Health Net Portfolio & Network Glossary

Health Net Small Group Plans & Networks

Description

HMO plans available in 5 networks:

• HMO: Full HMO network
• WholeCare HMO: Narrower HMO network
• SmartCare HMO: Narrow HMO network 
• CommunityCare HMO: Narrower HMO network
• Salud y Mas HMO: Narrow HMO network limited to specific service areas with cross border access to the SIMNSA network

PPO plans available in 2 networks:

• PPO: Full PPO network
• EnhancedCare PPO: Narrow PPO network in Los Angeles

HSA-compatible PPO plans available in the PPO network.

HSP plan (PCP selection required, in-network self-referrals permitted) available in the Health Net PureCare HSP narrow network.

Other Important Information

Description

Enhanced Choice Package Portfolio

Full HMOs, WholeCare, HMOs, SmartCare HMOs, Salud y Mas HMOs, CommunityCare HMOs, HSPs, EPOs, and Full PPOs.

EnhancedCare PPO Choice Package Portfolio

Full HMOs, WholeCare, HMOs, SmartCare HMOs, Salud y Mas HMOs, CommunityCare HMOs, HSPs, EPOs, EnhancedCare PPOs, Full PPO Bronze HSA and Full Bronze 60 PPO.

Essential Rx Drug List

Formulary that applies to all small group plans.

Rx Mail Order

CVS Caremark

Behavioral Health

Beginning in 2024: Health Net's Behavioral Health Services

Prior to 2024: MHN

Pediatric Dental

For embedded pediatric Dental benefits within Medical plans, plans use the following networks:

• PureCare HSP and HMO: Dental Benefit Providers of California
• PureCare One EPO and EnhancedCare PPO: Dental Benefit Administrative Services
• PPO: Dental Benefit Administrative Services

Pediatric Vision

For embedded pediatric Vision benefits within Medical plans, plans use the following networks:

• PureCare HSP and HMO: Envolve Vision
• PureCare One EPO and EnhancedCare PPO: Envolve Vision
• PPO: Envolve Vision