ENHANCED CHOICE AND SILVER CHOICE PROGRAMS Choice made simple

Transcription

1 SMALL BUSINESS GROUP (2-50 employees) ENHANCED CHOICE AND SILVER CHOICE PROGRAMS Choice made simple Effective January 1, 2009

2 THE BEST OF BOTH WORLDS: Looking to offer your employees the ultimate number of plan options and a set contribution that s affordable? Health Net Small Business provides these solutions in its Enhanced Choice and Silver Choice programs. Both options are available to employers with 2 50 employees and a 75% employee participation, with a minimum of 2 employees enrolled. ENHANCED CHOICE HOW IT WORKS!1!!1!1 1 2!!!1! % EMPLOYEE PARTICIPATION $EMPLOYER PAYS BASE PLAN MONTHLY PREMIUM FIXED DOLLAR AMOUNT (AS LOW AS $100 P/E P/M) ACCESS TO HEALTH NET S OR + + = ENHANCED CHOICE EMPLOYER PAYS PORTFOLIO 49 PLANS! Employees have the option of choosing from any of the plans in the portfolio, giving them the freedom to pick a plan that truly fits their needs. Employers contribute one of two ways. Either they choose a base plan and pay the monthly premium of that plan (per employee per month), or they pay a fixed dollar amount as low as $100 per employee per month. Either way, their costs are capped and employees get the plans they truly want and need. ENHANCED CHOICE PLAN 1 CHOICES: Standard HMO 10 Standard HMO 20 Standard HMO 30 Standard HMO 40 Standard EOA 10 Standard EOA 20 Standard EOA 30 Standard EOA 40 POS 10 POS 20 Standard PPO 10 Standard PPO 20 Standard PPO 30 Standard PPO 40 Standard HSA 2000 Standard HSA 3000 Standard HSA 4000 Salud HMO y Más 15 2 Salud HMO y Más 25 2 Salud Mexico 3 Flex Net Value HMO 10 Value HMO 20 Value HMO 30 Value HMO 40 Value EOA 10 Value EOA 20 Value EOA 30 Value EOA 40 Value PPO 10 Value PPO 20 Value PPO 30 Value PPO 40 Value HSA 1500 Value HSA 2500 Value HSA 3500 Value HSA 4500 Options PPO 3000 Options PPO 4000 Salud PPO 4 Salud EPO 4 Options HMO 25 Options HMO 35 Options EOA 25 Options EOA 35 Options PPO 250 Options PPO 500 Options PPO 1500 Options PPO Plans not included in Enhanced Choice: Silver Network and CalChoice 2Network limited to and Orange, and select ZIP codes of Riverside and San Bernardino counties 3Network limited to and Imperial counties 4Network limited to, Orange and Ventura Counties Standard/Value HSA and Options PPO 3000 and 4000 plans are HSA-compatible PPO insurance plans.

3 CHOICE AND AFFORDABILITY SILVER CHOICE Silver Choice offers a choice of plans to employees who live within the Silver Network area, a subset of Health Net s full network. The Silver Network area includes all or parts of Kern,, Orange, Riverside, San Bernardino,, and Ventura counties. Within these counties, members have access to more than 5,600 primary care physicians and 11,900 specialists (see Parent s Included in the HMO Silver Network chart on opposite page). With Silver Choice, members receive the same high quality of care, but at a lower price up to 20%! Employers contribute one of two ways. Either they choose a base plan and pay the monthly premium of that plan (per employee per month), or they pay a fixed dollar amount as low as $100 per employee per month. Either way, their costs are capped and employees get the plans they truly want and need. SILVER NETWORK: LOWER NET COST, SOLID QUALITY The Silver Network provides an affordable care network that doesn t sacrifice quality. It s simply a select subset of our regular network. It maintains excellent access and service standards. Members have access to more than 5,600 PCPs, 11,900 specialists and 100% of the hospital network, in an eight-county service area. SILVER CHOICE PLAN CHOICES: Standard HMO 10 Standard HMO 20 Standard HMO 30 Standard HMO 40 Standard PPO 10 Standard PPO 20 Standard PPO 30 Standard PPO 40 Standard HSA 2000 Standard HSA 3000 Standard HSA 4000 Value HSA 1500 Salud HMO y Más 15 2 Salud HMO y Más 25 2 Salud Mexico 3 Flex Net Value HMO 10 Value HMO 20 Value HMO 30 Value HMO 40 Value PPO 10 Value PPO 20 Value PPO 30 Value PPO 40 Value HSA 2500 Value HSA 3500 Value HSA 4500 Options PPO 3000 Options PPO 4000 Salud PPO 2 Salud EPO 4 Options 25 Options 35 Options PPO 250 Options PPO 500 Options PPO 1500 Options PPO 1750 HOW IT WORKS 1!!!1! 1!1!!1! Silver Network service area 75% EMPLOYEE PARTICIPATION The Silver Network is available in all or parts of Kern,, Orange, Riverside, San Bernardino,,, and Ventura counties. 2Network limited to and Orange, Riverside and San Bernardino counties 3Network limited to and Imperial counties 4Network limited to Ventura County Standard/Value HSA and Options PPO 3000 and 4000 plans are HSA-compatible PPO insurance plans. $EMPLOYER PAYS BASE PLAN MONTHLY PREMIUM OR EMPLOYER PAYS FIXED DOLLAR AMOUNT (AS LOW AS $100 P/E P/M) = LIVE WITHIN SILVER NETWORK AREA ACCESS TO HEALTH NET S SILVER CHOICE PORTFOLIO 37 PLANS!

4 SILVER NETWORK PARENT MEDICAL GROUPS Kern Bakersfield Family Medical Center - Heritage Physician Network Delano Regional Independence Access IPA Acclaim IPA Accountable Healthplan AKM, Inc. Alamitos IPA Alliance Physicians Medical Allied Health Care Providers, Inc Allied Physicians of California Altamed Health Services AmeriWest Anaheim Memorial IPA Angeles IPA Antelope Valley Medical Associates, Inc. Associated Hispanic Physicians of Southern California Bella Vista IPA Bright Medical Associates Brookshire IPA Cal Care IPA, Inc. Centinela Valley IPA Medical Citrus Valley Physician Community Family Care Crown City Doctors Eastland Exceptional Care Facey Medical Foundation Family Health Alliance Glendale Physicians Alliance, A, Inc. Good Samaritan Medical Practice Association Greater Covina - Regal Medical Health Care LA, IPA Heritage Health Care High Desert Hispanic Physicians / Medico Hispano IPA Hollywood Presbyterian Medical Huntington Park Mission Korean American La Vida, IPA La Vida Multi-Specialty Medical Center Bakersfield Bakersfield Bakersfield Cerritos Huntington Park Alhambra Lancaster Woodland Hills Whittier San Dimas West Covina Pasadena West Covina West Covina Mission Hills Long Beach Long Beach Covina Woodland Hills Palmdale Lancaster Agoura Hills Lawndale Lakeside Glendale Health Plan LaSalle Medical Associates, Inc. Memorial Healthcare IPA Mid Cities, IPA Omni Care Lynwood Orange Coast IPA Pacific Alliance Pacific Independent Physician El Monte Association Physician Associates. of the Pasadena Greater San Gabriel Valley Pioneer Provider Network, A, Inc. Prairie, Inc. Lawndale Premier Physician Network Redlands IPA Regal Northridge San Gabriel Valley Regal Medical Arcadia Seoul Serra Community Medical Clinic Sun Valley St. Mary IPA St. Vincent IPA Cerritos Talbert Cerritos Torrance Hospital IPA Torrance Universal Care Bellflower Verdugo Hills, Inc. Glendale West Covina Medical Clinic, Inc. West Covina Orange Affiliated Doctors of Orange County Garden Grove AMVI, Inc. Garden Grove AppleCare Buena Park Arta Health Network Irvine Bristol Park Anaheim Genesis Health Care Santa Ana Monarch Healthcare, Irvine A, Inc. Prospect Professional Care Santa Ana, Inc. Talbert Anaheim Universal Care Anaheim Riverside Beaver - Banning Banning Desert, Inc. Palm Springs Hemet Community Hemet Oasis Independent Physician Palm Springs Association Primecare of Riverside Riverside, Inc. Primecare of Temecula Temecula, Inc. Riverside Medical Clinic Riverside Riverside Physician Network Riverside Vantage Riverside San Bernardino Beaver Redlands Chino, Inc. Chino Choice, Inc Apple Valley Heritage Victor Valley Victorville High Desert Primary Care Victorville Physicians Inland Faculty Colton Pinnacle Fontana Pomona Valley, Inc. Ontario Primecare of Chino Chino Valley Regal Inland Region San Bernardino San Bernardino San Bernardino United Family Care Rialto Children's Physicians Medical Family Choice Greater Tri-Cities IPA Mercy Physicians Mid-County Physicians Medical Multicultural Primary Care Noble AMA IPA North County Health Services Park Terrace Medical Associates Primary Care Associated Medical Physicians Medical Sharp Community Sharp Mission Park Medical Sharp Rees-Stealy UCSD Healthcare Network Chinese Community Health Care Association Hill Physicians Physicians Integrated Medical Ventura Seaview IPA Valley Care IPA Oceanside Oceanside San Marcos Poway San Marcos Oceanside Oxnard Ventura For an up-to-date listing of the physicians and hospitals in the Silver Network, please visit > Search our Doctor Network.

5 Decision Power SM Health in Balance At Health Net, we re about more than just health care coverage. Sure, comprehensive benefits are essential, but so is making it easy for people to make the most of their health. That s why we created Decision Power. Grounded in science and reinforced by experience, Decision Power addresses the health needs of the whole person through integrated resources and support that span the entire spectrum of health from wellness resources to health coaching, chronic condition management to end-stage disease support. And of course Decision Power is available at no extra cost so that everyone can take advantage. Crafted by Health Net medical management in collaboration with provider groups and industry experts such as Health Dialog, Paradigm, and WebMD, Decision Power brings together trusted sources of medical and wellness information, building strong connections between patient, provider and payer. This design of partnership and integration gets results: Member Satisfaction: 87% of users stated that speaking with Decision Power Health Coaches made the quality of care they received from the providers better or much better. 1 Provider Satisfaction: Nearly 90% of providers who were aware of Decision Power agreed that they provided enhanced communication as a result of information from Decision Power to those patients who came in with evidence-based information culled from our expert online sources. 2 Lower High-Cost Service Utilization: 3.8% reduction occurred in both hospital utilization and ER visits per 1,000 chronic members. 3 Effective Outreach: 76% combined reach rate to Commercial and Medicare plan members in the high-risk chronic population. 4 Additional options You can round out your employee benefits package by also offering Chiropractic and Acupuncture coverage, available with Health Net HMO, ELECT Open Access and Point-of-Service plans as well as optional Dental, Vision, Life and Accidental Death & Dismemberment. 1Based on the independent 2007 Decision Power Member Satisfaction Survey, enterprise-wide average. Sample size: 802 program users and 800 non-users, yielding 95% confidence intervals of 5 +/- for all measures on the survey. 2Based on independent Health Net 2007 Decision Power Satisfaction Survey, conducted October 2007 January 2008 with 1,608 respondents for a 17.7% response rate. 3Commercial trends August 2006-July 2007 compared to August 2005-July 2006; Decision Power Monthly Contact and Utilization Report for Health Net of California. 4Decision Power Monthly Contact and Utilization Report, as of December 2007 for Health Net of California.

6 For more information please contact: Health Net Post Office Box 9103 Van Nuys, California Broker Services , option 4 Small Business Sales and Service Administration (English) (Spanish) (Mandarin) (Cantonese) (Korean) (Tagalog) (Vietnamese) Telecommunications Device for the Hearing and Speech Impaired Other options: Coverage for individuals and families: Coverage for family members over 65 years of age: Coverage for children in a low-income household: Coverage for businesses with 50+ employees: , option 4 Health Net Dental HMO plans are provided by Dental Benefit Providers of California, Inc. ( DBP ). Obligations of DBP are not the obligations of or guaranteed by Health Net, Inc. or its affiliates. Health Net Dental PPO and indemnity plans are underwritten by Unimerica Insurance Company. Obligations of Unimerica Insurance Company are not the obligations of or guaranteed by Health Net, Inc. or its affiliates. Health Net Vision PPO plans are underwritten by Fidelity Security Life Insurance Company and serviced by EyeMed Vision Care, LLC (together, the Fidelity Entities ). Discounts on vision care services and products are made available by EyeMed. The Fidelity Entities are not affiliated with Health Net of California, Inc. or Health Net Life Insurance Company (together, the Health Net Entities ). Obligations of the Fidelity Entities are not the obligations of or guaranteed by the Health Net Entities. Chiropractic and acupuncture care is underwritten by the American Specialty Health Plans of California, Inc., a wholly owned subsidiary of American Specialty Health, Incorporated (ASH). Obligations of American Specialty Health Incorporated (ASH) are not the obligations of or guaranteed by Health Net, Inc. or its affiliates. Term Life, Supplemental Term Life and AD&D products are issued by Health Net Life Insurance Company, a subsidiary of Health Net, Inc. Health Net Life currently reinsures a portion of its life and disability insurance risk with Hartford Life and Accident Insurance Company, which has an A.M. Best financial rating of A+ (Superior). Health Net HMO, EOA, POS and Salud con Health Net HMO plans are offered by Health Net of California, Inc., a subsidiary of Health Net, Inc. Health Net PPO, Flex Net and Salud con Health Net PPO and EPO insurance plans are underwritten by Health Net Life Insurance Company. Decision Power SM is not part of Health Net s commercial medical benefit plans nor affiliated with Health Net s provider network and it may be revised or withdrawn without notice. Decision Power is part of Health Net s Medicare Advantage benefit plans but is not affiliated with Health Net's provider network. Decision Power services, including Health Coaches, are additional resources that Health Net makes available to enrollees of Health Net of California and Health Net Life Insurance Company. WebMD, Health Dialog and Paradigm are registered trademarks/service marks of their respective owners. Used with permission (10/08) Health Net of California, Inc. is a subsidiary of Health Net, Inc. Health Net is a registered service mark of Health Net, Inc. A Better Decision SM and Decision Power SM are service marks of Health Net, Inc. All rights reserved.