HEALTH NET BLUE & GOLD PLAN

Plan Highlights

• Works just like the regular Health Net HMO
• Has a custom network of providers created exclusively for UC, including
• All UC Medical Centers and medical groups
• 13 of the 20 largest provider groups serving current UC Health Net members
• Lower premiums than the standard Health Net HMO

The Health Net Blue & Gold HMO works exactly like the regular Health Net HMO plan: You choose a primary care physician (PCP) who coordinates all of your care. When you need to see a specialist, your PCP refers you to the appropriate provider in the Health Net Bnetwork. You pay a copayment for most services, other than some preventive care, which has no copayment.

The only differences between the two Health Net plans are the cost of the monthly premiums and the network of providers.

If your providers are in the Health Net Blue & Gold network and you enroll, you’ll save the extra premium you’d pay for the full Health Net HMO network.

To see if your medical providers are in the Health Net Blue & Gold network, visit the Health Net website.

You must select the Health Net Blue & Gold HMO during Open Enrollment to participate.

If you are a current Health Net HMO member and take no action during Open Enrollment, you will remain in the Health Net HMO plan, even if your current doctor and medical group are in the Health Net Blue & Gold HMO plan.

Why isn’t my medical group in the Health Net Blue & Gold HMO network?

In developing the Health Net Blue & Gold HMO network, the cost of services was an important consideration.  Based on that, some provider groups were not included in the network. However, they were given the opportunity to modify their rates so that they could be included without adding to UC’s cost. The providers who agreed have been included.

Health Net and UC will continue to evaluate provider groups, with the goal of adding additional groups for 2012.

Plan Changes for 2012

The following medical groups and hospitals have been added to the Health Net Blue & Gold network:

• Alta Bates Medical Group and Medical Center – Alameda County
• Pacific IPA – Los Angeles County
• PAMF-MDP/Mills Peninsula Medical Group – San Mateo County
• Sutter Tracy Hospital – San Joaquin County

2011 Health Net Blue & Gold HMO Plan Costs
Pay Band (per annum)	Self	Self + Child	Self + Adult	Family
Under $47,000	$21.21	$38.18	$87.41	$104.38
$47,001 to $93,000	$54.36	$97.85	$163.09	$206.58
$93,001 to $140,000	$88.38	$159.09	$230.91	$301.62
$140,001 and above	$123.60	$222.49	$301.17	$400.05