Frequently Asked Questions for Brokers

Ambetter HMO and Ambetter PPO plans are offered by Health Net of California, Inc.

Under H.R. 1 (the One Big Beautiful Bill Act), beginning January 1, 2027, certain Lawfully Present Immigrants (LPI) will no longer be eligible for financial help through Covered California, including premium tax credits and cost-sharing reductions. Lawful Permanent Residents (LPRs, or green card holders), Cuban and Haitian entrants, and Compact of Free Association (COFA) migrants will continue to be eligible. Non-eligible LPI members will still be able to enroll in Covered California coverage, however, they will not receive financial assistance and may see higher premiums. Check with Covered California to see if your LPI clients qualify for financial assistance.

Lawfully Present Immigrants Eligibility Changes for Financial Assistance Starting January 1, 2027

REMAIN Eligible for Financial Assistance

  • Lawful Permanent Residents (LPR/Green Card holders)
  • Cuban and Haitian Entrants
  • Migrants from Compact of Free Association (COFA) countries (Micronesia, Marshall Islands, Palau)

LOSE Eligibility for Financial Assistance

  • Individuals with asylum status or pending applications
  • Refugees
  • Survivors of trafficking, domestic violence, and serious crimes
  • Individuals with Temporary Protected Status (TPS)
  • Individuals with work visas or student visas
  • Other humanitarian or temporary lawful statuses

Reminder

Deferred Action for Childhood Arrivals (DACA) lost Marketplace eligibility entirely effective August 25, 2025, due to the CMS Final Rule.

This page will be updated periodically so please bookmark it, as well as our member FAQ page.

Time to enroll and renew for 2027

Beginning on October 1st, use our new Enhanced Direct Enrollment tool to quote and submit Off Exchange Ambetter from Health Net applications. Brokers will also log in to this Enrollment Tool to view their pending applications instead of viewing them on the broker portal.

Instructions are available to help you get started with the new Ambetter from Health Net Enhanced Direct Enrollment tool:


What to know about 2027 Ambetter from Health Net Individual & Family Plans

Our 2027 portfolio is focused on working to keep you and your clients happy and satisfied with our most popular HMO and PPO plans, including subsidized1 plans for financial help.

Federal tax credits that help lower monthly premiums will continue to be available in 2027. Note that the enhanced premium tax credits provided under the Inflation Reduction Act expired at the end of 2025, so some clients may receive less financial assistance than in prior years. Your clients may also be eligible for a state subsidy through Covered California depending on their income.

We're delivering what you and your clients need in 2027

We're continuing value: What your clients love about their coverage and services stays!

  • My Health Pays program* where members can earn up to $572 per calendar year.
  • Convenient, affordable prescriptions
  • Behavioral health and wellness programs
  • Access convenience: telehealth, walk-in clinics, 24/7 nurse advice
We're supporting your 2027 business
  • Competitive compensation program.
  • Easy-to-sell and renew products and plans positioned for long-term growth
Average premium rate increase
  • 11.9% average premium rate increase for HMO plans2
  • 16.1% average premium rate increase for PPO plans2
  • In Imperial County we are offering the lowest priced HMO Bronze plan and the 3rd lowest Silver, Gold and Platinum HMO plans.2
  • In Kern County we are offering the lowest priced HMO Silver and the 2nd lowest HMO Gold and Platinum plans.2
  • In Los Angeles East we are offering the 3rd lowest priced HMO Silver plans.2
  • In Inland Empire we are offering the 2nd lowest priced HMO Gold, lowest priced Silver plans.2
  • We're still competitive on Bronze! Our Bronze PPO rates will invigorate your book of business.2
  • Take another look at our competitive Silver HMO rates in Southern California – delivering even more value.2

Your dedicated Account Executive is standing by to assist with regional rate details and strategies for your clients – including how available federal tax credits and state subsidies can help keep them covered. You can reach your Account Executive by calling 1-800-909-3447, Option 3 or email brokers@healthnet.com.

1 Financial help can be used only on plans purchased through Covered California. Coverage is available only to residents of California who meet Covered California eligibility requirements.

2 Based on the Covered California Individual Product Prices file available on Covered California Data & Research > 2027 Covered California Data > 2027 QHP Individual Product Prices, on July 21, 2026, for an individual aged 40 years old in the respective region.

Don't forget! Please remind your clients to make their January binder payments.

Important DatesDetails
October 1, 2026Covered California early renewal begins.
October 15, 2026Health Net mails 2027 Ambetter HMO and Ambetter PPO renewal letters.
November 1, 2026Open enrollment for 2027 begins in California.
Go to MyHealthNetCA for materials.
December 31, 2026Last day to enroll in new plan to take effect on January 1, 2027.

Your clients need to confirm information and income with Covered California to get tax credits in 2027.
January 31, 2027Last day to choose a new plan to take effect on February 1, 2027. Open enrollment for 2027 closes in California.

If eligible, clients may use a Special Enrollment Period to make changes after this date.

* My Health Pays is available to Ambetter from Health Net HMO and PPO members who can earn up to a maximum of $572 or 5,720 points per calendar year. Certain components require members to be age 18 and older. My Health Pays® rewards cannot be used for health coverage premiums or cost shares. Dollar reward amounts and points are subject to change without notice. Funds expire immediately upon termination of health coverage.

Ambetter from Health Net HMO and Ambetter PPO plans are offered by Health Net of California, Inc. Health Net of California, Inc. is a subsidiary of Health Net, LLC and Centene Corporation. Health Net is a registered service mark of Health Net, LLC. Covered California is a registered trademark of the State of California. All other identified trademarks/service marks remain the property of their respective companies. All rights reserved.

  • If a member is already enrolled in autopay, the auto-payment will draft their binder payment on their scheduled date. If their auto-payment is scheduled before the renewal is received by Health Net, then it will not draft until January. If a member needs to seek services earlier than their auto-payment date, they should manually make their binder payment. Members with auto-payments scheduled on the 15th or 16th will likely need to make a manual binder payment.
    • If manual binder payments are made, the binder payment will not pull on the auto-payment date because there will be no amount due.
    • Members can call the call center to make a payment or set up auto-payment.
  • All members will receive a new ID for benefits effective January 1, 2027. Renewing members will receive a new ID card in mid-December. New members will receive an ID card within 10 days of the binder payment effectuation. Members should throw away their previous ID card and begin using the new ID card for any services or prescriptions received beginning on January 1, 2027.

You can find plan information located on the Plan Materials page for your clients who need coverage. Materials include applications for the current year.

To check the status of an application, log in to your broker account; then select Eligibility, Status & Activity at the top of the page. Then select Application Status. Enter the application status type, date range and any optional fields you are looking for, and click Search.

Note: You will only be able to view status of applications that are linked to your broker ID. If you think that a client is not linked to your account, please contact Broker Sales and Service at brokers@healthnet.com for assistance.

Off-Exchange

Ambetter from Health Net may require proof of permanent residency prior to enrollment on off-exchange Individual & Family plans. Please see the enrollment form for proof of permanent residency requirements. You can find enrollment forms located on the Plan Materials page.

On-Exchange

Covered CA requires members to provide an attestation for their permanent address on the enrollment application. Covered CA may also request proof of permanent residency from the member post-enrollment.

Managing my Ambetter from Health Net Book of Business

To view commission statements, log in to your broker account and select the Commission Statements link at the top of the page. Statements from the past six months are displayed on that page.

We have a dedicated staff supporting your calls and emails. If you cannot find the information you need on this website, please contact us.

To view the status of client applications for the upcoming plan year, simply visit the Eligibility, Status & Activity section within the Broker Portal. For everything else – including applications for the remainder of this plan year – please continue to consult the Book of Business section after you log in to your broker account.

To find information about your pre-members such as a new member's ID number, log in to your broker account; then select Book of Business at the top of the page. Then select from either On-Exch Pre-Members or Off-Exch Pre-Members.

To help you during the enrollment period, we'll mail you a list of your current Individual & Family Plan clients in October.

For client information throughout the year, you can view your client list online. Log in to your broker account and then select Book of Business at the top of the page.

View your:

  • Active Member List
  • Canceled Member List
  • On-Exchange Pre-Members
  • Off-Exchange Pre-Members

Supporting a client who is a Health Net member

Log in to your broker account to locate your client's member ID. Your client's status will determine where to go.

Active Member

Select Book of Business at the top of the page. Your Active members will be listed.

Pre-Member

Select Book of Business at the top of the page. Then select either On-Exch Pre-Members or Off-Exch Pre-Members.

Member ID numbers start with either an R or a U, depending on when the member enrolled.

Once members pay their first month's premium, they will receive a member ID card in the mail. If they are active and have not received an ID card yet, members can order one or print a temporary one through the member portal.

Note: If the member is accessing their online account for the first time, they will need to register, and will need their member ID number to do so. Please see "Where do I find a member's ID number?" to assist them with obtaining their number.

There are several ways to pay, including online and automatic bill pay, by phone, with cash through MoneyGram, and by mail. For all the details, go to Pay My Bill.

There are several ways members can change their PCP.

  1. Members can log in to their online account. Once there, they can click Select/Change PCP.
  2. Or they can call the Customer Contact Center:

For a new PCP to be effective the first day of the month, members have until the last day of the prior month to submit the request.

Example: If a member calls to request a new PCP on 10/31, they can still request an effective date of 11/1. However, if a member calls on 11/1, they will be assigned a new PCP, effective 12/1.

Note: If necessary, brokers can contact Account Services to schedule a three-way call with the member to request a PCP change by phone.