Health Net has made the business decision to no longer offer Medicare Advantage Private-Fee-For-Service (PFFS) products for the 2010 plan year. Based on this announcement, Health Net will no longer market these products in California, Connecticut, Georgia, Hawaii, Massachusetts, New Mexico, New York, North Carolina, Oregon, Texas, Virginia and Washington, starting April 1, 2009. This decision only applies to PFFS. It has no impact on members enrolled in our other Medicare Advantage or stand-alone prescription drug plans (PDP).
This decision will allow Health Net to focus our resources on network-based Medicare Advantage and Part D plans. A number of factors were important in making this decision:
- Nationwide, we have a low level of membership for a product that has numerous administrative challenges and requires further investment if we were to offer it in 2010.
- Significant payment reductions from the government are expected for the next plan year based on the draft 2010 Call Letter.
- Most markets will require a provider network as of January 1, 2011. Health Net has evaluated the effort and resources required to build provider networks in order to meet these requirements and found it too costly in our non-core markets.
So what does this decision mean for you and your clients in 2009?
- All 2009 benefit plans will remain unchanged. Health Net will continue to pay claims and service member business without interruption.
- Health Net will no longer actively market our PFFS product starting April 1, 2009.
- Health Net will no longer pay commissions for new enrollments that are dated by the enrollee June 1, 2009 or after.
- We will continue to pay renewal PFFS commissions through December 31, 2009 per our producer contracts but all PFFS commissions will cease effective January 1, 2010.
- Health Net will send to contracted producers a letter with a contract amendment to incorporate these contract modifications.
Should you have any questions regarding Health Net's decision not to offer PFFS products, please click here for the Producer FAQ or you may contact our broker service center in your market. If you are authorized to write under an FMO or GA please contact your FMO or GA directly.
GA, HI, MA, NC, NM, NY, TX, VA
Call our Producer Concierge Team at 1-800-431-8549, Monday - Friday, 6:00 am - 5:00 pm PST (excluding holidays) with any questions. You may also e-mail them at
spd.concierge@healthnet.com
AZ, CA, OR, WA
Call our National Medicare Broker Service Center at 1-800-708-7646, Monday - Friday, 8 am - 5 pm PST (excluding holidays) with any questions. You may also e-mail them at HN_MedicarePrograms@healthnet.com
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