Jul 31, 2018
Six new Health Net HMO Plans are offered through CaliforniaChoice® with quoting for October 1, 2018. Health Net is introducing three new Platinum HMOs and three new Gold HMOs. These new additions mean that your clients now have more than a dozen Health Net HMO and HSP choices in Q4. Plus, the SmartCare network is available in the Platinum and Gold tiers, offering a tailored network, expanded benefits, and health incentives in one program for most of your Southern California clients as well as those in Santa Clara and Santa Cruz counties. Below are highlights of Health Net’s six new plans; complete details on these and all of the options from CaliforniaChoice® are available in the Benefit Summaries guide.
| Health Net | Platinum HMO C | Platinum HMO D | Platinum HMO E | Gold HMO C | Gold HMO D | Gold HMO E |
| Network | WholeCare | Salud HMO y Mas | SmartCare | WholeCare | Salud HMO y Mas | SmartCare |
| Calendar Year Deductible | None | None | None | None | None | None |
| Dr. Visit Copay | $30 Copay | $30 Copay | $30 Copay | $35 Copay | $35 Copay | $35 Copay |
| Out-of-Pocket Max Ind/Fam | $2,250/ $4,500 | $2,250/ $4,500 | $2,250/ $4,500 | $6,000/ $12,000 | $6,000/ $12,000 | $6,000/ $12,000 |
| Inpatient Hospital Services | $500/Day, 4 days max | $500/Day, 4 days max | $500/Day, 4 days max | $750/Day, 3 days max | $750/Day, 3 days max | $750/Day, 3 days max |
| Rx Benefits | $5/$20/ $30/30% $0 deductible | $5/$20/ $30/30% $0 deductible | $5/$20/ $30/30% $0 deductible | $15/$50/ $70/30% $0 deductible | $15/$50/ $70/30% $0 deductible | $15/$50/ $70/30% $0 deductible |
Western Health Advantage Expansion Western Health Advantage is now available in Santa Clara County, along with some additional areas within San Mateo County.
Contact your LISI Regional Sales Manager for details about the rate changes as they vary by plans and regions.
