May 16, 2024
Health Net discovered that the Small Group HMO Silver $55 plan (or comparable plan – see list below) had a $750 single/$1,500 family Prescription Drug Deductible. The Prescription Drug Deductible amount should have been $500 single/$1,000 family. This has been corrected in Health Net's system.
Following is a complete list of impacted plans by year:
- 2021-2022 Small Group HMO Silver $50 plan
- 2023-2024 Small Group HMO Silver $55 plan
- 2021-2024 CalChoice HMO Silver A plan
- 2023-2024 CalChoice HMO Silver D plan
While enrolled on the impacted plans, some members paid more than the $500/$1,000 deductible amount for pharmacy claims. To correct this, a refund will be processed for the amount the member overpaid toward their pharmacy deductible. Letters and refund checks for the 2021-2022 plans will be mailed first. Sample letters are attached:
- Sample Letter 1 2021 & 2022
- Sample Letter 2 2023 & 2024
If members are due a refund for 2023 and/or 2024, letters and a separate refund check will be issued at a later date once they are prepared.
An amendment to active 2023-2024 policyholders on the HMO Silver $55, HMO Silver A and HMO Silver D plans will also be issued.
Note: California Choice groups are also impacted.
We are committed to keeping you informed throughout this process. - stay connected with your Amwins Connect team for updates.
