'Health Net Wellness Rewards Program PUTTING YOUR

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Health Net of California, Inc. andHealth Net Life Insurance Company (Health Net)Health Net WellnessRewards ProgramPUTTING YOUR HEALTH FIRSTCoverage forevery stage of life

It Pays to Be WellREWARD YOUR HEALTH – AND REWARD YOURSELF!Log in to www.healthnet.comto get your reward!It’s easy to maintain a healthy lifestyle when you have thetools you need to make healthy choices. It’s even easier whenyou’re rewarded for taking an active role in your health!With the Health Net Wellness Rewards Program, you’ll get a 50 gift card when you complete a Health Risk Questionnaire(HRQ) and talk about it with your doctor.

QHow do I receivemy reward?To receive your reward, you mustbe an eligible Health Net memberand complete these steps:Log in to thewww.healthnet.commember site. (Note:If you are not yet registered onwww.healthnet.com, pleasecomplete the registrationprocess to get access to ourHRQ.) You’ll see the informationabout wellness rewards within30 days of your effective date. Complete the online HRQ. Schedule an appointment for yourpreventive care physical with yourPCP, and let them know you wouldlike to discuss your HRQ results withyour doctor. Important. Print your HRQreport and take it with you to yourpreventive care physical. The reporthas the HRQ results you will discusswith your doctor. Share your results with your PCP. After your appointment, logback in to your online account andcomplete the Primary Care PhysicianForm. This will confirm that you’veshared your results with your PCP.The PCP form can be found in theRewards section under “Credits.”Only after you have completedthese steps will you be eligible fora reward. Record any new healthinformation that you may havelearned from your PCP visit in youronline Personal Health Record.QWhat is the goal of theHealth Net WellnessRewards Program?It is designed to reward eligiblemembers when they complete twoactions. Taking the online HRQ. Sharing the results with your PCP.QWho is eligible forthe program?The program is open to anyHealth Net member age 18and over who is enrolledin a participating plan.1This includes employees,spouses, domesticpartners, children ages18 and over, COBRAbeneficiaries, andemployees on disabilityleave.QWho can receivea reward?Any eligible member who completesthe reward fulfillment requirementsis eligible to receive the 50 gift cardreward.QHow do I sign up totake my online HRQ?You will need to register as aHealth Net member atwww.healthnet.com. ClickRegister, then I’m a Member. Followthe instructions to complete yourregistration.1Eligible plans include:All group plans: SmartCare, Salud HMO y Más, HMO Full Network, and PPO plans (including OOS PPO).Large Group: HMO ExcelCare, EOA and EOA ExcelCare.Small Group: WholeCare HMO and CommunityCare HMO.Incentive does not apply to Small Group grandfathered plans.Get agift card!

Completing yourHealth Net HRQ is easy!Register for access to theHealth Net website atwww.healthnet.com. To accessthe HRQ, click on WellnessCenter and go to the link under“Don’t Forget to Take Your HRQ!”Prepare by gathering importanthealth information, such as yourcurrent height, weight, andblood pressure. Bring resultsfrom recent lab work if you haveit, such as cholesterol, glucoseand triglyceride levels. The moreexact your answers, the betteryour results will be.Follow the instructions tocomplete the HRQ.QHow do I find the HRQon the Health Netwebsite?1. Go to www.healthnet.com, andenter your user name and passwordinformation.2. To access the HRQ, click onWellness Center and go to thelink under “Don’t forget to takeyour HRQ!”3. After clicking the link, you’ll besent to our secure website.QWhat if I don’t haveonline access?QThe reward does not expire.QHow will I receive myreward notice andincentive fulfillmentinstructions?You will receive a notice (via USPS oremail) that includes instructions onhow to select your gift card.QHow long does it taketo receive my rewardnotice?Please allow Health Net ten businessdays to process your reward notice.QWhat can I get withthe gift card?The gift card is good at anyparticipating nationwide merchant.Depending on the retailer you choose,you can use your gift card online or instore. Please check with your retailerof choice if they accept gift cards foronline purchases before selectingyour reward. You can even donateyour reward to a nationally recognizedcharity.Who do I contact ifI do not receive myreward notice withinten business days?You can call the Customer ContactCenter number on the back of yourID card.QTo be eligible for the reward, youmust complete the HRQ online viathe www.healthnet.com website.Do not submit paper copies.QHow long will myreward be valid?What if I alreadyreceived a 50 gift cardreward for fulfillingthe HRQ incentiverequirements? Can Iget another reward?Eligible members may receive thegift card reward once every calendaryear. Incentive fulfillment requirementsstill apply.QHow do I know thatmy information will bekept confidential?Under federal law, Health Net cannotshare personal health informationwith your employer group, includingnames of participants in this program.The information we exchange with ourvendors is limited to what is neededto fulfill the incentive to qualify forthe reward.HRQ data is stored and protected ina secure database, and informationis sent through a secure, encryptedchannel. Please note, the informationin your HRQ results and your PersonalHealth Record cannot and will notbe used to calculate or adjust yourpremium.

Nondiscrimination NoticeIn addition to the State of California nondiscrimination requirements (as described in benefit coverage documents),Health Net of California, Inc. and Health Net Life Insurance Company (Health Net) comply with applicable federal civil rightslaws and do not discriminate, exclude people or treat them differently on the basis of race, color, national origin, ancestry,religion, marital status, gender, gender identity, sexual orientation, age, disability, or sex.HEALTH NET: Provides free aids and services to people with disabilities to communicate effectively with us, such as qualified sign languageinterpreters and written information in other formats (large print, accessible electronic formats, other formats). Provides free language services to people whose primary language is not English, such as qualified interpreters andinformation written in other languages.If you need these services, contact Health Net’s Customer Contact Center at 1-800-522-0088 (TTY: 711).If you believe that Health Net has failed to provide these services or discriminated in another way based on one of thecharacteristics listed above, you can file a grievance by calling Health Net’s Customer Contact Center at the number above andtelling them you need help filing a grievance. Health Net’s Customer Contact Center is available to help you file a grievance.You can also file a grievance by mail, fax or email at:Health Net of California, Inc./Health Net Life Insurance Company Appeals & GrievancesPO Box 10348, Van Nuys, CA 91410-0348Fax: 1-877-831-6019Email: Member.Discrimination.Complaints@healthnet.com (Members) om (Applicants)For HMO, HSP, EOA, and POS plans offered through Health Net of California, Inc.: If your health problem is urgent, if youalready filed a complaint with Health Net of California, Inc. and are not satisfied with the decision or it has been more than30 days since you filed a complaint with Health Net of California, Inc., you may submit an Independent Medical Review/Complaint Form with the Department of Managed Health Care (DMHC). You may submit a complaint form by calling theDMHC Help Desk at 1-888-466-2219 (TDD: 1-877-688-9891) or online at www.dmhc.ca.gov/FileaComplaint.For PPO and EPO plans underwritten by Health Net Life Insurance Company: You may submit a complaint by calling theCalifornia Department of Insurance at 1-800-927-4357 or online at /index.cfm.If you believe you have been discriminated against because of race, color, national origin, age, disability, or sex, you can alsofile a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights (OCR), electronicallythrough the OCR Complaint Portal, at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at: U.S. Department ofHealth and Human Services, 200 Independence Avenue SW, Room 509F, HHH Building, Washington, DC 20201, 1-800-368-1019(TDD: 1-800-537-7697).Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.

Health Net of California, Inc. and Health Net Life Insurance Company are subsidiaries of Health Net, LLC. Health Net and Salud con Health Net are registered service marks of Health Net, LLC.All other identified trademarks/service marks remain the property of their respective companies. All rights reserved.BKT013080EO02 (7/19)

Health Net member at . www.healthnet.com. Click Register, then I’m a Member. Follow the instructions to complete your registration. Get a gift card! 1. Eligible plans include: All group plans: SmartCare, Salud HMO y Más, HMO Full Network, and PPO plans (including OOS PPO). Large Grou