make a direct connection to the social media platform's service and may share information such as which of our Websites you have visited. Our Websites may also be made available through third party social media platforms.

Your participation with the services provided on social media platforms is voluntary. If you choose to sign on using this service, Health Net will collect certain information from your social media account including your public profile, user name, email address, birthday, stated location city, contact lists, and other interactions on that social media platform (such as interests and likes). The information we may have access to will vary by social media platform and is controlled by privacy settings on that platform and your choices on that platform. Your use of services on third party social media platforms are governed by the privacy statement and other terms of use for that third party social media platform, until such information is shared with us, and then such information is also subject to this Privacy Policy.

7. Mobile Applications Privacy Statement

Health Net has developed certain mobile applications that you may download to your mobile device. When you download a mobile application there may be an opportunity for you to provide us with, or for us to obtain, information about you such as contact information, preferences, photographs, and other identifying information. Our mobile application may also collect location information.

Information obtained through a mobile application will be used in accordance with this Privacy Policy. Upon first use, the mobile application will provide a link that allows you to see this Privacy Policy before registering or using the application. You can stop all collection of information by our mobile applications easily by uninstalling the mobile applications. You may use the standard uninstall processes available as part of your mobile device or via the mobile application marketplace or network. You may at any time opt-out from allowing us to have access to your premise location (GPS data) by adjusting the permissions in your mobile device.

8. Security

Health Net takes reasonable steps to protect the security of your information, including use of appropriate physical, technical, and administrative safeguards. The nature of the Internet, however, prevents us from guaranteeing the confidentiality of information we receive through the Website or via e-mail. Therefore, please do not use e-mail or this Website (unless you are logged in to your health.com account and use the secure forms available to you once logged in) to communicate information to us that you consider to be confidential.

9. Children

Health Net does not intentionally collect personal information from children under 13 years of age, and children under age 13 should not submit any personal information to us. If we become aware that a child has provided us with personal information without parental consent, or a parent or guardian of a child contacts us through the contact information provided below, we will use reasonable efforts to delete the child's information from our databases.

10. Opt-Out

Health Net may from time to time send electronic communications to you in the form of newsletters, notification of account status, and other communications, such as marketing. We may also send email communications regarding topics such as general health benefits, website updates, health conditions, and general health topics. We will offer appropriate consent mechanisms within the specific email communication, such as opt-out/unsubscribe, for marketing and certain other communications, or you can contact us as described below.

At certain locations on our Website where we request information about the user, our Website provides users the opportunity to opt-out of receiving communications from us. If you are a member and have registered on the healthnet.com site, you may also change your email preferences in your profile.

Please be aware that opting out of marketing or other communications will not apply to certain communications such as account status, website updates, or website functionality communications.

11. Contact Us

If you believe that Health Net is not following this privacy policy, you can file a complaint with us at the following address listed below, call the toll-free phone number on the back of your ID card or contact Health Net at 1-800-522-0088.

Health Net Privacy Office
Attention: Privacy Office
P.O. Box 9103
Van Nuys, CA 91409

Fax: (818) 676-8314

12. Your California Privacy Rights

If you want to restrict how we use your information or how we disclose your information to third parties, or have other questions about this Policy, you may submit your request online.

California residents may have certain additional rights, including the right to information about how personal information is shared with third parties for the third parties' direct marketing purposes during the preceding calendar year. Please be aware that we do not share your information with non-affiliated third parties for any third party direct marketing purposes. We may share personal information with affiliated entities that share the same brand name as Health Net. If you are a California resident, you have the right to submit a request to receive, with respect to such affiliated third parties that share the same brand name as Health Net, the following information: (a) the categories of information Health Net disclosed to such affiliated entities; and (b) the overall number of affiliated companies that share the same brand name. You may contact us for such information at 1-800-522-0088 or you may submit your request online.

Last Updated: 06/08/2016

Confidentiality Guideline

Confidentiality Guideline

Health Net, Inc. and all of its subsidiaries/affiliates ("Health Net") have adopted a strict guideline regarding the confidentiality of certain information provided to Health Net associates. This guideline applies to all Health Net associates as described below:

All Associates are prohibited from any unauthorized access to, use or disclosure of patient ("Member") or health care provider information, Health Net proprietary information, including, but not limited to, medical records, claims, benefits or other administrative data that is personally identifiable, in addition to, Health Net quality improvement programs, reports, and disease management information (hereinafter, collectively referred to as "Confidential Information").

Associates must hold in strict confidence, and not copy, disclose or permit the disclosure to any person, other than as stated in Health Net's Notice of Privacy Practices, any Confidential Information. Associates must comply with all Health Net policies and procedures concerning the safeguarding of all Confidential Information. Associates must comply with all applicable state and federal laws and regulations regarding Confidential Information.

Notice of Privacy Practices

Notice of Privacy Practices

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.
PLEASE REVIEW IT CAREFULLY.

Effective 08.14.2017

Covered Entities Duties:
Health Net* (referred to as "we" or "the Plan") is a Covered Entity as defined and regulated under the Health Insurance Portability and Accountability Act of 1996 (HIPAA).  Health Net is required by law to maintain the privacy of your protected health information (PHI), provide you with this Notice of our legal duties and privacy practices related to your PHI, abide by the terms of the Notice that is currently in affect and notify you in the event of a breach of your unsecured PHI.  PHI is information about you, including demographic information, that can reasonably be used to identify you and that relates to your past, present or future physical or mental health or condition, the provision of health care to you or the payment for that care. 

This Notice describes how we may use and disclose your PHI.  It also describes your rights to access, amend and manage your PHI and how to exercise those rights.  All other uses and disclosures of your PHI not described in this Notice will be made only with your written authorization.

Health Net reserves the right to change this Notice. We reserve the right to make the revised or changed Notice effective for your PHI we already have as well as any of your PHI we receive in the future.  Health Net will promptly revise and distribute this Notice whenever there is a material change to the following:

  • Uses or disclosures
  • Your rights
  • Our legal duties
  • Other privacy practices stated in the notice

We will make any revised Notices available on our website and in our Member Handbook.

Internal Protections of Oral, Written and Electronic PHI:
Health Net protects your PHI. We have privacy and security processes to help.

These are some of the ways we protect your PHI.

  • We train our staff to follow our privacy and security processes.
  • We require our business associates to follow privacy and security processes.
  • We keep our offices secure.
  • We talk about your PHI only for a business reason with people who need to know.
  • We keep your PHI secure when we send it or store it electronically.
  • We use technology to keep the wrong people from accessing your PHI.

Permissible Uses and Disclosures of Your PHI:
The following is a list of how we may use or disclose your PHI without your permission or authorization:

  • Treatment – We may use or disclose your PHI to a physician or other health care provider providing treatment to you, to coordinate your treatment among providers, or to assist us in making prior authorization decisions related to your benefits.
  • Payment – We may use and disclose your PHI to make benefit payments for the health care services provided to you. We may disclose your PHI to another health plan, to a health care provider, or other entity subject to the federal Privacy Rules for their payment purposes. Payment activities may include:
    • processing claims
    • determining eligibility or coverage for claims
    • issuing premium billings
    • reviewing services for medical necessity
    • performing utilization review of claims
  • Health Care Operations – We may use and disclose your PHI to perform our health care operations.  These activities may include:
    • providing customer services
    • responding to complaints and appeals
    • providing case management and care coordination
    • conducting medical review of claims and other quality assessment
    • improvement activities 

    In our health care operations, we may disclose PHI to business associates. We will have written agreements to protect the privacy of your PHI with these associates. We may disclose your PHI to another entity that is subject to the federal Privacy Rules. The entity must also have a relationship with you for its health care operations. This includes the following:

    • quality assessment and improvement activities
    • reviewing the competence or qualifications of health care professionals
    • case management and care coordination
    • detecting or preventing health care fraud and abuse
  • Group Health Plan/Plan Sponsor Disclosures – We may disclose your protected health information to a sponsor of the group health plan, such as an employer or other entity that is providing a health care program to you, if the sponsor has agreed to certain restrictions on how it will use or disclose the protected health information (such as agreeing not to use the protected health information for employment-related actions or decisions).

    Other Permitted or Required Disclosures of Your PHI:

  • Fundraising Activities – We may use or disclose your PHI for fundraising activities, such as raising money for a charitable foundation or similar entity to help finance their activities.  If we do contact you for fundraising activities, we will give you the opportunity to opt-out, or stop, receiving such communications in the future.
  • Underwriting Purposes – We may use or disclosure your PHI for underwriting purposes, such as to make a determination about a coverage application or request. If we do use or disclose your PHI for underwriting purposes, we are prohibited from using or disclosing your PHI that is genetic information in the underwriting process.  
  • Appointment Reminders/Treatment Alternatives – We may use and disclose your PHI to remind you of an appointment for treatment and medical care with us or to provide you with information regarding treatment alternatives or other health-related benefits and services, such as information on how to stop smoking or lose weight.
  • As Required by Law – If federal, state, and/or local law requires a use or disclosure of your PHI, we may use or disclose your PHI to the extent that the use or disclosure complies with such law and is limited to the requirements of such law.  If two or more laws or regulations governing the same use or disclosure conflict, we will comply with the more restrictive laws or regulations.
  • Public Health Activities – We may disclose your PHI to a public health authority for the purpose of preventing or controlling disease, injury, or disability.  We may disclosure your PHI to the Food and Drug Administration (FDA) to ensure the quality, safety or effectiveness of products or services under the jurisdiction of the FDA. 
  • Victims of Abuse and Neglect – We may disclose your PHI to a local, state, or federal government authority, including social services or a protective services agency authorized by law authorized by law to receive such reports if we have a reasonable belief of abuse, neglect or domestic violence.
  • Judicial and Administrative Proceedings – We may disclose your PHI in judicial and administrative proceedings. We may also disclose it in response to the following:

    • an order of a court
    • administrative tribunal
    • subpoena
    • summons
    • warrant
    • discovery request
    • similar legal request
  • Law Enforcement – We may disclose your relevant PHI to law enforcement when required to do so. For example, in response to a:

    • court order
    • court-ordered warrant
    • subpoena
    • summons issued by a judicial officer
    • grand jury subpoena

    We may also disclose your relevant PHI to identify or locate a suspect, fugitive, material witness, or missing person. 

  • Coroners, Medical Examiners and Funeral Directors – We may disclose your PHI to a coroner or medical examiner.  This may be necessary, for example, to determine a cause of death.  We may also disclose your PHI to funeral directors, as necessary, to carry out their duties.
  • Organ, Eye and Tissue Donation – may disclose your PHI to organ procurement organizations. We may also disclose your PHI to those who work in procurement, banking or transplantation of:
    • cadaveric organs
    • eyes
    • tissues
  • Threats to Health and Safety – We may use or disclose your PHI if we believe, in good faith, that the use or disclosure is necessary to prevent or lessen a serious or imminent threat to the health or safety of a person or the public.
  • Specialized Government Functions – If you are a member of U.S. Armed Forces, we may disclose your PHI as required by military command authorities.  We may also disclose your PHI:
    • to authorized federal officials for national security and intelligence activities
    • the Department of State for medical suitability determinations
    • for protective services of the President or other authorized persons
  • Workers’ Compensation – We may disclose your PHI to comply with laws relating to workers’ compensation or other similar programs, established by law, that provide benefits for work-related injuries or illness without regard to fault.
  • Emergency Situations – We may disclose your PHI in an emergency situation, or if you are incapacitated or not present, to a family member, close personal friend, authorized disaster relief agency, or any other person previous identified by you.  We will use professional judgment and experience to determine if the disclosure is in your best interests.  If the disclosure is in your best interest, we will only disclose the PHI that is directly relevant to the person's involvement in your care.
  • Inmates – If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release your PHI to the correctional institution or law enforcement official, where such information is necessary for the institution to provide you with health care, to protect your health or safety, or the health or safety of others, or for the safety and security of the correctional institution.
  • Research –Under certain circumstances, we may disclose your PHI to researchers when their clinical research study has been approved and where certain safeguards are in place to ensure the privacy and protection of your PHI.

Uses and Disclosures of Your PHI That Require Your Written Authorization
We are required to obtain your written authorization to use or disclose your PHI, with limited exceptions, for the following reasons:

Sale of PHI – We will request your written authorization before we make any disclosure that is deemed a sale of your PHI, meaning that we are receiving compensation for disclosing the PHI in this manner.

Marketing – We will request your written authorization to use or disclose your PHI for marketing purposes with limited exceptions, such as when we have face-to-face marketing communications with you or when we provide promotional gifts of nominal value.

Psychotherapy Notes – We will request your written authorization to use or disclose any of your psychotherapy notes that we may have on file with limited exception, such as for certain treatment, payment or health care operation functions.

Individuals Rights
The following are your rights concerning your PHI.  If you would like to use any of the following rights, please contact us using the information at the end of this Notice.

  • Right to Revoke an Authorization – You may revoke your authorization at any time, the revocation of your authorization must be in writing.  The revocation will be effective immediately, except to the extent that we have already taken actions in reliance of the authorization and before we received your written revocation.
  • Right to Request Restrictions – You have the right to request restrictions on the use and disclosure of your PHI for treatment, payment or health care operations, as well as disclosures to persons involved in your care or payment of your care, such as family members or close friends.  Your request should state the restrictions you are requesting and state to whom the restriction applies.  We are not required to agree to this request.  If we agree, we will comply with your restriction request unless the information is needed to provide you with emergency treatment.  However, we will restrict the use or disclosure of PHI for payment or health care operations to a health plan when you have paid for the service or item out of pocket in full.
  • Right to Request Confidential Communications – You have the right to request that we communicate with you about your PHI by alternative means or to alternative locations.   This right only applies in the following circumstances:  (1) the communication discloses medical information or provider name and address relating to receipt of sensitive services, or (2) disclosure of all or part of the medical information or provider name and address could endanger you if it is not communicated by the alternative means or to the alternative location you want. You do not have to explain the reason for your request, but your request must clearly state that either the communication discloses medical information or provider name and address relating to receipt of sensitive services or that disclosure of all or part of the medical information or provider name and address could endanger you if the communication means or location is not changed. We must accommodate your request if it is reasonable and specifies the alternative means or location where your PHI should be delivered.
  • Right to Access and Received Copy of your PHI – You have the right, with limited exceptions, to look at or get copies of your PHI contained in a designated record set.  You may request that we provide copies in a format other than photocopies.  We will use the format you request unless we cannot practicably do soYou must make a request in writing to obtain access to your PHI.  If we deny your request, we will provide you a written explanation and will tell you if the reasons for the denial can be reviewed and how to ask for such a review or if the denial cannot be reviewed.
  • Right to Amend your PHI – You have the right to request that we amend, or change, your PHI if you believe it contains incorrect information.  Your request must be in writing, and it must explain why the information should be amended.  We may deny your request for certain reasons, for example if we did not create the information you want amended and the creator of the PHI is able to perform the amendment. If we deny your request, we will provide you a written explanation. You may respond with a statement that you disagree with our decision and we will attach your statement to the PHI you request that we amend.  If we accept your request to amend the information, we will make reasonable efforts to inform others, including people you name, of the amendment and to include the changes in any future disclosures of that information.
  • Right to Receive an Accounting of Disclosures – You have the right to receive a list of instances within the last 6 years period in which we or our business associates disclosed your PHI.  This does not apply to disclosure for purposes of treatment, payment, health care operations, or disclosures you authorized and certain other activities. If you request this accounting more than once in a 12-month period, we may charge you a reasonable, cost-based fee for responding to these additional requests. We will provide you with more information on our fees at the time of your request.
  • Right to File a Complaint – If you feel your privacy rights have been violated or that we have violated our own privacy practices, you can file a complaint with us in writing or by phone using the contact information at the end of this Notice.  For Medi-Cal member complaints, members may also contact the California Department of Health Care Services listed in the next section. 

    You can also file a complaint with the Secretary of the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201 or calling 1-800-368-1019, (TTY: 1-866-788-4989) or visiting www.hhs.gov/ocr/privacy/hipaa/complaints

WE WILL NOT TAKE ANY ACTION AGAINST YOU FOR FILING A COMPLAINT.

  • Right to Receive a Copy of this Notice – You may request a copy of our Notice at any time by using the contact information list at the end of the Notice.  If you receive this Notice on our web site or by electronic mail (e-mail), you are also entitled to request a paper copy of the Notice.

Contact Information
If you have any questions about this Notice, our privacy practices related to your PHI or how to exercise your rights you can contact us in writing or by phone using the contact information listed below. 

Health Net Privacy Office
Attn: Privacy Official
P.O. Box 9103
Van Nuys, CA 9140

Telephone: 1-800-522-0088
Fax: 1-818-676-8314
Email: Privacy@healthnet.com

For Medi-Cal members only, if you believe that we have not protected your privacy and wish to complain, you may file a complaint by calling or writing:

Privacy Officer c/o Office of Legal Services
California Department of Health Care Services
1501 Capitol Avenue, MS 0010
P.O. Box 997413
Sacramento, CA 95899-7413

Phone: 1-916-445-4646 or 1-866-866-0602 (TTY:TDD: 1-877-735-2929)
E-mail: Privacyofficer@dhcs.ca.gov

FINANCIAL INFORMATION PRIVACY NOTICE

THIS NOTICE DESCRIBES HOW FINANCIAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

We are committed to maintaining the confidentiality of your personal financial information. For the purposes of this notice, "personal financial information" means information about an enrollee or an applicant for health care coverage that identifies the individual, is not generally publicly available, and is collected from the individual or is obtained in connection with providing health care coverage to the individual.

Information We Collect: We collect personal financial information about you from the following sources:

  • Information we receive from you on applications or other forms, such as name, address, age, medical information and Social Security number;
  • Information about your transactions with us, our affiliates or others, such as premium payment and claims history; and
  • Information from consumer reports.  

Disclosure of Information: We do not disclose personal financial information about our enrollees or former enrollees to any third party, except as required or permitted by law. For example, in the course of our general business practices, we may, as permitted by law, disclose any of the personal financial information that we collect about you, without your authorization, to the following types of institutions:

  • To our corporate affiliates, such as other insurers;
  • To nonaffiliated companies for our everyday business purposes, such as to process your transactions, maintain your account(s), or respond to court orders and legal investigations; and
  • To nonaffiliated companies that perform services for us, including sending promotional communications on our behalf.

Confidentiality and Security: We maintain physical, electronic and procedural safeguards, in accordance with applicable state and federal standards, to protect your personal financial information against risks such as loss, destruction or misuse. These measures include computer safeguards, secured files and buildings, and restrictions on who may access your personal financial information.

Questions about this Notice: If you have any questions about this notice.

Please call the toll-free phone number on the back of your ID card or contact Health Net at 1-800-522-0088.

*This Notice of Privacy Practices also applies to enrollees in any of the following Health Net entities:
Health Net of California, Inc., Health Net Community Solutions, Inc., Health Net Health Plan of Oregon, Inc., Managed Health Network, LLC and Health Net Life Insurance Company, which are subsidiaries of Health Net, Inc. and Centene Corporation. Health Net is a registered service mark of Health Net, Inc. All other identified trademarks/service marks remain the property of their respective companies. All rights reserved Rev. 04/06/2018

Terms of Use

Terms and Conditions of Use Agreement

This Terms and Conditions of Use Agreement ("Agreement") is a legal agreement between you and Health Net, Inc. ("Health Net" or "we") governing your use of this Web site (the "site"). 

YOUR USE OF THIS SITE IS SUBJECT TO THE TERMS AND CONDITIONS OF THIS AGREEMENT. BY ACCESSING, USING AND/OR VIEWING OUR SITE, YOU HEREBY AGREE TO BE BOUND BY THE TERMS OF THIS AGREEMENT. IF YOU DO NOT AGREE TO THESE TERMS AND CONDITIONS, YOU MUST EXIT THIS SITE.

We may revise the information on the site or otherwise change or update the site, including this Agreement. If we make changes to this Agreement, we will use reasonable efforts to post such changes before they become effective and to specify the date they will become effective. In the absence of any specific date being provided, the changes are effective immediately. A current version of this Agreement showing the effective date is always available at this location. We encourage you to periodically read this Agreement to see if there have been any changes to our policies that may affect you. Health Net may also make improvements and/or changes in products and/or services described on this site or add new features at any time without notice. Your continued use of the site will signify your continued agreement to this Agreement as it may be revised.

MINORS.
CHILDREN UNDER THE AGE OF THIRTEEN (13) ARE PROHIBITED FROM USING ANY HEALTH NET SITE. BY USING THIS SITE, YOU REPRESENT THAT YOU ARE OVER THE AGE OF 13.  Parents or legal guardians who allow a minor child to access www.healthnet.com or any of the services or information offered or through the site hereby agree that the parent or legal guardian shall be solely responsible for: (a) the online conduct of such minor; (b) monitoring such minor's access to and use of the site; and (c) the consequences of any use of the site by such minor.

WEBSITE ACCESS; PROHIBITED ACTIVITIES.
Provided that you are over the age of thirteen (13), we hereby grant you a personal, non-exclusive, non-transferable, revocable license to access our site and the information contained within the site.

The site contains software tools and databases that allow you to search and retrieve information. You may not gain unauthorized access to the site, to other users' accounts, names or personally identifiable information, or to other computers or websites connected or linked to the site. You may not send or otherwise transmit to or through this site chain letters, unsolicited messages, so-called "spamming" or "phishing" messages, or messages marketing or advertising goods and services.

You may use our services for lawful purposes only. You may not use our services to post, transmit or otherwise distribute unlawful material. Examples of unlawful material include, but are not limited to, threats of physical harm, defamatory statements, pornographic material, and copyrighted, trademarked, and other proprietary material used without proper authorization. You may not post, transmit or otherwise make available any virus, worm, spyware or any other computer code, file or program that may or is intended to damage or hijack the operation of any hardware, software or telecommunications equipment. You may not "flood" or disrupt our site through any means or process such as launching or using any automated system, including but not limited to, "robots," "spiders," or "offline readers." You may not misrepresent your identity or affiliation in any way. You may not restrict, discourage or inhibit any person from using the site, disclose personal information about other individuals on the site or obtained from the site or collect information about users of this site. You may not reverse engineer, disassemble or decompile any section or technology on the site, or attempt to do any of the foregoing. You are responsible for all use of our services and the site, with or without your consent, by yourself and others, which occurs by, through, or in connection with access to the site via your computer.

NO FEES FOR THIS SITE.
Health Net does not charge you any fees for using its site, but you may incur charges from your online service provider and/or telephone or cable companies.

REGISTRATION.
You are not obligated to register with Health Net in order to access this site. However, certain sections and features of this site are available only to Health Net members, brokers, providers and employers ("Registered Users"). If you are a Registered User, you agree to accurately maintain and update any information about yourself that you have provided to Health Net. You also agree to promptly notify us of any unauthorized use of your username, password or any other breach of security that you become aware of involving or relating to this site. 

USER SUBMISSIONS.
Health Net may offer users certain interactive features through the site from time to time. Interactive features may include the submission of commentary, feedback or other communications or materials by you and other users ("User Submissions").  You agree, represent and warrant that any User Submission is (a) truthful, accurate, and not misleading, (b) offered in good faith, and (c) that you have the right to transmit such information.

Any personal information you submit to our site (as well as any non-personal information collected by our site) is governed by Health Net's Privacy Policy

Subject to the limitations of Health Net's Privacy Policy, you hereby grant to Health Net a perpetual, irrevocable, royalty-free, transferable right and license to use, copy, display, distribute, modify, and create derivative works based upon any content you submit, including the right to incorporate the content into any form, medium or technology throughout the world without compensation to you. You further voluntarily waive any "moral rights" you may have in such content.

Members may use this site to view certain information from their Health Net history ("Health Net History") including, but not limited to, their medical claim history and prescription drug history.

COPYRIGHT, TRADEMARKS & TRADE DRESS.
All content included on the site, including but not limited to, any text, graphics and interactive features and any trademarks, service marks and logos contained therein (collectively "Materials") are owned by or licensed to Health Net, subject to copyright, trademark and other intellectual property rights under United States and foreign laws and international conventions.

Health Net® and Decision Power SM are registered service marks of Health Net, Inc. and all rights are reserved.  Members may have access to Decision Power SM through their current enrollment with many Health Net companies.  In Arizona, benefits are underwritten and/or administered by Health Net of Arizona, Inc., for HMO plans and Health Net Life Insurance Company for indemnity plans and life insurance coverage. The Health Net of Arizona, Inc. service area includes all Arizona counties. Health Net, Inc. is the parent company of  both  Health Net of Arizona, Inc. and Health Net Life Insurance Company.

No Materials from the site may be copied, reproduced, republished, uploaded, posted, transmitted, or distributed in any way without written permission of the rights owner, except that you may use information purposely made available by Heath Net for downloading from this Site, provided that you (1) keep intact all copyright and other proprietary notices, (2) use such information only for your personal, non-commercial informational purpose and do not copy or post such information on any networked computer or broadcast it in any media, (3) make no modifications to any such information, and (4) do not make any additional representations or warranties relating to such information. You agree not to circumvent, disable, or otherwise interfere with security related features of this Site or features that prevent or restrict use or copying of any Materials or content.

Modification of any Materials or use of any Materials for any other purpose is a violation of the copyrights and other proprietary rights of Health Net, or of other entities or persons where so indicated, unless Health Net or the owner has provided said Material for such express purpose. Permission for all other uses of Materials contained herein, including reproducing and distributing multiple copies or using Materials on any other website or networked computer or linking to any page at this site except the "home page" (http://www.healthnet.com), must be obtained from Health Net or the appropriate rights owner in advance; otherwise, such use is prohibited. Requests for such authorization from Health Net should be submitted via an email to WCOE@healthnet.com. All design rights, databases and compilation and other intellectual property rights associated with this Site, in each case whether registered or unregistered, and related goodwill, are proprietary to Health Net.

THIRD PARTY CONTENT/LINKS
As you view the site, you may notice links to third-party websites. If you use these links, you will leave this site. Certain of these linked websites may make use of Health Net proprietary intellectual property rights (such as copyrights, trademarks, service marks, logos and trade names) under license from Health Net. Health Net is not responsible for the availability or content of these other websites or for any viruses or other damaging elements encountered in linking to a third-party website. In addition, providing links to these websites should not be interpreted as endorsement or approval by Health Net of the organizations sponsoring such third-party websites or their products or services. This Agreement does not apply to any other websites.

Certain content and services offered to you on this site and via a link through this site are served on web sites hosted and operated by a third party ("Third Party Web Sites").  Once you click on a link to a Third Party Web Site, and leave Health Net's site, that site's privacy policy and terms of use, rather than Health Net's Privacy Policy and Terms of Use, govern your activities on that site. You should also be aware that some Third Party Web Sites offer mobile applications ("mobile apps") that can be downloaded to a mobile device (such as your phone or computing notebook) that would enable you to access Third Party Web Site content directly on your mobile device. The use of such mobile apps may be governed by a privacy policy and/or terms of use that may be different from, or in addition to, the privacy policy and terms of use that govern the Third Party Web Site. Health Net does not endorse and is not responsible for the privacy practices of the Third Party Web Sites or any mobile apps provided by any third party. You should review the privacy policy and terms of use posted on each of these web sites and mobile apps to understand how that Third Party Web Site or mobile app collects, uses, and discloses your information. You can determine whether you are on a Third Party Website if your browser shows a URL address that does not end in healthnet.com.

DISCLAIMER
Our site contains various types of information originating from ourselves or third parties, including outside vendors that provide health-related information or goods and services. The site provides information about health issues designed to help users make better decisions. But medical information is not the same as medical advice. Although we go to great lengths to make sure our information is accurate and useful, we urge you to consult a physician if you want professional assurance that our information, and your interpretation of our information, is appropriate to your particular situation.

AS THE USER OF THIS SITE, YOU ASSUME FULL RISK AND RESPONSIBILITY FOR ANY AND ALL USE OF THIS SITE, INCLUDING THE INFORMATION PRESENTED ON THE SITE. THE SITE IS INTENDED TO BE A GENERAL INFORMATION RESOURCE ONLY AND DOES NOT CONSTITUTE MEDICAL ADVICE AND IS NOT A SUBSTITUTE FOR PROFESSIONAL MEDICAL ADVICE OR TREATMENT. YOU ARE RESPONSIBLE FOR SEEKING PROFESSIONAL MEDICAL ADVICE IF YOU HAVE ANY QUESTIONS ABOUT YOUR HEALTH OR A HEALTH CONDITION. YOU AGREE TO HOLD HEALTH NET AND ITS AFFILIATES HARMLESS FROM ANY AND ALL CLAIMS RELATING TO YOUR USE OF, YOUR RELIANCE UPON, OR ERRORS OR OMISSIONS IN, INFORMATION FOUND ON THIS SITE.

THE SERVICES, INFORMATION AND FUNCTIONS CONTAINED ON OUR SITE ARE PROVIDED "AS IS" WITHOUT WARRANTY OF ANY KIND. WE EXPRESSLY DISCLAIM ANY AND ALL REPRESENTATIONS AND WARRANTIES, EXPRESS OR IMPLIED, INCLUDING THOSE OF ACCURACY, COMPLETENESS, NON-INFRINGEMENT, MERCHANTABILITY AND FITNESS FOR A PARTICULAR USE OR PURPOSE, CONCERNING OUR SERVICES OR THE ADEQUACY, ACCURACY OR COMPLETENESS OF THE INFORMATION OR SERVICES INCLUDED ON OUR SITE, THAT THE SERVICES WILL BE UNINTERRUPTED OR ERROR-FREE, THAT DEFECTS WILL BE CORRECTED OR THAT THIS SITE OR THE SERVER THAT MAKES IT AVAILABLE ARE FREE OF VIRUSES OR OTHER HARMFUL COMPONENTS. WE EXPRESSLY DISCLAIM LIABILITY FOR ERRORS IN OR OMISSIONS FROM SERVICES, INFORMATION, OR MATERIALS, INCLUDING HEALTH-RECORD HISTORIES, PRESCRIPTION AND NONPRESCRIPTION DRUG PURCHASE HISTORIES, OR PRESCRIPTION REFILL INFORMATION. WE ARE NOT RESPONSIBLE FOR THE CONTENT OF ANY LINKED WEBSITE OR ANY LINK CONTAINED IN A LINKED WEBSITE, EXCEPT TO THE EXTENT THAT SUCH WEBSITE OR LINK IS OWNED AND OPERATED BY HEALTH NET OR ITS AFFILIATE(S).

LIMITATION OF LIABILITY.
Use of our services is at your own risk. With regard to outside vendors and information providers, we do not endorse, or otherwise recommend or approve any product or information located on or available through our site. We do not own or control other networks, sites, or hyperlinked sites outside of our own site, including the outside vendors accessed through our site.

We have made reasonable efforts to validate that our lists of participating providers displayed are up to date and accurate. However, the continued participation of any one physician, hospital or other provider cannot be guaranteed. Please call the provider prior to scheduling an appointment to verify that the provider continues to be part of our network. EXCEPT WHERE LAW PROVIDES OTHERWISE, WE WILL NOT BE LIABLE TO YOU OR ANYONE ELSE FOR ANY HARM TO YOU OR OTHERS RESULTING FROM THE USE OF OUR SITE AND/OR THE PRODUCTS AND SERVICES PROVIDED THROUGH OUR SITE. TO THE MAXIMUM EXTENT PERMITTED BY LAW, IN NO EVENT WILL WE BE LIABLE TO YOU OR ANYONE ELSE FOR ANY SPECIAL, INCIDENTAL, DIRECT, INDIRECT, CONSEQUENTIAL OR PUNITIVE DAMAGES WHATSOEVER, INCLUDING, WITHOUT LIMITATION, DAMAGES FOR PERSONAL INJURY, WRONGFUL DEATH, LOSS OF REVENUE, BUSINESS INTERRUPTION, LOSS OF BUSINESS INFORMATION OR ANY OTHER PECUNIARY LOSS, LOSS OF TECHNOLOGY, LOSS OF RIGHTS OR SERVICES, LOSS OF DATA, INTERRUPTION OR LOSS OF USE OF ANY EQUIPMENT, MENTAL ANGUISH, EMOTIONAL DISTRESS, OR INVASION OF PRIVACY, ARISING OUT OF THE USE OF OR INABILITY TO USE OUR SITE AND/OR THE PRODUCTS AND SERVICES PROVIDED THROUGH OUR SITE, EVEN IF WE HAVE BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES, WHETHER UNDER THEORY OF CONTRACT, TORT (INCLUDING NEGLIGENCE), STRICT LIABILITY, OR OTHERWISE.

EXCEPT WHERE LAW PROVIDES OTHERWISE, WE ARE NOT RESPONSIBLE OR LIABLE FOR THE ACTS OR OMISSIONS OF OUTSIDE VENDORS OR INFORMATION PROVIDERS, OR FOR PERFORMANCE (OR NON-PERFORMANCE) WITHIN OUTSIDE NETWORKS OR INTERCONNECTION POINTS BETWEEN OUR SITE AND OTHER NETWORKS AND/OR SITES THAT ARE OPERATED BY THIRD PARTIES. WE ALSO MAKE NO REPRESENTATION REGARDING YOUR ABILITY TO TRANSMIT AND RECEIVE INFORMATION FROM OR THROUGH OUR SITE, AND YOU AGREE AND ACKNOWLEDGE THAT AT TIMES YOUR ABILITY TO ACCESS OUR SITE MAY BE IMPAIRED OR DISRUPTED. ALTHOUGH WE WILL USE COMMERCIALLY REASONABLE EFFORTS TO TAKE ANY ACTION WE CONSIDER APPROPRIATE TO REMEDY AND AVOID SUCH EVENTS, WE CANNOT GUARANTEE THAT THEY WILL NOT OCCUR, AND ACCORDINGLY WE DISCLAIM ANY AND ALL LIABILITY RESULTING FROM OR RELATED TO SUCH EVENTS.

WE ARE NOT LIABLE FOR ANY FAILURE OR DELAY IN OUR PERFORMANCE DUE TO ANY CAUSE BEYOND OUR REASONABLE CONTROL, INCLUDING ACTS OF WAR, ACTS OF GOD, EARTHQUAKE, FLOOD, EMBARGO, RIOT, SABOTAGE, LABOR SHORTAGE OR DISPUTE, GOVERNMENTAL ACT OR FAILURE OF THE INTERNET.

INDEMNIFICATION.
You agree to defend, indemnify and hold Health Net and its directors, officers, employees, agents, affiliates and successors harmless from and against any and all claims, demands, liabilities, judgments, losses, damages, costs, fees and expenses (including but not limited to reasonable attorneys' fees) arising from or relating to your use of the site or your acts or omissions, including but not limited to (1) infringement or misappropriation of any intellectual property rights, (2) defamation, libel, slander, obscenity, pornography, or violation of the rights of privacy or publicity, (3) spamming, or any other offensive, harassing or illegal conduct or violation of this Agreement, or (4) any damage or destruction to our site, to us, or to other persons or parties.

TERMINATION AND INVESTIGATION.
Health Net may terminate the license granted to you under the above "Website Access; Prohibited Activities" section at any time if you are in breach of this Agreement. The license will terminate immediately without notice from Health Net if, in Health Net's sole discretion, you fail to comply with any term or provision of this Agreement. Upon such termination, you may not access, use, or view the site.

Health Net expressly reserves the right, in its sole discretion, to terminate a Registered User's www.healthnet.com account due to any act that would constitute a violation of this Agreement.  If you wish to wish to deactivate your www.healthnet.com account, please contact us.

We reserve the right to investigate suspected violations of this Agreement. If we become aware of possible violations, we may initiate an investigation that may include gathering information from you or any user involved and the complaining party, if any, and examination of other material. We may suspend the provision of our services temporarily, or we may permanently remove the material involved from our servers, provide warnings to you, or suspend or terminate your access to our services. We will determine what action will be taken in response to a violation on a case-by-case basis, and at our sole discretion. We will fully cooperate with law enforcement authorities in investigating suspected lawbreakers.

BREACH.
You hereby acknowledge that your breach of this Agreement may result in immediate and irreparable harm to Health Net, for which there will be no adequate remedy at law, and that Health Net shall be entitled to equitable relief to compel you to cease and desist all unauthorized use, evaluation and/or disclosure of information obtained through the site. Your breach of this Agreement may also entitle Health Net to bring an action against you for any and all other remedies available at law or in equity.

JURISDICTION.
This Agreement, and the rights and obligations of you and Health Net hereunder, shall be governed by, and construed in accordance with, the laws of the State of California and the guidelines created by the Centers for Medicare and Medicaid Services (CMS). Except where applicable law requires a different dispute resolution process, you further agree that any legal action or proceeding between you and Health Net arising out of or relating to this Agreement or your use of the site shall be brought exclusively in a federal or state court of competent jurisdiction sitting in Los Angeles, California, and you hereby expressly and irrevocably consent to the jurisdiction and venue of such courts.

NO WAIVER; SEVERABILITY.
A waiver of any breach of any provision of this Agreement shall not be deemed to be a waiver of any repetition of such breach or in any manner affect any other terms or conditions of this Agreement. In the event that any provision of this Agreement is held to be unenforceable, it will not affect the validity or enforceability of the remaining provisions and will be replaced by an enforceable provision that is the closest to the intention underlying the unenforceable provision.

ASSIGNABILITY.
We may assign our rights and delegate our duties under this Agreement either in whole or in part at any time, at our sole discretion, and without your consent. You may not assign, sublicense or otherwise transfer your rights or obligations, in whole or in part, under this Agreement to anyone else.

RELATIONSHIP.
This Agreement does not establish any relationship of partnership, joint venture, employment, franchise or agency between you and us.


ADDITIONAL INFORMATION FOR REGISTERED USERS
REGARDING ELECTRONIC DOCUMENT DELIVERY ("EDD")

Some Registered Users may elect to enroll in Health Net's "Electronic Document Delivery" ("EDD") program.By enrolling, you agree and acknowledge the following:

  • You understand that if you enroll in electronic document delivery your consent to the terms of this "Electronic Document Delivery" section will be effective indefinitely, until you cancel electronic document delivery or it is cancelled by us.  We may cancel the EDD service at any time without prior notice.
  • You consent to receiving electronic delivery via www.healthnet.com, and to stop U.S. mail delivery, of the paper versions of all documents selected in your Document Delivery Preferences within your Health Net online profile. You understand that your electronic consent bears the same legal authority as your written signature and is binding by law.
  • You agree to maintain a valid email address with Health Net as a condition of participating in our EDD program. Unless you have elected not to receive such notifications, Health Net will send an email to the email address you have provided to notify you when a new document is available on our site and indicate the category of document. The email will provide a link to a login page on our site's secure portal. After you log in, your specific document(s) will be displayed.  If we are unable to notify you via email when a document becomes available due to a bad and/or cancelled email account, we will attempt to contact you to update your email address. If we are unable to make contact with you, we will revert your Document Delivery Preferences back to U.S. mail delivery for all document types, and send a letter notifying you of the change. You can log into www.healthnet.com and update your email address and document delivery preferences at any time.
  • You acknowledge that you may obtain a paper copy of any electronic document free of charge by contacting Health Net. In addition, you understand that you may download or print a copy of any of these documents online by logging in to your account on www.healthnet.com.
  • Except as otherwise provided herein, you understand that you may terminate electronic delivery for any category of documents or modify your email notification preferences at any time, free of charge, by clicking the Change Document Delivery Preferences link within your online profile and changing your document delivery choice to Mail (USPS) or by contacting Health Net.  Your cancellation will be effective within a reasonable period of time after we receive it.
  • For members enrolling in Health Net’s EDD program, you agree that you have full authority to accept the terms of this EDD section on behalf of each beneficiary on your plan. You also agree that each beneficiary has full authority to act individually in all matters relating to this online service.
  • For Medicare Advantage Members, you acknowledge and agree that you will maintain a valid email address during the time you are enrolled in the Health Net EDD program. Health Net will notify you at your designated email address when documents are available for viewing. If you elect to receive documents via EDD, you may not opt out of receiving notifications when electronic documents become available.  Should your email address become invalid or email undeliverable, delivery of the selected documents will automatically return to the standard USPS mail delivery format
  • You acknowledge and agree that certain minimum hardware and software are needed to make electronic transactions, listed below. You represent that you have the necessary computer hardware and software to view, download and print any documents you have elected to receive electronically.
    • To view your documents, or download or print them for future reference, you will need a browser listed in the Supported Browsers section below, as well as a printer with graphics capabilities.
    • Some documents, such as EOB's and EOC's may be available online only in PDF ("Portable Document Format"). To view a PDF, you'll need Adobe Acrobat® Reader which your browser may already provide or which you may download free from Adobe's site at www.adobe.com. If you need technical assistance, you may Contact Us. Downloading may be slow depending on your Internet connection. You may want to test your connection to our site and your viewing, downloading, or printing experience before agreeing to electronic delivery.

Depending on your specific plan, some exceptions to EDD may apply. For example, as noted above, Medicare members who elect to receive documents via EDD may not opt out of receiving notifications when electronic documents become available.  Members will also continue to receive hard copies of any material that are currently unavailable in electronic form and/or if for any reason the EDD is unavailable for certain Health Net plans.

The time it takes to process your change from U.S. mail delivery to electronic document delivery varies depending on the documents you select, as does the amount of time the document is available on the site.  A list of common documents that may be provided via Electronic Document Delivery is below.


For Members:


  • Explanation of Benefits (EOBs). When you select these documents, we will reflect the change to electronic delivery within 48 hours on average, although it could take longer for U.S. mail deliveries already in progress to stop. As your EOB documents become available, notifications will be sent to your email address informing you that the EOB is available for viewing on the healthnet.com website (after logging into your account).  EOBs will remain on the www.healthnet.com website for up to 7 years.  You may opt out of receiving such email notifications when new EOBs are available, even if you elect to receive only electronic EOBs, by changing your Delivery Preferences in your profile on the healthnet.com website.  Not available to all members.
  • Coverage Documents (Evidence of Coverage ("EOC"), Certificates of Insurance, Student Handbooks, Summary of Benefits and Coverage, etc.). In AZ, you can elect to receive these documents electronically. When you select these documents, we will reflect the change to electronic delivery within 48 hours on average, although it could take longer for U.S. mail deliveries already in progress to stop. As your EOC documents become available, notifications will be sent to your email address (unless you have elected not to receive notifications) and they will remain on our site for up to 7 years.  Not available to all members.
  • Billing Statements. For Individual and Family Plan ("IFP") members, you can elect to receive billing statements electronically through the healthnet.com website instead of receiving such statements via postal mail.  When you select these documents, we will reflect the change to electronic delivery within 48 hours on average, although it could take longer for U.S. mail deliveries already in progress to stop. As your billing statements become available, notifications will be sent to your email address (unless you have elected not to receive such notifications) and they will remain on our site for up to 7 years. Not available to all members.
  • Medicare Annual Notice of Change Materials (ANOCs). When you select these documents, we will reflect the change to electronic delivery within 48 hours on average, although it could take longer for U.S. mail deliveries already in progress to stop. As your ANOC documents become available, notifications will be sent to your email address and they will remain on our site for up to 7 years.
  • Medicare Post Enrollment Materials. When you select these documents, we will reflect the change to electronic delivery within 48 hours on average, although it could take longer for U.S. mail deliveries already in progress to stop. As your Post Enrollment documents become available, notifications will be sent to your email address  and they will remain on our site for up to 7 years.
  • All Future Available Online Documents. When you select this option, we will automatically set your delivery preference to online and notify you via email as new document types become available for electronic document delivery (unless you have elected not to receive such notifications).
  • Directories. When you select these documents, we will reflect the change to delivery preference within 48 hours on average, although it could take longer for any hardcopy mail deliveries already in progress to stop. As your new plan year directories become available notification will be sent to your email address. Documents will remain on our site for up to 7 years.
  • Please note: Not all document types listed above may apply to your respective plan.

For Brokers :


  • Commission Statements. When you select these documents, we will reflect the change to electronic delivery within 48 hours on average, although it could take longer for U.S. mail deliveries already in progress to stop. As your commission statements become available, notifications will be sent to your email address (unless you have elected not to receive such notifications) and they will remain on our site for up to 7 years.

For Employers :


  • Coverage Documents (Evidence of Coverage, Certificates of Insurance, Student Handbooks, Summary of Benefits and Coverage, etc.). In CA, your member's coverage documents will be defaulted to online delivery. Members will be notified via a mailed letter when their coverage documents are available online. If you prefer to have us mail coverage documents to your members, please speak with your account representative.
  • General Service Agreements (GSAs). In CA, your GSA will be available online. If you wish to have a hard copy mailed to you, please contact your account representative.

SUPPORTED BROWSERS

Our officially supported list of browsers is as follows:

  • Internet Explorer 9 and above
  • Firefox 40 and above
  • Safari 7 and above
  • Google Chrome 45 and above

Health Net makes every effort to ensure that our web site functions properly on the aforementioned browsers. All updates are tested on these browsers as well as more recent versions that are implied, but not listed, above (such as Google Chrome 40 and Internet Explorer 11). If we discover any way in which the site does not work properly on a supported browser, a high priority "fix it ticket" is created, and our web team begins work on resolving the issue immediately.

Thank you for taking the time to review this Agreement. We look forward to providing services to you.

Effective: 3/31/2015
Last Updated: 3/17/2016

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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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