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Health Net Sending Refund to Some HMO Silver $55 Members

Important Notice: A refund is being sent to some Small Group HMO Silver $55 Plan members 

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:

 

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.