County of Kern 2021 Open Enrollment - Presentation For: County of Kern Presentation by: Kern County Health Benefits
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County of Kern 2021 Open Enrollment Presentation For: County of Kern Presentation by: Health Net of California Confidential & Proprietary
Important things to note!
Open Enrollment is from October 16
through November 13, 2020
For Health Net enrollment form, please contact:
Kern County Health & Wellness
Address: 1115 Truxtun Avenue, 1st Floor,
Bakersfield, CA 93301
Phone: 661.868.3182
Email: healthbenefits@kerncounty.com
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Explore Your 2021
Health Net Choices!
Whether you’re new to Health Net, or coming back to us for
2021, we’re here to provide useful information about Health
Net open during your enrollment.
• Choose the right Health Net plan for you and your family
• Find local doctors in the networks according to your plan
• Access wellness and specialty programs for County of
Kern Retirees and their families.
• Use our website and social media tools to help manage
your health
• Earn rewards for improving your health!
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Privileged & Confidential
Why Choose
Health Net?
During this year’s open enrollment, here are some things to consider:
• Health Net delivers affordable plans throughout California
• We believe you deserve reliable health coverage from a local
company that understands your needs.
• For over 40 years, Health Net has supported Californians through
various stages of life, and that’s what we continue to do.
• We work to make a positive difference in the
lives of the people we serve.
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Privileged & Confidential
Health Net Plan Options
Plans Network Population
Early Retirees HMO Plan Full HMO Network • For Retirees under 65 years old
• Must reside in the Full HMO
services area
• Must choose a Primary Care
Physician and Medical Group
Health Net Point of Service • Coordinates with Medicare
Medicare COB/POS Network • Pharmacy benefit is through
(Coordination of Benefits/ Tier 1: HMO Silver Script.
Point of Service) Plan Tier 2: PPO • 3 tier networks to choose from
Tier 3: OON* for your services.
Seniority Plus HMO Seniority Plus • Must have Medicare parts A and
Retiree Plan HMO Network B to enroll
• Must reside in the Seniority Plus
service area
• Must choose a Primary Care
Physician and Medical Group
*OON stands for out-of-network providers
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Privileged & Confidential
Plan Overview
Early Retirees HMO Plan
Benefits* Full HMO
Out of Pocket Maximum $1500 member/
$4500 family
Periodic health evaluations/Preventive care services $5 copay
CVS Minute Clinic (preventive and non-preventive services) $5 copay
Doctor/ Specialist office visits $5 copay
X-ray and laboratory including complex radiology (MRI, CT, $0
SPECT and PET)
Inpatient Hospitalization $0
Outpatient Hospitalization $0
Emergency/Urgent Care Services $35 copay
Chiropractic** (20 visits max per calendar year) $5 copay
Eyewear (lenses/framed covered once every 24 months) $100 allowance
*This chart is a summary of benefits only. All benefits are subject to the definitions, limitations and exclusions set forth in the Evidence
of Coverage (EOC) document. Basic members are encouraged to review this document before making their final decision.
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**Chiropractic services are available through the AmericanPrivileged
Specialty Health
& Confidential
Plan Overview
Health Net Medicare COB/POS Plan
Benefits* POS(1) POS(2) POS(3)
HMO PPO OON**
Deductibles None None $200 member/
$600 family
Periodic health evaluations/Preventive $10 copay $20 copay 30% coins (+ deductible)
care services
CVS Minute Clinic (preventive and $10 copay N/A N/A
non-preventive services)
Doctor/ Specialist office visits $10 copay $20 copay 30% coins (+ deductible)
X-ray and laboratory including $0 10% coins 30% coins (+ deductible)
complex radiology (MRI, CT, SPECT
and PET)
Inpatient Hospitalization $0 10% coins 30% coins (+ deductible)
Outpatient Hospitalization $0 10% coins 30% coins (+ deductible)
Emergency/Urgent Care Services $35 copay $50 copay 30% coins (+ deductible)
*This chart is a summary of benefits only. All benefits are subject to the definitions, limitations and exclusions set forth in the Evidence
of Coverage (EOC) document. Basic members are encouraged to review this document before making their final decision. 7
**OON stands for out-of-network providers Privileged & Confidential
Plan Overview
Seniority Plus HMO for Retirees
Benefits* HNSP**
Out of Pocket Maximum $3400
Annual routine physical exam (one exam per calendar year) $0
Doctor/ Specialist office visits $10 copay
X-ray and laboratory including complex radiology (MRI, CT, $0
SPECT and PET)
Inpatient Hospitalization $200 copay
Outpatient Hospitalization $0
Emergency/Urgent Care Services $50 copay
Chiropractic/Acupuncture (20 visits combined per calendar year) $10 copay
Eyewear (lenses covered every 12 months/ $100 allowance
frames covered once every 24 months)
*This chart is a summary of benefits only. All benefits are subject to the definitions, limitations and exclusions set forth in the Evidence
of Coverage (EOC) document. Basic members are encouraged to review this document before making their final decision.
**Health Net Seniority Plus (HNSP)
***Chiropractic and Acupuncture services are available through the American Specialty Health
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Privileged & Confidential
Your Pharmacy Benefits
Plan Generic Brand Non- Specialty
Formulary Drugs
Early Retirees HMO Plan $5 retail/ $10 retail/ $35 retail/ Applicable tiers
$10 MO* $20 MO* $70 MO*
Health Net Medicare $10 retail/ $15 retail/ $35 retail/ 25% coins
COB/POS Plan $20 MO* $30 MO* $70 MO*
Seniority Plus HMO Retiree Plan $10 retail/ $20 retail/ $40 retail/ 25% coins
$20 MO* $40 MO* $80 MO*
Visit our website, www.healthnet.com for the most updated Formulary Drug List
or to find a pharmacy within our network.
Note: A formulary is a list of covered drugs selected by our plan. We will cover
the drugs listed in our formulary as long as the drugs are medically necessary
and the prescription is filled at a plan network pharmacy. Some medications
require prior authorization when quantity limits or step therapy is indicated.
*MO stands for Mail Order Program Privileged & Confidential 9
Health and Wellness
with Heart and Soul
A bridge to healthy actions
The Decision Power: Health & Wellness program
gives you personalized tools along with the
support and confidence to take action for positive,
lasting health changes. Highlights include:
• Health Coaching Program
• Quit for Life tobacco cessation
• Health Risk Questionnaire
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Privileged & ConfidentialWellness Health Coaching
Personalized support
You work one on one with a health coach:
• Learn what to expect when trying to make a healthy change.
• Understand what motivates you.
• Decide exactly what focus are to choose.
• Set specific health goals.
• Track your progress – Individual health coach will help every
step of the way!
Privileged & ConfidentialQuit for Life
Tobacco Cessation Program
Utilizes Multiple
Avenues for
Program Success
•Telephonic
•Online
•Text*
______________
Health Net
Results in 2018
88.7%
Satisfaction
34.1% Quit Rate!
To enroll, call 1-866-Quit-4-Life or 1-800-893-5597,
select from menu option
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Privileged&& Proprietary
Confidential ConfidentialHealth Risk
Questionnaire
At Health Net, we view
wellness as an individual’s
personal desire to live a
healthy and productive life.
The Health Risk
Questionnaire (HRQ)
provides an individual
report of his/her behavioral
and medical health risks.
Complete your HRQ and earn
a $50 gift card reward!
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Privileged & ConfidentialCVS MinuteClinic
MinuteClinic is a walk-in health care service, staffed by nurse practitioners and physician
assistants. You can often find MinuteClinics inside select CVS/pharmacy stores.
MinuteClinic is an ideal solution when you can’t see your doctor and need non-emergency
treatment. Specialist referrals must be obtained through your assigned Physician Group.
Note: This program is
available for Health Net
Medicare COB/POS and
Early Retiree HMO
plans only.
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Privileged & ConfidentialmyStrength
The health club for your mind™
Proven tools for Free and Personal and Engaging and
your mind, body convenient private inspirational
and spirit With web and Your home page is Activities help
Help you learn to mobile apps, made for you. you learn new
reduce stress, you’ll have myStrength is ideas while
anxiety, depression, support at home secure and private. keeping you
or substance use. and on the go. motivated!
Privileged & ConfidentialExpanded Programs for 2021
Active&Fit Active&Fit Direct fitness discount program
DIRECT TM
• Members receive simultaneous access to all fitness center facilities
within the national network—10,000+ major fitness centers
• Just $29.99/month fee (plus $29.99 initiation fee); member funded
• Find out more at HealthNet.com (under Wellness Center tab)
• Online directory maps
• Free Guest Pass to try-out clubs (available at most centers)
• Option to switch fitness centers at any time
• Online fitness tracking from a variety of popular wearable
devices, apps, and exercise equipment.
Note: This program is
available for Health Net
Medicare COB/POS and
Early Retiree HMO
plans only.
Privileged & Confidential 16Health Net mailers for you
9/10/2020 17
Privileged & ConfidentialFor Seniority Plus HMO Retirees
• The Silver&Fit program,
designed for older adults
• Fitness Facility Program
Access to local health clubs and
nationwide fitness centers.
• Home Fitness Program
• Fitness Challenges
• Silver&Fit Connected!
• Resource Library
• Rewards Program
To enroll or find a participating
fitness center
1. Go to www.SilverandFit.com
2. Or call the toll-free customer service at
(877) 427-4788.
Privileged & Confidential 18How to reach us: Early Retirees: 800-522-0088 Health Net Medicare COB/POS: 800-676-6976 Seniority Plus Retirees: 800-275-4737 Website: www.healthnet.com Confidential & Proprietary
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