Health Net Insurance Company, also known as Ambetter, is a California-based healthcare provider offering comprehensive health plans for individuals, families, and Small businesses. Health Net Insurance Company is one of the Eight California Choice(Cal Choice) carrier partners. With 90,000 network providers, Health Net Insurance Company serves 3 million members across the state. It collaborates with local organizations to promote healthy lifestyles and combat poverty and violence.

That’s why investing in a good health coverage plan is essential. Health coverage helps pay for significant medical costs, prescription drugs, and emergencies. The company actively commits to providing affordable, quality healthcare for Small Businesses.

Health Net knows running a successful small business takes commitment and requires long hours and sacrifice – particularly in California. That’s why Health Net offers various health plans that work as hard as you do. Each PlanPlan is tailored to fit the needs of businesses like yours. Whether you have two or 100 employees, you can count on Health Net for big coverage for your small group.

2024 Ambetter HMO Group Health Plan (Through California Choice(Cal Choice) )

If you value a consistent healthcare cost and prefer a familiar doctor to manage your care, then Ambetter HMO plans may be the right choice. Under this PlanPlan, your primary care physician (PCP) is responsible for referring you to specialists and facilities within the Ambetter HMO network as needed. It’s important to note that this Plan covers no out-of-network services except for emergency care, urgent care, and Health Net-approved services.

Here are the three provider networks under the 2024 Ambetter HMO plans: 

  1. WholeCare HMO
  2. SmartCare HMO 
  3. CommunityCare HMO

Below are some of the most popular Ambetter HMO group health plans: 

  1. BRONZE HMO A: Belongs to the CommunityCare provider. This Plan comes with a Calendar year Deductible of $6,300 and $12,600. The Out-of-Pocket Max for Individuals is $9,100 and $18,200 for Families. The PlanPlan offers a copay of $60.
  2. SILVER HMO D: This Plan comes with no Calendar year Deductible. The Out-of-Pocket Max for Individuals is $9,450 and $18,900 for Families. The Plan offers a copay of $55.
  3. GOLD HMO A: Belongs to the WholeCare provider. This PlanPlan comes with no Calendar year Deductible. The Out-of-Pocket Max for Individuals is $7,250 and $14,500 for Families. The PlanPlan offers a copay of $30.
  4. PLANTINUM HMO E: This Plan comes with no Calendar year Deductible. The Out-of-Pocket Max for Individuals is $2,700 and $5,400 for Families. The Plan offers a copay of $30.

2024 Ambetter PPO Group Health Plan(Through California Choice(Cal Choice)

If you prioritize having the freedom to choose your healthcare provider while keeping the cost in check, Ambetter PPO plans are the right option. With an Ambetter PPO plan, you can select your primary care physician (PCP) from their network and get care from specialists without needing a referral from your PCP. The network is customized to suit your needs.

However, if you visit a doctor not part of the PPO network, you may have to pay a higher deductible or co-insurance as a plan member.

2024 HealthNet Group Health Plan Types

Ambetter Platinum and Gold Plans: If you require frequent medical care, these plans offer various options and are highly recommended. The Ambetter Platinum and Gold Plans are excellent choices due to their high monthly premiums, low copays, and no deductibles – all of which make them stand out from the rest of the Ambetter plans.

Ambetter Silver Plans: These plans come with moderate premiums, deductibles, copays, and copayments. If you seek medical attention occasionally and want a good balance between your monthly plan premiums and the cost of care, Ambetter Silver Plans are a great choice. Additionally, Ambetter offers a special Silver plan called the Ambetter HMO Enhanced Silver Plans.

Ambetter Bronze Plans: If you rarely visit the doctor but want protection in case of an emergency, these plans typically offer lower monthly premiums but entail higher out-of-pocket costs when receiving care. Choose the Ambetter Bronze Plans for such circumstances.

Key Terms to Know

COPAY- A copay is a fixed amount for a specific medical service. For example, The BRONZE HMO A Plan will have a copay of $60 for a doctor’s visit. This means you’ll pay $60 every time you see a doctor, regardless of the total cost of the visit.

DEDUCTIBLE – Your Deductible is the amount you must pay out of pocket before your insurance starts covering your medical costs.

PREMIUM – Your monthly premium is the amount you pay for your health insurance coverage. This is a set fee you pay regardless of whether or not you use your insurance.

Do I need a licensed Broker to get a health plan for my employee?

Working with a broker can be highly beneficial for self-employed business owners. At Skyline Benefit, we can guide you in finding the most suitable Plan for your business and employees. We can also help you understand different options, including traditional health insurance, high-deductible, and self-funded plans. Additionally, we offer valuable advice and guidance on plan management, such as controlling costs and complying with healthcare regulations at no cost.

Need Help with Group Health Insurance

Skyline Benefit is an independent health insurance broker in Fullerton, CA that offers affordable and flexible group health insurance options.  Selecting the best group health insurance plans can be overwhelming; our mission is to simplify the process and help our clients every step of the way.

Schedule a consultation today. Call us at: (714) 888-5112

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