Just as Covered California will continue to let Certified Insurance Agents enroll individuals and families in the new ACA health plans, Health Net of California will also accept new applications for enrollment. Applications for both Covered California and Health Net must be submitted by April 15th for a May 1st effective dates. This is only for new enrollment and not for plan changes between carriers.
Health Net still accepting applications
Health Net is still accepting applications for Off and On Exchange plans through April 15th for May 1st effective dates, 2014.
- Off Exchange – must receive application by 4/15/14
- Electronic Applications must be submitted online by end of day 4/15 to get the 5/1 effective date (must include credit card or ABD for initial payment)
- Covered CA On Exchange – must complete online application by 4/15/14. No paper applications accepted that are postmarked after 3/31/14.
Health Net Payments Covered California
- Pay By Phone: 800-539-4193 Credit Cards can be used for first time payment. Phone operating times are 8am to 8pm. Long wait times and busy signals are being experienced due to high volume. Please provide Covered CA App ID# and SSN.
- Pay By Phone (Automated): 877-200-9260. Caller must have their Bill#/Subscriber ID# (R#) in order to make a payment.
- Pay by Mail: (I highly do not suggest this) Payment can be mailed to Health Net, PO BOX 60515, City of Industry, CA 91716-0515. Be sure to provide Covered CA App ID# and SSN if the member does not have their bill yet.
Health Net Off Exchange Payments
Health Net at 800-839-2172 to make this payment OFF Exchange Apps with Payment payable to “Health Net” – Health Net Individual & Family Enrollment, PO Box 1150, Rancho Cordova, CA 95741-1150. OFF Exchange Payments – PO Box 894702 Los Angeles, CA 90189-4702
Payment types Automatic Bank Draft (ABD)
Be aware of what checking each box on this form represents:
- ABD First month’s payment = HN will process for just the 1st month premium.
- Credit Card First month’s payment = HN will process for just the 1st month premium (No credit card option for ongoing payments).
- ABD Monthly premium payment = HN will process for all premium payments, but based on timing of form we may draw two months premium together.
- ABD First month’s payment AND Monthly premium payment = HN will process the one-time payment for 1st month premium and use the ongoing for all future months.
90 day grace period
Policies with subsidies have a premium payment grace period of 90 days instead of 30. This grace period applies to future months only, not the Initial Payment. The initial payment is still due on the 15th of the same month the policy becomes effective.
After initial 30 day period
During month 1, HN will pay claim. During month 2 and 3 of delinquency, the doctor should treat the patient as a “cash” patient and they have the choice of either seeing the member and having the member pay cash, or NOT seeing the member since they don’t have insurance.
Dental and vision
By sending in an application off exchange with your member number on it and include a note asking just to add Dental only that will be done but it will carry a future effective date- it won’t go retro.
Primary subscriber change
HN changed who the IFP Primary Subscriber is even though the rates
are the same. This can be changed, email Membership and ask for them to ref. the application and change primary subscriber back to JOHN DOE and on the subject line just put “Switch Primary within Family” Please give them a member number or some kind of identifier. Send it into membership [email protected]
Effective date mismatch
Subscriber wanted a 2/1 for this person but HN assigned a 3/1 due to HN or Covered CA’s processing time. Send a request to “Effective Date Confirmation / Change Eff. Date” on the subject line and proof of fax confirmation or original email to HN and send to [email protected]
Deductible roll-over to new plan type
If the move is from a PPO to a PPO OR from a HMO to a HMO then the
deductible/OOPM will rollover. However, if between HMO/PPO it does not. Note some plans don’t have deductibles.