Health Net Plan & Rate Updates Effective January 2025
Health Net announced plan and rate updates for January 1, 2025 effective dates. Rates are available for quoting!
Rates
Quarterly Rate Change (may vary by plan and region)
- HMO: 1.7%
- PPO: 1.9%
Annual Rate Change
- HMO: 8.4%
- PPO: 6.8%
Dental: New rates available.
Vision: No rate or plan changes at this time.
Optional chiro: All plans will have the chiro rider option in 2025. The chiro rider will be an additional $3.00 PMPM for all HMO and PPO plans.
Medical Plan Updates
Health Net is adding 3 new plans in 2025:
- Platinum PPO 0/5
- Gold PPO 1500/20% (this plan replaces the Gold PPO 1600/0)
- Silver PPO 2500/50
Health Net is closing the CommunityCare HMO plans from their portfolio. These plans were only available in regions 15, 16, 18, and 19.
Dental Plan Updates
Health Net is introducing three new Dental PPO plans in 2025, one with a $3,000 annual maximum, and two with unlimited maximums:
Below is a snapshot of the benefits of each of Health Net's new Dental PPO plans. Please see the benefit summaries linked above for complete details.
| Benefit | Essential 9 3000 | Classic 7 Unlimited | Classic 11 Unlimited |
|---|---|---|---|
| Annual Maximum | $3,000 | Unlimited | Unlimited |
| In-network | 100/90/60 | 100/80/50 | 100/90/60 |
| Out-of-network | 100/90/60 | 100/80/50 | 90/90/60 |
| Endo/Perio | Basic | Basic | Basic |
| Child/Adult Ortho | $3,000 lifetime | Not covered | $3,000 lifetime |
| OON Reimbursement | MAC | UCR | UCR |
2025 Portfolio Highlights
- No deductible: Health Net offers competitive Gold and Silver plans with no deductible.
- Teladoc: All plans have access to Teladoc for behavioral health and general medical needs.
- Bundling: Health Net can be written alongside any carrier with no limit to the number of carriers so long as participation is met.
- Network mix: You can mix and match all of Health Net's networks, giving groups the option to offer multiple plans and networks to their employees.
Simplified Underwriting Programs
Enhanced Choice
- 5 enrolled subscribers minimum.
- No DE9C, payroll, or ownership documents are required.
- No prior carrier bill is required.
- All eligible employees declining coverage must provide a waiver including those enrolling with another carrier.
- Employees enrolled on another carrier through the same employer will not count against 25% participation.
HMO with 6
- 6 enrolled subscribers minimum.
- Mix and match any plans from the HMO networks
- No DE9C, payroll, or ownership documents are required.
- No waivers are required (when not paired with Life or Employer Paid Dental/Vision).
- No participation attestation required.
- No prior carrier bill is required.
Flexible Underwriting
- 2 weeks of payroll for a Startup Group of any size (down to 1)!
- Mix and match any of Health Net's 61 plans.
- Health Net can be written alongside any carrier, no limit to the number of carriers if participation is met.
- 70% participation for groups of 1-4 enrolling.
- 25% participation for groups of 5-100 enrolling - not a promotion!
- Health Net accepts PEO subgroups with a quarterly wage report or 2 weeks of payroll from the PEO.
6% for 6 Broker Bonus Program
As a reminder, Health Net's is offering a 6% commission rate on new medical business for the life of the case when you sell any new Small Group with 6 or more enrolled employees. This bonus program continues through January 2025 effective dates. See their flyer for complete details.
Book Rates
Book rates will be posted to the B&P website when they are available.
For questions, please contact a member of your B&P Sales Team – 888.722.3373.