1 Welcome to Health Net 2011 Your health, your choice.

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Presentation transcript:

1 Welcome to Health Net 2011 Your health, your choice

2 Two HMO plan choices New! Health Net Blue & Gold HMO Health Net HMO Head-to-toe benefit coverage Predictable copayments More cost-saving potential … All for you from the people who put health first. New for you

3 IF YOU NEED A HEADLINE, THIS IS IT. The Quick Compare BenefitMember paysHealth Net HMO Blue & Gold HMO Preventive care office visits$0 (covered in full) √√ Doctor office visits$15 √√ Specialist office visits$15 √√ Immunizations$0 (covered in full) √√ X-rays and lab procedures$0 (covered in full) √√ Maternity care$0 (covered in full) √√ Urgent careNow lower! $15 √√ Emergency care$50 √√ Hospitalization$250 per admission √√ Prescription Drugs: Retail (30-day supply)$5 generic $20 brand formulary $35 non-formulary √√ Mail order or UC Walk- up Services ( 90-day supply) $10 generic $40 brand formulary $70 non-formulary √√

4 IF YOU NEED A HEADLINE, THIS IS IT. The Quick Compare Member paysHealth Net HMO Blue & Gold HMO DeductibleNone √√ Out-of-pocket maximum (per calendar year) $1,000 for one member $2,000 for two members $3,000 family (three or more) √√√√√√ √√√√√√ Lifetime maximumNone √√

5 IF YOU NEED A HEADLINE, THIS IS IT. Fast Facts All UC medical groups and centers Many of the doctors currently caring for University members Stringent quality standards Coverage in all 30 California counties Search Blue & Gold Go to Click the Get Started button Use the searchable directories to look up doctors and hospitals Inside the Blue & Gold Network

6 IF YOU NEED A HEADLINE, THIS IS IT. Decision Power ® information, resources and support – including online health programs and personal coaches Decision Power ® Healthy Discounts acupuncture chiropractic health-related items including fitness club memberships, vitamins and weight management programs High-tech conveniences online medical records, benefit details, claims information Health Net Mobile – our smart phone app Text4baby, Take 5 maternity program and more health-boosting resources Beyond Benefits

7 Inside

8 IF YOU NEED A HEADLINE, THIS IS IT. Joe is a Health Net HMO member whose doctor is in the Blue & Gold network. By enrolling in Blue & Gold HMO, Joe pays less for the same benefits. Are you Blue & Gold? Mary and her husband are Health Net members. Her doctor is in Blue & Gold but her husband’s is not. He hasn’t seen his doctor that often and is comfortable making a change in exchange for the premium cost-savings.

9 IF YOU NEED A HEADLINE, THIS IS IT. Molly and her family have always preferred PPO plans and the choice to go out-of- network. Now they’re wondering if the out-of-network option is worth what they’ll have to pay each month since their primary doctors are all in the Blue & Gold network. Are you Blue & Gold? Sam rarely goes to the doctor so he wants a plan that costs him less in payroll deductions each month.

10 IF YOU NEED A HEADLINE, THIS IS IT. Brenda and Sal both have doctors who only participate in the full Health Net network. They don’t really want to change but the savings they’d get with Blue & Gold has them re-considering. They’re planning to ask friends who have doctors in the Blue & Gold for recommendations. Then they’ll decide. Are you Blue & Gold? Fred and his partner want a plan that doesn’t require a lot of active management and leaves them more room in their household budget for travel.

11 1.Keep your address and phone number updated with UC ( 2.Call your Primary Care Physician (PCP) and get a check up. 3.Know when to get preventive screenings. 4.Register at for cost savings tips and more. 5.Choose generics when filling prescriptions. 6.Use the Mail Order or UC Walk-up program for maintenance drugs and get a 90-day supply for the price of two months at retail – that’s one month free! 7.Call your PCP in an urgent situation. It may be more appropriate for you to go to an Urgent Care Center rather than an Emergency Room. 8.Take charge of your health with Decision Power ®. Health 101 Tips…to maximize your benefits

12 Log on to the dedicated UC custom website at Talk to a dedicated UC Customer Service representative at from 8 a.m. to 6 p.m. Consult with a Decision Power Health Coach ( ) –Personal coaching available 24/7 –Nurses, registered dietitians, respiratory therapist –Ask to speak to the same Health Coach Here for you

13 IF YOU NEED A HEADLINE, THIS IS IT. Top 5 reasons why Health Net is a Better Decision 1.Choice of health plans: Health Net HMO and the new Health Net Blue & Gold HMO for more savings opportunity. 2.Predictable costs with fixed copayments such as $15 for urgent care (down from $50 in 2010). 3.Extra services like Decision Power, product discounts and high-tech conveniences. 4.Financial strength and stability: Health Net is ranked #146 on the 2009 Fortune Dedicated support at and Make the choice for health

14 Health Net Disclaimers The benefits described here are a summary only. All benefits are subject to the definitions, limitations and exclusions set forth in the Summary of Benefits included with open enrollment information. Employees are encouraged to review them before making their final decision. 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. Decision Power Healthy Discounts is not part of your Health Net benefit program and is not intended to take the place of any covered benefits. Decision Power Healthy Discounts providers are independent businesses. CA71797 (10/10) Health Net of California, Inc. and Health Net Life Insurance Company are subsidiaries 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 other trademarks remain the property of their respective companies. All rights reserved.