Health Net released their Q4 rate and benefit updates for small group plans. All medical and ancillary plans report 0.0%. While HMO and HSP plans were given a rate pass, most PPO and EPO plans are identical to Q3 rates.

Health Net is Expanding Their PPO Offering

Effective December 1, Health Net is expanding their Off-Exchange PPO offering to better align with the marketplace. There are five new plans total. One plan is a Silver PPO HSA on the Full Network, available in all regions. The following four plans (Gold Value, Silver Value, Silver H.S.A., and Bronze H.S.A) are in Health Net’s new PPO network, EnhancedCare, which is a subset of Health Net’s Full Network and is available in Region 15 and Region 16. Some features of the plans in the EnhancedCare network are:

  • EnhancedCare PPO Value plans waived the deductible for PCP visit, but the deductible applies for specialist visits.
  • EnhancedCare PPO Value plans integrate medical and pharmacy deductibles; they also waive the deductible for generics.
  • Members are responsible for pharmacy co-pays after they meet their deductible for specialty drugs.

Are these new plans game changers?  How do they stack up against industry incumbents and disruptors in your region? Your local LISI Sales Representative has the scoop on where these plans may or may not be competitive. Don’t be blindsided by your competition. Contact LISI today to see where you need to focus your retention and growth strategies!

Pharmacy Network Update: New AdvancedChoice

CVS, WalMart, Costco, Safeway, and Vons are some of the big names attached to their new pharmacy network, AdvancedChoice. This tailored network is effective October 1 and does not include Walgreens. Health Net states that group members will receive notification 60 days in advance of their employer’s renewal date. The first batch of letters are expected to go out August 1 for October renewals targeting new and renewing members on CommunityCare, Salud, and SmartCare plans. New groups that join EnhancedCare will receive letters about AdvancedChoice beginning December 1, 2017. Other plan designs are not being moved to this new pharmacy network and will continue to use the full pharmacy network.

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