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Quarterly Magazine for Health Net Associates • Fall-Winter 2006



Inside:
Health Net
Ramps Up
to Attract
Members
Regional plans roll
out innovative
solutions




The Making
of a Great
Place to Work
                                                                 Cover Story:
                                                          THE ROOTS
                                                         of Health Net
A Year After Katrina
MHN is Still Aiding Recovery Efforts
                                                          National Provider Network
                                                                       Management
Issue Highlights

              The Roots of Health Net
                                                                                               Published by: Health Net, Inc.
                                                                                                 Corporate Communications
                                                                                                        21650 Oxnard Street
              National Provider Network Management
                                                                                                     Mail Code CA-102-22-07
              page 3
                                                                                                   Woodland Hills, CA 91367

                                                                                               We welcome your ideas and
              We Live Here, Too                                                            feedback. Contact Linda Lalande
              HNOR Rides the Cycling Craze in Portland                                               or Margaret Longo at:
              page 8                                                                         Connections@healthnet.com.
                                                                                               For internal distribution only

              Health Net Ramps Up to Attract Members
                                                                                              Health Net, Inc. is among the
                               NE                        PA
                                                                                             nation’s largest publicly traded

OR            Regional plans roll out innovative solutions
              page 9
                                                                                           managed health care companies.
                                                                                            Its mission is to help people be
                                                                                           healthy, secure and comfortable.
                                                                                                For more information, go to
                                                                                                         www.healthnet.com.
                                                                                        This publication contains forward-looking statements
              Rolling Out an Array of Senior Products                                    within the meaning of Section 21E of the Securities
                                                                                            Exchange Act of 1934, as amended, and Section
              New plans, new geographies, new advertising                               27A of the Securities Act of 1933, as amended, that
                                                                                             involve a number of risks and uncertainties. All
              page 20                                                                       statements, other than statements of historical
                                                                                            information provided herein, may be deemed to
                                                                                        be forward-looking statements. Readers are cautioned
              The Making of a Great Place to Work                                     not to place undue reliance on these forward-looking
                                                                                     statements. The company undertakes no obligation to
                                                                                       publicly revise these forward-looking statements to
              Beginning our journey–and why it’s important                              reflect events or circumstances that arise after the
              page 22                                                                                                date of this publication.




Images of the Themes that Unite Us
Look for these icons to identify Health Net’s three important themes. The icons are used
in communications about what is going on in the company and how we are succeeding.




         PERFORMANCE                              GROWTH                        GREAT PLACE TO WORK
   Progress and achievements that        Efforts to expand and increase        Examples of a high-performance
   support Health Net’s business          the quality of Health Net’s           environment that supports
    strategy and financial goals                    business                       associates and serves
                                                                                      customers well


                                                                                           fall 2006      connections                   4
GREAT PLACE TO WORK


                               Thanks for Making the Connections
                                 Last quarter’s launch of Connections magazine began a partnership.
                                 We asked for your readership, participation and feedback – and you
                                 responded. Here’s what you said.

                                   Did you like Connections?                       Your Voice: What you said you’d like to see in
                            Overwhelmingly, YES. “Finally,                         Connections is already shaping the magazine.
                          a way to get information that
                          doesn’t require a keyboard and
                                                                                   “Connections is telling me why Health Net is a quality
                          mouse… layout was clean, colorful…                       company for the customer. What are we doing to help
                          graphics were interesting and                            ourselves?” See page 22 –The Making of a Great Place
                          creative… articles were easy to                          to Work.
read and enjoyable… I can read this at my own pace on
                                                                                   “How about something fun included with all the
break or at home… it’s one more way to feel a part of
                                                                                   information?” See page 18 – HN Dollar
such a big organization.”
                                                                                   and page 25 – Earnings Lingo quiz.
Counterpoint: “Can’t we do this online?”
  Like the difference between snapshots and a family                               “Some comparative stories across the business units?”
portrait – our HN Connect online “newspaper” reports                               See page 9 – Regional plans roll out innovative solutions.
current, time-sensitive news in an ever-changing format,
                                                                                   “Features on various departments within the company
while Connections takes a broader, enterprise perspective
                                                                                   and what they do to move us forward – how they affect
to show how we’re changing and advancing over time.
Connections also is proving to be a welcome source of                              or support other areas.” See page 3 – first in a series of
company information to many associates who don’t have                              department profiles.
time during their workday to access HN Connect on a                                “I want to feel more of a family atmosphere, to get to
regular basis.                                                                     know more about the people and what they do.”
Did Connections help you become better informed?                                   “More stories about and from associates, more faces
   “I found the articles ‘got right to the point’ about what is                    of associates.” See page 19 – MHN and Katrina recovery,
going on with the company, and our goals, and how we are                           and refer to Associate Place weekly profiles on HN
working together to achieve them… some articles were a                             Connect.
little long… I’ve read some of the stories on HN Connect.”
  Connections’ purpose is to provide context. At times it                          “Updates and changes in the health care industry.”
reinforces messages from HN Connect – and we work hard                             Look for industry perspectives in future issues and
to add a fresh viewpoint.                                                          see the Daily News Summary on the front page of
                                                                                   HN Connect for industry news.
We’re all ears. Keep reading and sending your
feedback– everyone benefits!                                                       “More about our benefits… like the 401(k) article.”
For an online copy of this magazine, live links to related stories and to submit   See page 22 – The Making of a Great Place to Work,
ideas and feedback go to: HN Connect > Find It Fast > Newsletters > Connections.   and future articles, as well as updates on HN Connect,
                                                                                   with details found in HR Link.
CONNECTIONS DEFINED                                                                “More about the programs that each region is a part
                                                                                   of in their communities.” See page 8 – HNOR Rides
Connections is a quarterly associate magazine that
                                                                                   the Cycling Craze in Portland.
showcases what Health Net does, how and why we
do it and who is making it happen. Stories focus on                                “More local events, updates on projects.” Look to
our Performance, Growth and Great Place to Work                                    HN Connect for time-critical, events-based reporting
themes, and feature information and perspectives to                                and project updates.
help us work together, better serve our customers
and build a culture of performance.
                                                                                                      fall-winter 2006   connections      1
What’s Health Net’s Business?
    More than a claims processor, we help members get the best care
    A message from Scott Law, chief network officer, Health Net, Inc. and Health Net of California.


    Scenario: A Health Net member is diagnosed with a severe medical condition.
    Faced with difficult decisions and in unfamiliar territory, how can Health Net best help this person
    navigate through this challenging situation – and do so in a way that our assistance is welcomed,
    and the member ultimately experiences a better outcome because we were involved?
       Dealing with such situations is Health Net’s business.        Health Net’s efforts to contract and maintain a robust
    It’s not only our business – it’s what we want to be great at.   network of qualified providers – and how they support the
    Our goal is to excel at bringing members the right care,         regional provider network organizations that do the heavy
    at the right time, in the right place, for the right cost.       lifting of actually recruiting the doctors and negotiating
      That’s why we have made a conscious effort to link             the contracts.
    the care managed by Medical Management with the                    The next issue of Connections will focus on our Medical
    delivery networks designed and maintained by Network             Management team and how they are helping members
    Management. We know that collaboration between                   get the most appropriate, cost-effective care in the right
    these two important areas of our business is key to              setting – including the products and new technology, such
    establishing health care management as a central skill –         as UNITY, that are making it easier for associates to better
    a core competency – for Health Net.                              serve member needs.
     We are making enormous strides and will be sharing                Our business is about continuously improving health
    more information with you in future communications.              care access, choices and outcomes in an affordable way.
      In this issue, our spotlight shines on the National            Read on to learn how we’re working to achieve these
    Provider Network Management group. This story explores           fundamental goals that benefit our members, our local
    the role National Provider Network Management plays in           markets and Health Net’s overall performance.




                         Capturing Kindness at Health Net
                        Giving back to the communities we serve is all in a day’s work at Health Net. In December, Health
                        Net will host our company’s signature holiday event, Celebration of Children (CoC), in
                        six cities across the country.
                            Fifteen years ago, CoC began as the brainchild of Health Net Chairman Roger Greaves, his wife,
                          Erika, and a group of associates who decided they would rather give to kids than have holiday
                          office parties. Ensuring its success, Erika has continued hands-on involvement, nurturing the
    colorful affair into a heartwarming company tradition that brightens the lives of thousands of youngsters.
    Join the happy Health Net elves. Volunteers are needed for this year’s Celebration of Children. Give a toy,
    give an hour to wrap gifts, give a morning during the events. Look for information from your local volunteer
    coordinator and on HN Connect.
    Reaching out in other ways? We recognize the generosity of associates is wide-ranging. Every year, Health
    Net groups sponsor other charitable events during the holidays. To help us capture your kindness, please contact
    Connections@healthnet.com as soon as you can – PRIOR to the event – to let us know how you are making a
    difference in the communities we serve.


2    connections fall-winter 2006
PERFORMANCE




THE ROOTS of Health Net
National Provider Network Management


S
Seeding growth with tools to deliver: right care, right cost, right time, right place
       o just what business is
       Health Net in? Sounds like
       a simple enough question;
after all, we are a managed
health care company – ergo –
we’re in the managed health
care business. True enough, but
that’s just a surface description.
Dig deeper, and it becomes
clear that we’re actually in the
business of delivering the right
care, at the right time, in the
right place, for the right cost.
And it’s through achievement
of this foursome that our
company experiences growth.
  Health Net’s National Provider
Network Management (PNM)
team is a central member of the
team that drives company
growth. “The National PNM team
collaborates to support our 300
PNM associates, located across
the country, who are negotiating
and maintaining our provider
contracts for the continuum of services that our members need,” explains Scott Law,
chief network officer, Health Net, Inc. and Health Net of California.
  “While contracting and maintaining robust networks of qualified providers is a cornerstone of our business,
the role of National PNM is to improve our core provider network management capabilities,” he says. Scott
recently has been asked to focus more intensely on building the PNM force in California. During this time,
Douglas Cowieson, vice president for National PNM, is assisting Scott with National PNM efforts.
  Working with regional PNM staff, National PNM provides services, tools, processes and hands-on assistance.
“This support helps our PNM organization build more effective provider contracts,” says Scott, “in terms of
overall cost and the ability to administer, ensuring we have full control over what and how we pay.”


Editor’s Note: At press time, a new organizational structure for Provider Network Management was being announced.
However, Scott Law and Douglas Cowieson remain as named in this article. For details, see HN Connect.



                                                                                                  fall-winter 2006   connections   3
National PNM’s role:
                                    Central “trunk for regional “branches”
                                                  ”
                                    A few simple guiding principles apply to define the work
                                    National PNM spearheads:
                                    • Work that can be done more efficiently centrally, e.g., provider
                                      communications and training.
                                    • Work that requires a critical mass that cannot be achieved optimally
                                      by an individual region, e.g., coordination of benefits data capture.
                                    • Work that should have a corporate oversight, e.g., some audit
                                      functions, such as contract review for conformity to required
                                      standards.
                                    By putting these principles into practice on behalf of the
                                    PNM regional divisions, the National PNM management team
                                    accomplishes the following:
                                    • Develops processes and tools to better support associates, members
                                      and providers.
                                    • Designs and conducts training for both providers and the PNM
                                      associates who serve them.
                                    • Will implement a contract management system designed to
                                      eventually track every provider contract – in total about 150,000
                                      contracts.
                                    • Provides the tools and mechanisms to analyze our own and our
                                      competitors’ performance.

PNM works with many                 • Replaced regional provider surveys with a national survey to

departments within the
                                      measure provider satisfaction and in response to results, helps
                                      conceive, execute and monitor improvement programs.

organization to help achieve
                                    • Tracks the costs of health care services in an effort to help keep


goals and to support Health
                                      these costs in check. This extends to providing detailed information
                                      on the latest government reimbursement requirements and analysis


Net’s growth and profitability.
                                      of specific medical costs.
                                    • Tracks and monitors the costs and charges associated with new

Some good examples of this
                                      technology and implantable devices.


multi-faceted and broad
                                    • Centrally contracts with vendors to develop networks and fee
                                      schedules for areas of the country where we currently have no

work are outlined here.
                                      major business. Thus, traveling Health Net members can still
                                      receive timely and cost-effective care.
                                    • Provides access to and analysis of coordination of benefits claims.
                                    • Creates central purchasing reports and hospital analysis.




 4   connections fall-winter 2006
Tools to nourish all PNM associates
 It is National PNM’s role to ensure that associates that work with providers
 have the information and tools needed to succeed in their jobs. Toward this
 end, National PNM is developing a comprehensive training program for PNM
 associates and providers. The training program, to be launched soon, will be a
 highly usable, accessible and understandable tool designed to build specific skills.
   National PNM additionally works to strengthen its connection with associates
 by hosting meetings centering on topics chosen for their educational value.
 “In 2007, we’ll host a biannual review of our initiatives in January and August,”
 says Scott.




Cultivating provider partnerships invigorates member satisfaction
                                                Research shows that member satisfaction is directly influenced by how
                                                physicians feel about Health Net. “One of our goals is to be recognized by
                                                providers and their staffs as a responsive business partner with whom it’s
                                                easy to work,” says Scott.
                                                  National PNM centralized the regional survey process to better gauge
                                                provider satisfaction. This annual survey and its results are now a central,
                                                organization-wide tool that replaces regional survey efforts.
                                                  “Results from the first annual survey show that the vast majority of
                                                doctors see their relationship with Health Net continuing on a long-term
                                                basis,” says Scott. “They believe that Health Net is committed to working
                                                in partnership with physicians to provide quality care – more so than other
                                                plans – on a national level.”
                                             “In response to the survey results,
                                                                                                   “In response to the survey
                                                                                                   results, we are ensuring the
                                           we are ensuring the creation of quality
                                           improvement plans throughout the

                                                                                                   creation of quality improvement
                                           regions,” says Douglas. “It’s a very exciting

                                                                                                   plans throughout the regions…
                                           time. We are able to target specific things
                                           associates and the company can do

                                                                                                   it’s a very exciting time. We
     to increase provider satisfaction, which leads to greater member satisfaction


                                                                                                   are able to target specific things
     and builds Health Net’s reputation and enrollment.”


                                                                                                   associates and the company
     National PNM identified and is addressing three drivers of provider satisfaction:
     1) Timely and accurate payment – National PNM is continually upgrading

                                                                                                   can do to increase provider
        technology to ensure that associates have the tools to be efficient.


                                                                                                   satisfaction, which leads to
     2) Ease of doing business – For our providers and their office staffs, as well
        as for PNM associates, Health Net purchased software to build a learning

                                                                                                   greater member satisfaction
        management system to provide training that will make it easier to do

                                                                                                   and builds Health Net’s
        business with Health Net, mentioned above.
     3) Relationships – PNM actively encourages open communication with

                                                                                                   reputation and enrollment.”
        providers, such as participation in fair contract negotiations, inclusiveness

                                                                                                   Douglas Cowieson, vp, National PNM
        in decision-making processes and responsiveness to provider requests.
     Detailed survey results are available on the HN Connect Provider Network Management page.




                                                                                                 fall-winter 2006   connections     5
Competitive Intelligence
    Harvesting information for fruitful planning
    The foundation of solid planning is
    competitive intelligence. Recognizing
    this, National PNM created a program
    to gather competitive information and
    share it with the regions and Health
    Net leadership.
      “Providing competitive intelligence
    enables us to be data-driven when
    developing strategies and continuous
    quality improvement measures,” says
    Kristina Rodriguez, director, National
    PNM. “With tools and information
    gathered through competitive intelligence, we are                 Says Kristina, “Our ability to compare a competitor’s
    better able to pinpoint where we are effective, how            network to Health Net’s current provider network is vital
    we compare to others in the industry and how we                to allow us to be truly focused in our network growth
    can improve.”                                                  and development efforts. Using a program through a
      For example, National PNM reviewed Health Net’s              vendor, Strenuus, we are able to compare our networks
    provider Web portal and compared it to competitors.            to competitors at a detailed provider level. This valuable
    Kristina explains, “We found that providers really wanted      information enables our regional PNM associates to identify
    the ability to obtain prior authorization within our portal.   where our current and future members can benefit from
    As a result, we are now making this capability available.      additional network building and improve our network
    We learned of other areas where we can capitalize on           access. This can be the deal clincher if we can show a
    our strengths and where we need to shore up weaknesses         prospective client that we can better serve their member-
    on the functionality of our Web site.”                         ship or identify where member care will transfer to if the
                                                                   client chooses Health Net.”



    Sowing the seeds of affordable access
    Cutting costs for consumers and the company
    An exciting National PNM initiative under way is a project poised to produce significant financial savings for Health Net.
    Specifically, PNM’s vendor – Multiplan – is building an out-of-network (ONET) funnel that will be a dynamic single point
    of transfer for claims that come in categorized as ONET. When this project is completed later this year, claims from
    non-participating providers can be routed through a funnel or hierarchy of leased networks.
       Consider this example: A Health Net member visits a provider and then the provider bills us. Initially, the provider is
    determined to be out-of-network. By then tapping into the ONET funnel technology, we launch a search to uncover if
    a contract discount may be available through our leased network arrangements. Quite often, a relationship is uncovered
    that allows us to pay a negotiated rate, rather than paying full billed charges. The goal, wherever possible, is to pay
    claims at negotiated rates. “Given that our company-wide out-of-network expense is substantial, the savings opportunity
    that this provides obviously makes this is a priority,” Scott notes.
      Another PNM cost-saving initiative that is being developed ensures that we always take advantage of a directly
    contracted Health Net participating provider discount for services received outside the region where the member is
    enrolled.
      Here’s how it works: PNM contractors add into agreements “affiliate language” indicating that the doctor or hospital
    will honor the same rates for a member affiliated with a Health Net plan from outside their region. For instance, a
    Connecticut member who visits a California Health Net provider would receive a participating provider discount, just
    as if they had received care from a participating provider in their home state.


6    connections fall-winter 2006
Contract Management System
 working into the future
In 2007, the National PNM team will be
configuring a new tool to permit us to store,
amend, standardize and report on all provider
contracts within the company. This new tool,
i-Many Contract Management System, will
give Health Net:
• A potent disaster recovery program for all of
  our contracts.
• A single repository for contracts accessible
  anywhere in the country.
• Standard contract terms and approved
  variables from templates available online.
• Managed limits of authority to ensure
  contracts are negotiated and signed
  according to Health Net requirements.
• A single point of entry for contract terms
  and rates.
• Approvals and reviews sent via a single,
  trackable workflow process.
• Simple e-mail routing of edits, amendments,
  suggestions and attachments within Health
  Net and externally to our providers.
• Role and security-based access to all aspects
  of our contracts.
  The development of this new and important
tool will commence with Strategic Sourcing by
year-end, then moves into a pilot project in
New Jersey PNM in early 2007, before unfolding company-wide. “To ensure we deliver the ideal product for all
associates, I’m heading a steering committee to oversee the system’s direction and content,” says Bill Lamoreaux,
chief operations officer, Health Net of the Northeast. “This efficient new system will improve our workflow,
accuracy and service in a way that will make it easier for providers to do business with us, and easier for associates
to do their jobs.”




The power of PNM
 Clearly, National PNM plays a pivotal role – one that extends far beyond contracting – in fueling
 the engine that helps drive Health Net’s growth. From surveying providers to collecting competitive
 intelligence and keeping company costs in check, National PNM is among the fundamental forces
 that keep Health Net in the business of delivering the right care, at the right
 time, in the right place, and for the right cost.


                                                                                     fall-winter 2006   connections      7
GREAT PLACE TO WORK




     We Live Here, Too
     HNOR Rides the Cycling Craze in Portland
       As Bicycling magazine’s best city for cycling in North America, Portland, Ore., offers
     countless occasions for cycling enthusiasts to enjoy the sport. The Rose City also is the
     hub of business for Health Net of Oregon (HNOR), headquartered just outside Portland
     in Tigard. Working to be known as a leading local health plan, HNOR is tapping into
     the community’s passions. The cycling scene is a natural fit.
       For the past two years, HNOR has sponsored one of the city’s annual bike races,
     the Portland Twilight Criterium. As part of this effort, HNOR also sponsors Team
     Health Net, America’s top cycling team. For its part, Team Health Net makes it
     a priority to visit various Health Net offices and events around the nation.
       “Oregonians are passionate about cycling and the healthy lifestyle that
     accompanies the sport. The Criterium is a great way to be part of an important
     community event and to reach active people,” says Matt Gougler, manager, HNOR Marketing.




                                                                                                                                                           ers
                                                                                                                                                        itt
       On Aug. 11, 2006, thousands of spectators jammed the streets as several city blocks were




                                                                                                                                                      Gr
                                                                                                                                                   le
     transformed into a virtual velodrome as cyclists took to the pavement for two fast-paced,




                                                                                                                                                 Ky
     60-minute sprints. Team Health Net’s Garrett Peltonen placed first in the race, with other
     Team Health Net cyclists right behind in second, third and fourth place.


     For Health Net, sponsorship is more than banners and signage;
     it’s also an opportunity to involve associates and members in the action.

     Free helmets for kids
       Children and parents rallied to receive free bicycle helmets as part of HNOR’s Heads Up! Bicycle
     Safety Program. HNOR associate volunteers fit 175 children with the brightly colored helmets,
     complete with a Health Net reflective sticker. “We want Portland’s children to enjoy a safe
     bicycle ride this summer,” said Camille Cadran, HNOR volunteer and Quality Improvement
     manager. (Pictured right.)
                                                                                                                           Camille Cadran, manager, Quality
                                                                                                                           Improvement, fits an excited
                                                                                                                           little boy with a free Health
                                           Bird’s eye view for business partners                                           Net bike helmet.
                                             On the day of the big race, HNOR’s business partners gathered
                                           on the veranda of the Oregon Historical Society, one of the course’s
                                           prime viewing areas. HNOR treated local brokers, employer groups
                                           and community contacts to a reception that included a visit by
                                           Team Health Net.
                                             The race offered a unique opportunity to build relationships
Sweeping the Criterium: Team Health Net
                                           with business contacts in a relaxed environment where Health Net
rider Karl Menzies took 4th place after    was prominently featured. “Oregon is an extremely competitive
teammates Garrett Peltonen (1st), Kyle     marketplace and the Criterium was a way for us to raise Health
Gritters (2nd) and Greg Henderson (3rd).   Net’s profile and show appreciation for our local partners,” says               Janice Finley, manager,
                                           Cindy Fineran, vice president, HNOR Sales.                                      Finance, buckles a girl’s free
                                                                                                                           Health Net bike helmet.
                                           For more information: http://www.teamhealthnet.com/news/2006/HNCriterium.html


     8       connections fall-winter 2006                                                                       summer 2006     connections                  12
GROWTH                                                                                                                                                    N

           Health Net Ramps Up
                                                                                                                                     OR


           to Attract Members
        Regional plans roll out innovative solutions
          While America is a nation of 50 united states, each member of this union
       is unique from a market perspective. It only makes sense, then, that our
       union of health plans – Health Net of Arizona, Health Net of California,
       Health Net of the Northeast and Health Net of Oregon – must develop
       strategies and products designed to dovetail with the unique needs of their
                                                                                                                                                      NE
                                                                                                       OR
       local markets. As you will see on the pages that follow, each has done just
       that; and while their approaches vary, each plan shares the common goal


                                                                                                                                                                   OR
       of increasing commercial growth.
         Health Net also continues to focus on the growth of our other revenue-
       generating lines of business, such as Medicare, Medicaid, MHN, Pharmacy
       and Health Net Federal Services (HNFS). Look for upcoming coverage in
       subsequent issues of Connections.

                                                                                                                                         NE
How the Regions Stack Up                                                                OR
                 Medical Membership
             (as of September 30, 2006)                                                                 Premium Revenues (in thousands)
  includes Commercial/ASO, Medicare and Medicaid                                                            (as of third quarter 2006)

                                                                                                                                                         California
                                                                                                               Total Premium Revenues                    $1,647,806
                  Total Medical Membership                                                                             $3,249,478
                          3,384,719                                                                                                                      51%


                                                                                  Other: MHN,
                                                                                     HNFS and
                                                            California          Senior Products
                                                                                                                                                         Oregon
                                                            2,298,160                  $698,331
                                                                                                                                                         $145,823
                                                            68%                            21%
                                                                                                                                                         5%
                                                  Oregon                                                                                   Arizona
               Northeast                          154,875                                                        Northeast
                                   Arizona                                                                                                 $162,524
               776,836             154,848        5%                                                             $594,994
                                                                                                                                           5%
               23%                 5%                                                                            18%


Editor’s Note: Health Net’s HMO, POS, insured PPO and government contracts subsidiaries provide health benefits to more than 6 million individuals in 27 states
and the District of Columbia through group, individual, Medicare, Medicaid, TRICARE and Veterans Affairs programs. Health Net’s behavioral health services
subsidiary, MHN, provides behavioral health, substance abuse and employee assistance programs (EAPs) to approximately 7.3 million individuals in various states,
including the company’s own health plan members. Health Net’s subsidiaries also offer managed health care products related to prescription drugs, and offer
managed health care product coordination for multi-region employers and administrative services for medical groups and self-funded benefits programs.


                                                                                                                   fall-winter 2006      connections               9
HEAL NET of OREGON (HNOR)
                                TH
                                                                      NE                                                 PA
               OR
                                    Originally founded in 1938 as PACC Health Plans,
                                    HNOR is today among the Pacific Northwest’s
                                    leading health plans, with one of the region’s
                                    strongest and most extensive health care
                                    networks.




                             Commercial Market Strategy                                        HNOR Medical Membership
                               HNOR is entering the second year of a two-year                  (as of September 30, 2006) includes
                             strategy to break into the Individual market. The               Commercial/ASO, Medicare and Medicaid
                             primary target is young families in the Portland area                         154,875 = 5%
                                                                                                        of Health Net total
                             (population 1.7 million).
                               In addition, Individual and Family Plan (IFP) products will
                             be marketed statewide through a television campaign and
                             direct mail this winter targeting brokers, rural residents
                             and early retirees. Because online shopping is so popular in
                             Oregon, IFP products are sold through eHealth Insurance,
                             which generates 20 to 45 percent of HNOR’s monthly
                             applications – a unique situation in Health Net.
                               Beyond good service, to attract new business HNOR
                             relies on a broad network and value-added options, such                  HNOR Premium
                             as extensive wellness program offerings, Decision Power,                   Revenues
                                                                                                  (in thousands) as of Q3 2006


                             Successes
                             Web tools, and a new dental and vision package.
                                                                                                        $145,823 = 5% of
                                                                                                         Health Net total

                              HNOR successfully expanded its commercial business statewide and into


                             HNOR in the market
                             Washington State in 2005. IFP is launching statewide in Oregon this winter.


                               HNOR provides group, individual and Medicare health plans, including PPO, HMO,
                             POS and traditional indemnity plans, as well as the region’s first Medicare Advantage
                             PPO. HNOR offers alternative care (chiropractic, acupuncture, naturopathic medicine
                             and massage therapy) as a core benefit in group and IFP. HNOR also offers group
                             prescription drug, vision and dental coverage.



                                       HNOR is entering the second year of a successful two-year
                                       strategy to break into the Individual market. The primary
                                       target is young families in the Portland area (population
                                       1.7 million). Online shopping is popular with this crowd,
                                       generating 20 to 45 percent of HNOR’s monthly IFP
                                       applications.


10   connections fall-winter 2006
SALES ENVIRONMENT                                         HEADQUARTERS

                                                                      Tigard, Ore.
     Sales Network: 622 appointed independent brokers
                                                                      300 associates
     Major competitors: Blue Cross Blue Shield of Oregon,
     Kaiser, Providence Health Plans, LifeWise
                                                                      ENROLLMENT
     Competitive Landscape: PPO is a very popular option in
     Oregon, with 79 percent of HNOR’s membership in PPO              154,875 medical members in
     plans. This market is extremely competitive, with eight          Oregon and Washington State
     carriers fighting for commercial membership                      as of September 30, 2006




New or enhanced releases:
                                                                      LEADERSHIP

                                                                      Stephen Lynch, president,
IFP Plans                                                             Regional Health Plans
• Dental & Vision Plan Option – A unique combined $30 rider           Chris Ellertson, regional health
  members can easily add to their IFP. It’s in demand, and            plan officer
  competitors offer one or the other, but not both.
• Gemstone Portfolio – Introduced in fall 2005 (Pearl 25 HMO,
  Diamond 15, Emerald 40, Garnet 50, Crystal HDHP). This IFP          PHYSICIAN NETWORK
  portfolio offers a wide range of HMO and PPO options and is
  aggressively priced to draw new IFP members and migrate             23,000 physicians
  existing members.
• Topaz First Dollar – For fall 2006, this competitively priced
  package features alternative care services and an immediate
  spending account of $250 – before the deductible applies –
  for chiropractic, acupuncture, massage therapy, naturopathy         FA C I L I T I E S N E T W O R K
  and preventive care.
                                                                      135 hospitals
Commercial Plans
                                                                      1,608 retail chain and
• Rx Plus – Four pharmacy plans being introduced to groups of
                                                                      independent pharmacies
  51+. Rx Plus’ primary selling point is that its plans have a
  “lighter” or less stringent prior-authorization requirement,
  for which a 10 percent additional premium will be charged.
• PPO Fifty Plans – Targeted toward small groups, this is an      C U S T O M E R S E R V I C E S TAT S
  employer’s most affordable option. These plans offer a
  simple design coupled with an affordable price and
  feature 50 percent cost share on all eligible services,             On average, processes more than
  with no deductible for in- or out-of-network services.              4,500 claims and responds to
  The plans pay 100 percent of catastrophic expenses                  1,500 calls per day
  after the out-of-pocket maximum is reached.




                                                                        fall-winter 2006   connections    11
HEAL NET of CALIFORNIA (HNCA)
                  TH

                  Health Net’s largest health plan, HNCA is one of the
                  largest network-model health plans in California. Health
                  Net’s unique California model of organized care delivery
                  drives physician behavior and allows for coherent
                  management of care, quality and resources.




                                                                                             HNCA Medical Membership

                         Commercial Market Strategy
                                                                                            (as of September 30, 2006) includes
                                                                                          Commercial/ASO, Medicare and Medicaid
                                                                                                     2,298,160 = 68% of
                           Attracting smaller businesses (2 - 250 employees) is a top                  Health Net total
                         goal, along with building the PPO network and increasing
                         the number of PPO members. HNCA is focused on:
                         • Retaining membership in organized care delivery.
                         • Developing products emphasizing patient choice: Health
                           Savings Accounts (HSA) banking arrangements and
                           consumer directed/organized care.


                                                                      NE
                         • Building broker relationships.



             OR Successes
                         • Continuing targeted advertising.

                                                                                                                            PA
                           After several years of commercial membership losses, HNCA                 HNCA Premium
                         has seen a return to growth in Small Group, Mid-Market and                    Revenues
                                                                                                 (in thousands) as of Q3 2006
                         Individual and Family Plans (IFP), since the end of 2005, both
                                                                                                      $1,647,806 = 51% of
                         organically and due to the Universal Care acquisition.
                                                                                                        Health Net total
                         • IFP is up 14 percent to nearly 92,000 members.
                         • Small Business Group is up 12 percent to nearly 320,000.
                         • Mid-Market is up 9 percent to just over 404,000 members.
                         • Commercial, POS and Medicare lines of business received NCQA
                           “Excellent” accreditation status.




                                            After several years of commercial membership losses,
                                            HNCA has seen a return to growth in Small Group,
                                            Mid-Market and Individual and Family Plans (IFP),
                                            since the end of 2005, both organically and due to
                                            the Universal Care acquisition.




12   connections fall-winter 2006
SALES ENVIRONMENT                                       HEADQUARTERS


                                                                      Woodland Hills, Calif.
      Sales Network: 10,000 appointed independent brokers
      and agents; 8,500 have business placed with HNCA                More than 2,700 associates
                                                                      in 17 locations throughout
      Major competitors: Blue Cross of California, Kaiser,            California
      Blue Shield of California, PacifiCare/United Health Care,
      Aetna, Cigna                                                    ENROLLMENT

      Competitive Landscape: While the majority of                    2,298,160 medical members
      California businesses are small (2 - 250 employees), a          as of September 30, 2006
      significant number of people are employed by mid-sized
      and large companies. Both HMO and PPO health care
      costs in California are significantly lower than in most
      other parts of the country. This attracts employers as a        LEADERSHIP
      good value, even with the state’s higher housing costs.
      HNCA is the state’s fourth largest health plan                  Stephen Lynch, president, Regional
                                                                      Health Plans
                                                                      Patricia Clarey, chief operating

HNCA in the market
                                                                      officer, HNCA

  HNCA offers coverage for vision, dental, life insurance*,
chiropractic and alternative medicine; HMO, POS, PPO,                 PHYSICIAN NETWORK
Medicare, Healthy Families and Medi-Cal plans in the individual
and family, senior, small (2 - 50), mid-market (51+ distributed       51,000 physicians
by brokers) and large group (those groups represented by


New or enhanced releases:
consultants, including Labor & Trust) markets.


• Small Business Group (SBG) – In May 2006, launched four             FA C I L I T I E S N E T W O R K
  new benefit plans - HMO 10, HMO 30, PPO 25 and PPO 35 –
  resulting in 7,750 new members for SBG – an increase of             300 PPO hospitals
  2.3 percent.                                                        260 HMO hospitals
• EZAccess HSA – Introduced in July, connects an HSA plan with        5,000 retail chain and
  a Wells Fargo HSA account via a debit card. Allows members          independent pharmacies
  to take control of their health care purchases with a savings
  account they own and control. Builds on existing HSA plan
  membership, which has grown 183 percent since the begin-        C U S T O M E R S E R V I C E S TAT S
  ning of the year, and now totals more than 9,000 members.
• HMO Silver Network – In 2005, created a select network              On average, processes 20,000
  of cost-efficient providers. Enables employers to reduce            claims and responds to 25,000
  premiums by 8 to 15 percent. Concept continues to build             calls each day
  sales momentum, as membership has grown to nearly
  11,000, a 108 percent increase since the beginning of 2006.




* Offered by HN Life Insurance Company and administered by
Health Net of California.




                                                                        fall-winter 2006   connections     13
HEAL NET of ARIZONA (HNAZ)
                             TH

                         Celebrating 26 years of meeting Arizonans’
                         health plan needs, HNAZ has been ranked the
                         No. 1 HMO for two years running by Ranking
                         Arizona magazine.




                         Commercial Market Strategy
                                                                                           HNAZ Medical Membership
                                                                                           (as of September 30, 2006) includes
                                                                                         Commercial/ASO, Medicare and Medicaid
                           Overcoming a lack of name recognition and other market                     154,848 = 5%
                         challenges, HNAZ is in the second year of an effective three-               Health Net total
                         year period of recovery, organized around a strategy dubbed
                         “Raising Arizona.” Committed to being innovative and offering
                         a comprehensive product menu, HNAZ recognizes that
                         maintaining a stable cost and pricing position is critical.
                         To support growth, HNAZ is:
                         • Making a significant investment in targeted marketing and
                           advertising.


               NE
                         • Keeping expenses in check.
                         • Meeting membership goals.                                                HNAZ Premium
                                                             PA
                         • Improving contracting and network medical management,
                           products and services.
                                                                                                      Revenues
                                                                                               (in thousands) as of Q3 2006
                                                                                                       $162,524 = 5%
                         • Segmenting the group market to identify areas that offer                   Health Net total
                           the greatest opportunity for growth.
                         • Focusing sales and marketing efforts on the brokerage community as it



                         Successes
                           controls more than 95 percent of targeted business.



                         HNAZ has:
                         • Undertaken significant community outreach efforts that are effectively building brand
                           recognition.
                         • Attained price stability and offers a portfolio of products that meet consumer needs.
                         • Been rewarded with recaptured business due to discipline and operational improvements
                           over the past two years, such as claims payment accuracy and timeliness.
                         • Implemented UNITY, a software program that tracks Medical Management results.
                         • Achieved an “Excellent” accreditation rating from NCQA.


                                    HNAZ is in the second year of an effective three-year period of
                                    recovery, organized around a strategy dubbed “Raising Arizona.”
                                    With more than 95 percent of desired business controlled by the
                                    brokerage community, the focus is on capturing this audience as
                                    a means to gaining membership.

14   connections fall-winter 2006
SALES ENVIRONMENT                                             HEADQUARTERS


                                                                         Tempe, Ariz.
    Sales Network: 3,000 appointed independent brokers
                                                                         300 associates in Tempe and Tucson.
    Major competitors: Blue Cross Blue Shield of Arizona,                Operations (claims, membership,
    Humana, LifeWise, Aetna, Cigna, United                               member and provider calls, etc.)
                                                                         are handled out of the Shelton,
    Competitive Landscape: Arizona, with two major                       Conn., office by 250 associates
    metropolitan centers – Phoenix and Tucson – is America’s
    second fastest growing state. It is home to a large,
    underserved population, as fully one-third of Arizona’s              ENROLLMENT
    residents are either uninsured or on Medicaid. HNAZ is
    the state’s fourth largest health plan                               154,848 medical members
                                                                         as of September 30, 2006




HNAZ in the market
                                                                         LEADERSHIP


  HNAZ offers coverage for vision, dental, life insurance*,              Stephen Lynch, president,
chiropractic and alternative medicine; Individual and Family             Regional Health Plans
(HMO and PPO); Employer-sponsored Plans (HMO, PPO, POS                   Mark El Tawil, president, HNAZ
Plus and Indemnity); Medicare Advantage HMO; Medicare
Supplements; Multiple Option and National Provider Network
                                                                         PHYSICIAN NETWORK

New or enhanced releases:
access for PPO and POS Plus products.

                                                                         5,673 physicians
• Empowerment for a Healthier Life Style HMO and PPO plans:
  Includes Decision Power SM to help members be informed and
  confident in their medical care decisions; and It’s Your Life to
  help members deal with personal or family challenges.
• High-Deductible Health Savings Account-compatible PPO:                 FA C I L I T I E S N E T W O R K
  With lower premiums, tax benefits and control over health
  care dollars, this product is designed to appeal to a variety of       57 hospitals
  health care consumers.                                                 1,000 retail chain and
• Broker tool kit: Created as part of an initiative to strengthen        independent pharmacies
  broker communications and to make doing business with
  Health Net easier, this kit includes a CD loaded with forms,
  collateral, streamlined underwriting guidelines and other
  useful tools, including a handy palm-sized tool kit that           C U S T O M E R S E R V I C E S TAT S
  brokers can keep in their glove boxes.
• eHealth online search tool: In an effort to increase its               On average, processes 5,000-
  opportunity for selection, HNAZ contracted with eHealth                6,000 claims per day and
  to obtain priority placement in search results for Individual          responds to more than
  and Family Plan shoppers.                                              2,000 calls each day




*Offered by Health Net Life Insurance Company and administered by
Health Net of Arizona.




                                                                           fall-winter 2006   connections      15
HEAL NET of the NORTHEAST (HNNE)
                           TH

              NE               For the past 30 years, HNNE – one of the
                                                        PA
                               largest health plans in the Northeast –
                               has offered a wide array of full-service
                               health plans in the tri-state area.




                       Commercial Market Strategy
                                                                                              HNNE Medical Membership
                                                                                            (as of September 30, 2006) includes
                                                                                          Commercial/ASO, Medicare and Medicaid
                         Facing intense competition, HNNE’s goal is to become a                        776,836 = 23%
                       leading local health plan with an overall emphasis to execute                  Health Net total
                       a “customer solutions” strategy.
                         HNNE returned to profitability and renewed growth in 2005
                       and 2006 through brand investment, an updated product portfolio,
                       accurate pricing and leaner plan designs with lower price points
                       and by focusing on fruitful geographies.
                         Small and mid-size businesses remain the primary commercial
                       targets in all three states, along with Medicare in Connecticut
                       and New York. In New York, the focus is to build on momentum
                       and return to growth. In New Jersey, the task is to achieve a
                       competitive cost structure and return to growth.                             HNNE Premium
                                                                                                      Revenues
                         To grow enrollment, HNNE is introducing an array of new,               (in thousands) as of Q3 2006
                       highly competitive products and providing enhanced benefits                     $594,994 = 18%
                       to members. Consumer-driven health plans also are in the mix,                   Health Net total



                       Winning Priorities
                       along with enhancing self-insured product capabilities.


                          HNNE is successfully executing a multiple-year improvement plan by employing
                       five winning priorities:
                         1. Achieve profitable growth through execution of superior “customer solutions” strategies.
                         2. Deliver excellent service to customers, providers, regulators and to each other.
                         3. Achieve competitive health costs.
                         4. Deliver the analytics that drive insightful business decisions.



                       Successes
                         5. Establish HNNE as a great place to work.



                       • Re-establishing gross margins in the business, a basis for stability and long-term growth.
                       • Retaining customers, a sign of improved enrollment stability.
                       • Recontracting with all hospitals and improving health care costs versus the competition.
                       • Launching new products such as the integrated Health Savings Account (HSA) with
                         Wells Fargo.
                       • Growing membership in target segments.
                       • Achieved an “Excellent” accreditation rating from NCQA and was awarded “Quality Plus
                         Distinction” in NCQA’s Member Connections rating category for effectively engaging
                         members in their own care, especially via the Web.

16   connections fall-winter 2006
SALES ENVIRONMENT                                           HEADQUARTERS


                                                                      Shelton, Conn., for business
    Sales Network: 3,400 appointed independent brokers
                                                                      conducted in Connecticut,
    and agents and 1,600 agencies
                                                                      New Jersey and New York.
    Major competitors:                                                Approximately 1,800 associates
    Connecticut: WellPoint (Anthem);                                  in five locations in Connecticut,
    Oxford/UnitedHealthcare; ConnectiCare                             New Jersey, and New York
    New Jersey: Oxford/UnitedHealthcare; Aetna; Horizon
    Blue Cross Blue Shield of New Jersey                              ENROLLMENT
    New York: Oxford/UnitedHealthcare; Aetna; WellPoint
    (Empire Blue Cross Blue Shield of New York)                        776,836 medical members
                                                                       as of September 30, 2006
    Competitive Landscape: In the New York market,                          Connecticut    368,900
    HNNE’s focus is on small businesses. In New Jersey,                     New York       239,547
    both small- and mid-size businesses are prevalent.                      New Jersey     168,389
    In Connecticut, mid-size businesses have been the
    primary target, but now attention is being turned to
                                                                      LEADERSHIP
    the small-business market as well

                                                                      Steve Nelson, president, HNNE


HNNE in the market
                                                                      Bill Lamoreaux, chief operations
                                                                      officer, HNNE
  The Northeast health plans offer HMO, POS, PPO and self-
insured options to local and multi-region employers with small,
mid-sized and large businesses, and Medicare and Medicaid for


New or enhanced releases:
individuals, families and seniors.                                    PHYSICIAN NETWORK

                                                                      80,000 physician and professional
• Outlook - Portfolio of preferred plans characterized by higher      providers representing more than
  member cost sharing, stringent underwriting guidelines and          150,000 office locations
  competitive pricing that provide solid, basic coverage at
  extremely attractive price points. Launched EPO and POS
  plans for small group in New York and will add for re-entry         FA C I L I T I E S N E T W O R K
  into New Jersey and update of products in Connecticut.
                                                                      250 hospitals
• HSA - Implemented for small group in Connecticut and New
  York. Expanded portfolio of consumer-directed plans and offers      5,500 retail chain and
  low-cost alternative for employers. An HSA debit card also was      independent pharmacies
  instituted across the tri-state middle-market segment.
• Health Reimbursement Arrangement (HRA) - Integrated HRA
  product in the tri-state region that will allow HNNE to better
                                                                   C U S T O M E R S E R V I C E S TAT S
  compete with major market players. To be launched first
  quarter of 2007.
                                                                      On average, processes 40,000
                                                                      claims per day; responds to
HNNE returned to profitability and renewed growth                     10,000 phone calls per day
in 2005 and 2006 through brand investment, an
updated product portfolio, accurate pricing and
leaner plan designs with lower price points and
by focusing on fruitful geographies.

                                                                        fall-winter 2006   connections     17
PERFORMANCE


                          Debunking the myth of
Health Insurance Company Profits
     People perceive health care profits to be 51 percent of skyrocketing costs.
     Fact is, profits are only 3 percent.
          ccording to a recent study conducted by Public Opinion Strategies, consumers believe the profits of health
     A    insurance and pharmaceutical companies are a main factor driving increases in health care costs. A survey of
     800 adults revealed that Americans estimated typical health insurance company profits at a whopping 51 percent
     of health care spending – a gross misperception.
       The truth, as illustrated below, is that health insurance industry profit is only 3 percent; that’s 3 cents on the dollar.
     Health Net is working to bust the 51 percent myth by partnering with America’s Health Insurance Plans (AHIP) to
     educate decision makers and the public about the realities of rising health care costs, and by doing our part to stem
     the tide of rising costs with innovative solutions.
                                                                                                                                        Profit
     Where Does 1 Dollar of a Health Net
                                                                                                                              Selling costs
     Member’s Premium Go?
     The answer is, Health Net* spends 85 cents of each                                                                          G&A
     premium dollar on patient medical care. Only 3 cents                                              (cost of running the company)
     is company profit.                                                                           Ancillary Services
                                                                                                           Drugs

             38¢ Hospital                                            33¢ Physicians                                10¢        4¢       10¢        2 3¢




                                                           85¢                                                                            12¢        3¢
                                           Member health care costs                                                                    SG & A         Profit
                                                                                                                                       costs
 * Health Net is in line with benchmarks in the industry based on a PricewaterhouseCoopers’ analysis for AHIP, Factors Fueling Rising Healthcare Costs 2006.



18   connections fall-winter 2006
mhn still aiding recovery efforts
 After the killer storm struck America’s Gulf Coast,
 the U.S. Navy relied on the ready resources of
 Health Net’s behavioral health division, MHN



 T       rying not to panic her two preschoolers, the
         young mother hurriedly loaded her mini-van with
         bare essentials – clothes, blankets, water, a family
 photo album. It was Aug. 29th of last year, and Hurricane
 Katrina was barreling toward the Biloxi home that she
 and her husband – a petty officer in the U.S. Navy – had
                                                                    Actual MHNGS cases
 purchased just weeks before he shipped out to Iraq.                Recently MHNGS’ Gulf Coast team shared some actual
                                                                    cases they encountered post-Katrina. Here are just two
   When the young mom returned days later, she
                                                                    of their many stories:
 discovered that Katrina had devoured their home.
   She wasn’t alone. In fact, hundreds of Navy families              • Just months after losing his house to Katrina, this

A Year After Katrina
 had to simultaneously contend with the uncertainty
 that looms when a loved one is at war coupled with
 the overwhelming devastation brought to the southern
                                                                       MHNGS client lost his wife to a terminal illness. Adding
                                                                       further stress was the fact that his wife passed away
                                                                       out of town, but was buried locally. Tracking down her
MHN Still Aiding Recovery Efforts
 U.S. by three hurricanes, Katrina (August), Rita (September)          death certificate – which the man urgently needed for
 and Wilma (October). Fortunately, they had somewhere                  her life insurance policy and to apply for financial aid to
 to turn: Health Net’s Managed Health Network                          rebuild his house – thus became a significant challenge
 Government Services (MHNGS).                                          that only added to the man’s psychological and
 Navy turns to MHNGS                                                   financial stress. Although it wasn’t part of her job,
   The Navy, which has installations throughout the hard               an MHNGS case manager ran interference and quickly
 hit Gulf Coast region, quickly realized that its internal             solved the problem. She also referred the man to a
 resource – called Fleet and Family Service Centers –                  grief counselor and continues to monitor his progress.
 couldn’t alone respond to the massive need left in
 Katrina’s wake. The Navy turned to MHNGS.                           • For this MHNGS client – a 26-year-old marine – Katrina
                                                                       left him with both an aching heart and a bulging
   And MHNGS, which operates under a Department of
                                                                       waistline. His heart ache stemmed from separation.
 Defense subcontract, readily responded. In short order,
 MHNGS initially dispatched 25 clinicians and financial                The storm shredded the house he shared with his
 counselors to installations throughout the Gulf Coast,                wife; until they could rebuild, he had to live on base,
 Florida and Tennessee (many hurricane victims were                    and she with her parents some distance away. The
 evacuated to the latter).                                             combined stress of Katrina’s devastation and his
                                                                       wife’s absence led the marine to munch more than
   “This team of associates is still working with the Navy
                                                                       usual. In fact, he packed on enough pounds to threaten
 in the Gulf Coast, and will continue to do so through
                                                                       his continued enlistment. A skilled MHNGS clinician
 the end of the year,” explains Elaine Shelub, manager,
                                                                       armed the young man with an arsenal of stress-
 MHNGS. These associates’ hard work hasn’t gone
 unnoticed. “Directors of the Fleet and Family Service                 reduction techniques that enabled him to cope
 Centers have repeatedly commented what an outstanding                 while simultaneously cutting calories.
 job our people have done, particularly in relation to
 outreach and being a great source for referrals.”
 Clients can take comfort
   While it will likely take years for the battered Gulf
 Coast to completely rebound, at least those hurricane
 victims who are MHNGS clients can take comfort in              See HN Connect for an update on the Health Net associate who lived
 knowing that caring clinicians and counselors stand            through the storm, Karen Williams, MHNGS victim advocate in
 ready to serve.                                                Gulfport, Miss., and more MHNGS case stories from the recovery zone.


                                                                                            fall-winter 2006    connections            19
GROWTH



       Rolling Out an Array of Senior Products:
       New plans, new geographies, new advertising
A perspective from Sam Srivastava, chief senior products officer

                              Our continuing strategy is ‘Simplicity is the pathway to trust’... meaning, if we can make
                           it simple for seniors where no one else can, we will build their trust in us and encourage
                           them to consider Health Net. We are taking the consultative approach – let us help you
                           understand what you have today, how our plans compare, and let us do it in a way that
                           best meets your needs – at a group seminar, over the phone, or we’ll even come to your
                           house if you’d like, in our core markets.
                              For 2007 and beyond, Health Net will expand its markets and, based on our success
                           in Arizona, plans to develop more retail storefronts in California, Oregon, New York and
                           Connecticut. We’ve enhanced and streamlined our products with revised and improved
                           collateral that is color-coded and easy to understand. We’re introducing new fall advertising
                           to boost name recognition and generate qualified leads that will drive sales.


Color-coded plans make it simple
                   Available in all 50 states and                                     Arizona, California,
                   the District of Columbia                                           Oregon
                   Orange - Stand-alone Prescription                                  Brown - Medical Coverage
                   Drug Plan features generic and brand-                              Medicare Supplement Plan with
                   name drugs. There are three plans to                               a slightly higher premium than
                   choose from; two of the plans offered                              other plans in exchange for the
                   come without a deductible so that                                  convenience of not having to pay
                   members are covered from their very                                charges when you visit the doctor
                   first prescription, and one plan offers                            and the freedom to see any doctor
                   generic drug coverage with no “doughnut                            who accepts Medicare.
                   hole” gap.

                   Oregon, Washington State                                           Arizona, California,
                   Aqua - Medical-only Plan that gives                                Connecticut, New York
                   members the freedom to see any doctor                              Amber - Medical and Drug
                   nationwide who accepts Medicare.                                   Coverage Plan for Medicare/Medicaid
                                                                                      dual-eligible individuals who
                                                                                      qualify under the government’s
                                                                                      financial guidelines; features costs
                                                                                      that may be greatly reduced or even
                                                                                      eliminated.


 20   connections fall-winter 2006
Arizona, California,                                Arizona, California,
                Connecticut, New York                               Connecticut, New York
                Green - Comprehensive HMO Medical                   Ruby - HMO with combined
                Plan with a $0 monthly plan premium                 medical and drug coverage.
                and minimal copayments for doctor
                visits and other services.




                Connecticut                                         Arizona
                Navy - Medical and Prescription Drug                Sage - Medical and Drug Plan
                Plan with affordable copayments for                 with automatic enrollment into
                in-network services; for a higher cost,             our disease management program
                allows subscribers to see physicians                for members with coronary artery
                outside Health Net’s network who                    disease or high cholesterol, at no
                accept Medicare.                                    extra cost.




                California, Connecticut,                            Arizona, California,
                Hawaii, New Mexico, New                             Oregon, Washington State
                York, Texas, Washington State                       Violet - Combines medical
                Pearl - Our newest offering, a Private              and drug coverage with simple
                Fee-for-Service Medical Plan that gives             copayments for doctor and
                members the freedom to see any                      hospital visits, no matter which
                doctor who accepts Medicare. Only                   doctor you see.
                Connecticut has an option that also
                includes drugs for a higher premium.



Why nearly half-a-million people already have chosen Health Net Medicare plans.
                                                            — Excerpted from the new Medicare Collateral
“We tailor                        “We show
our services     “We make         you what                                           “We give you
                 understanding your costs may             “We strive for
to Medicare                                                                          Decision
                 our plans easy.” be before you           the highest
beneficiaries                                                                        Power SM.”
                                                          quality care
like you.”                        sign up.”               possible.”




                                                                  fall-winter 2006   connections       21
The Making of a
Great Place to Work
     Beginning our journey –
          and why it’s important.


      Thanks to you, Health Net is building a better company.
     Our solid performance and budding growth prove it.
       Now, we’ve set our sights even higher. Jay Gellert,
     president and chief executive officer, stated as much
     with the launch of this year’s associate survey, saying,
     “Becoming better is important. Becoming great is our
     goal.” We want to become a great company – and a
     Great Place to Work.
       “These two goals are very interconnected,” says Karin
     Mayhew, senior vice president, Organization Effectiveness
     for Health Net. The proof: “The companies that earn a place
     on Fortune magazine’s ‘100 Best Companies to Work for
                                                                     How are we making Health Net a Great Place
     in America’ consistently outperform their competitors.” 1
                                                                     to Work?
       Research aside, it seems obvious that the way people             “It begins with our attitude – we must be willing to
     are treated makes a difference in how they perform. It’s        exchange ideas, and not be afraid to ‘show our work’
     not surprising then, that studies have shown that over          and share honest evaluations of what we are striving
     time, companies appearing on the “100 Best Places to            to accomplish,” says Karin. “We need to be willing to
     Work” have competitive advantages.                              examine and identify where we are now – and see how
     What are these competitive advantages?                          it matches up to where we need to go.”
       Besides being a place employees look forward to going           “Remember,” notes Jay, “becoming great is a journey
     every day, being a Great Place to Work has a host of            that all of us at Health Net are undertaking to achieve
     up sides:                                                       the goal we’ve agreed upon: to be a great company that
     • more qualified people want to work there                      supports associates and serves customers well. We’ve
     • lower turnover                                                begun, but we aren’t there yet. My personal goal is that
                                                                     we won’t have to ask ‘are we there yet?’ for long – the
     • higher levels of customer satisfaction and customer loyalty
                                                                     results will speak for themselves.”
     • greater innovation, creativity and risk taking
                                                                     Here are just a few examples of what Health
     • higher productivity, and
                                                                     Net is doing to build a Great Place to Work.
     • reduced health care costs                                       Focus on people: We pay for performance, and we
     What makes a Great Place to Work?                               single out examples of outstanding associates and
       “At the heart of it is creating a work environment            praise their good work.
     where associates trust the people they work for, have           • Examples: The Heart & Soul Recognition Awards
     pride in what they do and enjoy the people they work              program; SPOT Awards; HNFS STAR Program;
     with,” explains Karin.                                            Associate Place features on HN Connect; Service
       The common theme: quality relationships ... relationships       Anniversary Awards; and numerous other department
     between associates and management … between associates            and business unit recognition programs that let
     and their jobs … and among associates themselves.                 associates know they are valued and appreciated.


                                                                                               1
                                                                                                   2006 Great Place to Work® Institute, Inc.



22     connections fall-winter 2006
Focus on tools and processes: Health Net is improving    ance reviews, while others are online like the TALEO
its tools to manage our work and support our people.     staffing system. COMPASS will link all of this together
Many initiatives are facilitating greater performance    electronically. Health Net will have a centralized,
and growth, as well as improving associate engagement.   easy-to-use, desktop resource that lets us evaluate
• Examples: ITG’s Workstation Refresh Program; the       the strengths of our people, provide development
  new Macess.EXP electronic document management          opportunities to grow their careers – and enable us
  system; UNITY case management system; the              to see what other talents need to be honed to make
  TALEO applicant tracking system; Connections           us great. There will be tools for managers, and tools
  magazine and video capability on HN Connect.           for all associates.
                                                            “Setting our 2007 goals using COMPASS is a key step,”
Look for more examples from the regions
                                                         Andy explains. “It will allow Health Net to capture,
in future issues.                                        compare and share what we’re doing individually,
Next: COMPASS, our Talent Management                     within business units and across the enterprise – to
System                                                   ‘align our goals’ – so that we’re all rowing in the same
  Having the right people … making sure we support       direction and not duplicating effort.”
one another and our performance goals … developing         Ultimately, this will help us make the best use of our
our skills … paying for performance … planning and       associates’ talents and achieve our performance goals.
building for future talent needs – these are the           Being able to identify and integrate associate
components of Talent Management.                         goals and clarify accountability is something
  “Associates are our talent, and we need to be able     associates have consistently mentioned in Health
to make the most of what you offer and your              Net’s Annual Associate Survey. Addressing this
development potential,” says Andy Ortiz, vice            concern also directly responds to recommendations
president, Talent Management and Leadership              from the work teams from last year’s Leadership
Development. “To help us do that, this fall we’re        Summit.
introducing Compass, a comprehensive, integrated           This is another reason for associates to participate
Talent Management System. It will be rolled out in       in the annual survey process – to make sure you
phases – we’ll all begin using Compass for our 2007      share your perspective and ideas about how to
goal-setting process.”                                   make Health Net a Great Place to Work.
  Right now, Health Net has separate tools, separate     Look for more about COMPASS, the new Talent
processes for managing our people. Some processes        Management System, on HN Connect.
are paper-based, such as goal setting and perform-




                                                                                    fall-winter 2006   connections   23
Defining what we stand for                                Community: Health Net and our associates care
                                                                 about the communities they serve … How? Katrina
               Walking the Talk                                  relief support, contributions to the Pentagon Memorial
           Health Net is demonstrating the value we place        Fund, sponsorship of Celebration of Children, Kick It
         on the lives of our associates, our customers and       With Health Net in California, Habitat for Humanity
         our communities.                                        in the Northeast, United Way in Arizona, and many
           Associates: We provide a wide range of benefits       more. See page 8, We Live Here, Too, and Capturing
         to meet associates’ diverse needs, including medical,   Kindness at Health Net on page 2.
         dental, life and disability insurance, PTO, a brand-
         new online discount program to support work-life
         balance, educational reimbursement, health club           Health Net is determined to
         reimbursement, referral bonuses, as well as a 401(k)
         Savings Plan with match and new investment                be a company with lasting
         options. Enhancements to several of these programs
         will be announced in 2007.
                                                                   performance in the industry,
           Customers: iBilling for Individual and Family Plan      and companies that achieve
         customers on www.healthnet.com is just the latest
         example of our “customer solutions” strategy – to
                                                                   this pay attention to those
         become the health care company that uniquely              who make it happen – their
         understands and serves its customers with the
         solutions they need.                                      employees. Health Net is
                                                                   committed to doing just that.




           Imagine … here’s the associate experience we aspire to create by improving
           our work climate and building our reputation as a Great Place to Work …

     “The company takes care of the people, and                    “Management truly encourages and expects
     the people in turn take care of the profits.”                 individuals to care for themselves outside of
     “Personal and professional opportunities are                  work. They understand that quality personal
     many. The company is always striving to improve               lives contribute to doing a good job.”
     itself and at the same time giving individuals the            “This is a great place to work because people
     motivation and encouragement to achieve their                 care about each other. It doesn’t seem so much
     desires.”                                                     like work when you are surrounded by people
     “Every morning I wake up excited to get to work               who care about you as an individual.”
     and do the best I can for a company that really               “I feel I make a difference. My job allows me
     appreciates it.”                                              latitude to make decisions and implement them
     “I always strive for the best results, but I am not           in order to get the job done. At the end of the
     afraid to make mistakes, which allows me to be a              day, I can look back and see what I have been able
     risk taker. I am able to explore my ideas at this             to accomplish with a great feeling of satisfaction.”
     company.”


24   connections fall-winter 2006
Health Net Connections Internal Brand Print Magazine #1
Health Net Connections Internal Brand Print Magazine #1

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Health Net Connections Internal Brand Print Magazine #1

  • 1. Quarterly Magazine for Health Net Associates • Fall-Winter 2006 Inside: Health Net Ramps Up to Attract Members Regional plans roll out innovative solutions The Making of a Great Place to Work Cover Story: THE ROOTS of Health Net A Year After Katrina MHN is Still Aiding Recovery Efforts National Provider Network Management
  • 2. Issue Highlights The Roots of Health Net Published by: Health Net, Inc. Corporate Communications 21650 Oxnard Street National Provider Network Management Mail Code CA-102-22-07 page 3 Woodland Hills, CA 91367 We welcome your ideas and We Live Here, Too feedback. Contact Linda Lalande HNOR Rides the Cycling Craze in Portland or Margaret Longo at: page 8 Connections@healthnet.com. For internal distribution only Health Net Ramps Up to Attract Members Health Net, Inc. is among the NE PA nation’s largest publicly traded OR Regional plans roll out innovative solutions page 9 managed health care companies. Its mission is to help people be healthy, secure and comfortable. For more information, go to www.healthnet.com. This publication contains forward-looking statements Rolling Out an Array of Senior Products within the meaning of Section 21E of the Securities Exchange Act of 1934, as amended, and Section New plans, new geographies, new advertising 27A of the Securities Act of 1933, as amended, that involve a number of risks and uncertainties. All page 20 statements, other than statements of historical information provided herein, may be deemed to be forward-looking statements. Readers are cautioned The Making of a Great Place to Work not to place undue reliance on these forward-looking statements. The company undertakes no obligation to publicly revise these forward-looking statements to Beginning our journey–and why it’s important reflect events or circumstances that arise after the page 22 date of this publication. Images of the Themes that Unite Us Look for these icons to identify Health Net’s three important themes. The icons are used in communications about what is going on in the company and how we are succeeding. PERFORMANCE GROWTH GREAT PLACE TO WORK Progress and achievements that Efforts to expand and increase Examples of a high-performance support Health Net’s business the quality of Health Net’s environment that supports strategy and financial goals business associates and serves customers well fall 2006 connections 4
  • 3. GREAT PLACE TO WORK Thanks for Making the Connections Last quarter’s launch of Connections magazine began a partnership. We asked for your readership, participation and feedback – and you responded. Here’s what you said. Did you like Connections? Your Voice: What you said you’d like to see in Overwhelmingly, YES. “Finally, Connections is already shaping the magazine. a way to get information that doesn’t require a keyboard and “Connections is telling me why Health Net is a quality mouse… layout was clean, colorful… company for the customer. What are we doing to help graphics were interesting and ourselves?” See page 22 –The Making of a Great Place creative… articles were easy to to Work. read and enjoyable… I can read this at my own pace on “How about something fun included with all the break or at home… it’s one more way to feel a part of information?” See page 18 – HN Dollar such a big organization.” and page 25 – Earnings Lingo quiz. Counterpoint: “Can’t we do this online?” Like the difference between snapshots and a family “Some comparative stories across the business units?” portrait – our HN Connect online “newspaper” reports See page 9 – Regional plans roll out innovative solutions. current, time-sensitive news in an ever-changing format, “Features on various departments within the company while Connections takes a broader, enterprise perspective and what they do to move us forward – how they affect to show how we’re changing and advancing over time. Connections also is proving to be a welcome source of or support other areas.” See page 3 – first in a series of company information to many associates who don’t have department profiles. time during their workday to access HN Connect on a “I want to feel more of a family atmosphere, to get to regular basis. know more about the people and what they do.” Did Connections help you become better informed? “More stories about and from associates, more faces “I found the articles ‘got right to the point’ about what is of associates.” See page 19 – MHN and Katrina recovery, going on with the company, and our goals, and how we are and refer to Associate Place weekly profiles on HN working together to achieve them… some articles were a Connect. little long… I’ve read some of the stories on HN Connect.” Connections’ purpose is to provide context. At times it “Updates and changes in the health care industry.” reinforces messages from HN Connect – and we work hard Look for industry perspectives in future issues and to add a fresh viewpoint. see the Daily News Summary on the front page of HN Connect for industry news. We’re all ears. Keep reading and sending your feedback– everyone benefits! “More about our benefits… like the 401(k) article.” For an online copy of this magazine, live links to related stories and to submit See page 22 – The Making of a Great Place to Work, ideas and feedback go to: HN Connect > Find It Fast > Newsletters > Connections. and future articles, as well as updates on HN Connect, with details found in HR Link. CONNECTIONS DEFINED “More about the programs that each region is a part of in their communities.” See page 8 – HNOR Rides Connections is a quarterly associate magazine that the Cycling Craze in Portland. showcases what Health Net does, how and why we do it and who is making it happen. Stories focus on “More local events, updates on projects.” Look to our Performance, Growth and Great Place to Work HN Connect for time-critical, events-based reporting themes, and feature information and perspectives to and project updates. help us work together, better serve our customers and build a culture of performance. fall-winter 2006 connections 1
  • 4. What’s Health Net’s Business? More than a claims processor, we help members get the best care A message from Scott Law, chief network officer, Health Net, Inc. and Health Net of California. Scenario: A Health Net member is diagnosed with a severe medical condition. Faced with difficult decisions and in unfamiliar territory, how can Health Net best help this person navigate through this challenging situation – and do so in a way that our assistance is welcomed, and the member ultimately experiences a better outcome because we were involved? Dealing with such situations is Health Net’s business. Health Net’s efforts to contract and maintain a robust It’s not only our business – it’s what we want to be great at. network of qualified providers – and how they support the Our goal is to excel at bringing members the right care, regional provider network organizations that do the heavy at the right time, in the right place, for the right cost. lifting of actually recruiting the doctors and negotiating That’s why we have made a conscious effort to link the contracts. the care managed by Medical Management with the The next issue of Connections will focus on our Medical delivery networks designed and maintained by Network Management team and how they are helping members Management. We know that collaboration between get the most appropriate, cost-effective care in the right these two important areas of our business is key to setting – including the products and new technology, such establishing health care management as a central skill – as UNITY, that are making it easier for associates to better a core competency – for Health Net. serve member needs. We are making enormous strides and will be sharing Our business is about continuously improving health more information with you in future communications. care access, choices and outcomes in an affordable way. In this issue, our spotlight shines on the National Read on to learn how we’re working to achieve these Provider Network Management group. This story explores fundamental goals that benefit our members, our local the role National Provider Network Management plays in markets and Health Net’s overall performance. Capturing Kindness at Health Net Giving back to the communities we serve is all in a day’s work at Health Net. In December, Health Net will host our company’s signature holiday event, Celebration of Children (CoC), in six cities across the country. Fifteen years ago, CoC began as the brainchild of Health Net Chairman Roger Greaves, his wife, Erika, and a group of associates who decided they would rather give to kids than have holiday office parties. Ensuring its success, Erika has continued hands-on involvement, nurturing the colorful affair into a heartwarming company tradition that brightens the lives of thousands of youngsters. Join the happy Health Net elves. Volunteers are needed for this year’s Celebration of Children. Give a toy, give an hour to wrap gifts, give a morning during the events. Look for information from your local volunteer coordinator and on HN Connect. Reaching out in other ways? We recognize the generosity of associates is wide-ranging. Every year, Health Net groups sponsor other charitable events during the holidays. To help us capture your kindness, please contact Connections@healthnet.com as soon as you can – PRIOR to the event – to let us know how you are making a difference in the communities we serve. 2 connections fall-winter 2006
  • 5. PERFORMANCE THE ROOTS of Health Net National Provider Network Management S Seeding growth with tools to deliver: right care, right cost, right time, right place o just what business is Health Net in? Sounds like a simple enough question; after all, we are a managed health care company – ergo – we’re in the managed health care business. True enough, but that’s just a surface description. Dig deeper, and it becomes clear that we’re actually in the business of delivering the right care, at the right time, in the right place, for the right cost. And it’s through achievement of this foursome that our company experiences growth. Health Net’s National Provider Network Management (PNM) team is a central member of the team that drives company growth. “The National PNM team collaborates to support our 300 PNM associates, located across the country, who are negotiating and maintaining our provider contracts for the continuum of services that our members need,” explains Scott Law, chief network officer, Health Net, Inc. and Health Net of California. “While contracting and maintaining robust networks of qualified providers is a cornerstone of our business, the role of National PNM is to improve our core provider network management capabilities,” he says. Scott recently has been asked to focus more intensely on building the PNM force in California. During this time, Douglas Cowieson, vice president for National PNM, is assisting Scott with National PNM efforts. Working with regional PNM staff, National PNM provides services, tools, processes and hands-on assistance. “This support helps our PNM organization build more effective provider contracts,” says Scott, “in terms of overall cost and the ability to administer, ensuring we have full control over what and how we pay.” Editor’s Note: At press time, a new organizational structure for Provider Network Management was being announced. However, Scott Law and Douglas Cowieson remain as named in this article. For details, see HN Connect. fall-winter 2006 connections 3
  • 6. National PNM’s role: Central “trunk for regional “branches” ” A few simple guiding principles apply to define the work National PNM spearheads: • Work that can be done more efficiently centrally, e.g., provider communications and training. • Work that requires a critical mass that cannot be achieved optimally by an individual region, e.g., coordination of benefits data capture. • Work that should have a corporate oversight, e.g., some audit functions, such as contract review for conformity to required standards. By putting these principles into practice on behalf of the PNM regional divisions, the National PNM management team accomplishes the following: • Develops processes and tools to better support associates, members and providers. • Designs and conducts training for both providers and the PNM associates who serve them. • Will implement a contract management system designed to eventually track every provider contract – in total about 150,000 contracts. • Provides the tools and mechanisms to analyze our own and our competitors’ performance. PNM works with many • Replaced regional provider surveys with a national survey to departments within the measure provider satisfaction and in response to results, helps conceive, execute and monitor improvement programs. organization to help achieve • Tracks the costs of health care services in an effort to help keep goals and to support Health these costs in check. This extends to providing detailed information on the latest government reimbursement requirements and analysis Net’s growth and profitability. of specific medical costs. • Tracks and monitors the costs and charges associated with new Some good examples of this technology and implantable devices. multi-faceted and broad • Centrally contracts with vendors to develop networks and fee schedules for areas of the country where we currently have no work are outlined here. major business. Thus, traveling Health Net members can still receive timely and cost-effective care. • Provides access to and analysis of coordination of benefits claims. • Creates central purchasing reports and hospital analysis. 4 connections fall-winter 2006
  • 7. Tools to nourish all PNM associates It is National PNM’s role to ensure that associates that work with providers have the information and tools needed to succeed in their jobs. Toward this end, National PNM is developing a comprehensive training program for PNM associates and providers. The training program, to be launched soon, will be a highly usable, accessible and understandable tool designed to build specific skills. National PNM additionally works to strengthen its connection with associates by hosting meetings centering on topics chosen for their educational value. “In 2007, we’ll host a biannual review of our initiatives in January and August,” says Scott. Cultivating provider partnerships invigorates member satisfaction Research shows that member satisfaction is directly influenced by how physicians feel about Health Net. “One of our goals is to be recognized by providers and their staffs as a responsive business partner with whom it’s easy to work,” says Scott. National PNM centralized the regional survey process to better gauge provider satisfaction. This annual survey and its results are now a central, organization-wide tool that replaces regional survey efforts. “Results from the first annual survey show that the vast majority of doctors see their relationship with Health Net continuing on a long-term basis,” says Scott. “They believe that Health Net is committed to working in partnership with physicians to provide quality care – more so than other plans – on a national level.” “In response to the survey results, “In response to the survey results, we are ensuring the we are ensuring the creation of quality improvement plans throughout the creation of quality improvement regions,” says Douglas. “It’s a very exciting plans throughout the regions… time. We are able to target specific things associates and the company can do it’s a very exciting time. We to increase provider satisfaction, which leads to greater member satisfaction are able to target specific things and builds Health Net’s reputation and enrollment.” associates and the company National PNM identified and is addressing three drivers of provider satisfaction: 1) Timely and accurate payment – National PNM is continually upgrading can do to increase provider technology to ensure that associates have the tools to be efficient. satisfaction, which leads to 2) Ease of doing business – For our providers and their office staffs, as well as for PNM associates, Health Net purchased software to build a learning greater member satisfaction management system to provide training that will make it easier to do and builds Health Net’s business with Health Net, mentioned above. 3) Relationships – PNM actively encourages open communication with reputation and enrollment.” providers, such as participation in fair contract negotiations, inclusiveness Douglas Cowieson, vp, National PNM in decision-making processes and responsiveness to provider requests. Detailed survey results are available on the HN Connect Provider Network Management page. fall-winter 2006 connections 5
  • 8. Competitive Intelligence Harvesting information for fruitful planning The foundation of solid planning is competitive intelligence. Recognizing this, National PNM created a program to gather competitive information and share it with the regions and Health Net leadership. “Providing competitive intelligence enables us to be data-driven when developing strategies and continuous quality improvement measures,” says Kristina Rodriguez, director, National PNM. “With tools and information gathered through competitive intelligence, we are Says Kristina, “Our ability to compare a competitor’s better able to pinpoint where we are effective, how network to Health Net’s current provider network is vital we compare to others in the industry and how we to allow us to be truly focused in our network growth can improve.” and development efforts. Using a program through a For example, National PNM reviewed Health Net’s vendor, Strenuus, we are able to compare our networks provider Web portal and compared it to competitors. to competitors at a detailed provider level. This valuable Kristina explains, “We found that providers really wanted information enables our regional PNM associates to identify the ability to obtain prior authorization within our portal. where our current and future members can benefit from As a result, we are now making this capability available. additional network building and improve our network We learned of other areas where we can capitalize on access. This can be the deal clincher if we can show a our strengths and where we need to shore up weaknesses prospective client that we can better serve their member- on the functionality of our Web site.” ship or identify where member care will transfer to if the client chooses Health Net.” Sowing the seeds of affordable access Cutting costs for consumers and the company An exciting National PNM initiative under way is a project poised to produce significant financial savings for Health Net. Specifically, PNM’s vendor – Multiplan – is building an out-of-network (ONET) funnel that will be a dynamic single point of transfer for claims that come in categorized as ONET. When this project is completed later this year, claims from non-participating providers can be routed through a funnel or hierarchy of leased networks. Consider this example: A Health Net member visits a provider and then the provider bills us. Initially, the provider is determined to be out-of-network. By then tapping into the ONET funnel technology, we launch a search to uncover if a contract discount may be available through our leased network arrangements. Quite often, a relationship is uncovered that allows us to pay a negotiated rate, rather than paying full billed charges. The goal, wherever possible, is to pay claims at negotiated rates. “Given that our company-wide out-of-network expense is substantial, the savings opportunity that this provides obviously makes this is a priority,” Scott notes. Another PNM cost-saving initiative that is being developed ensures that we always take advantage of a directly contracted Health Net participating provider discount for services received outside the region where the member is enrolled. Here’s how it works: PNM contractors add into agreements “affiliate language” indicating that the doctor or hospital will honor the same rates for a member affiliated with a Health Net plan from outside their region. For instance, a Connecticut member who visits a California Health Net provider would receive a participating provider discount, just as if they had received care from a participating provider in their home state. 6 connections fall-winter 2006
  • 9. Contract Management System working into the future In 2007, the National PNM team will be configuring a new tool to permit us to store, amend, standardize and report on all provider contracts within the company. This new tool, i-Many Contract Management System, will give Health Net: • A potent disaster recovery program for all of our contracts. • A single repository for contracts accessible anywhere in the country. • Standard contract terms and approved variables from templates available online. • Managed limits of authority to ensure contracts are negotiated and signed according to Health Net requirements. • A single point of entry for contract terms and rates. • Approvals and reviews sent via a single, trackable workflow process. • Simple e-mail routing of edits, amendments, suggestions and attachments within Health Net and externally to our providers. • Role and security-based access to all aspects of our contracts. The development of this new and important tool will commence with Strategic Sourcing by year-end, then moves into a pilot project in New Jersey PNM in early 2007, before unfolding company-wide. “To ensure we deliver the ideal product for all associates, I’m heading a steering committee to oversee the system’s direction and content,” says Bill Lamoreaux, chief operations officer, Health Net of the Northeast. “This efficient new system will improve our workflow, accuracy and service in a way that will make it easier for providers to do business with us, and easier for associates to do their jobs.” The power of PNM Clearly, National PNM plays a pivotal role – one that extends far beyond contracting – in fueling the engine that helps drive Health Net’s growth. From surveying providers to collecting competitive intelligence and keeping company costs in check, National PNM is among the fundamental forces that keep Health Net in the business of delivering the right care, at the right time, in the right place, and for the right cost. fall-winter 2006 connections 7
  • 10. GREAT PLACE TO WORK We Live Here, Too HNOR Rides the Cycling Craze in Portland As Bicycling magazine’s best city for cycling in North America, Portland, Ore., offers countless occasions for cycling enthusiasts to enjoy the sport. The Rose City also is the hub of business for Health Net of Oregon (HNOR), headquartered just outside Portland in Tigard. Working to be known as a leading local health plan, HNOR is tapping into the community’s passions. The cycling scene is a natural fit. For the past two years, HNOR has sponsored one of the city’s annual bike races, the Portland Twilight Criterium. As part of this effort, HNOR also sponsors Team Health Net, America’s top cycling team. For its part, Team Health Net makes it a priority to visit various Health Net offices and events around the nation. “Oregonians are passionate about cycling and the healthy lifestyle that accompanies the sport. The Criterium is a great way to be part of an important community event and to reach active people,” says Matt Gougler, manager, HNOR Marketing. ers itt On Aug. 11, 2006, thousands of spectators jammed the streets as several city blocks were Gr le transformed into a virtual velodrome as cyclists took to the pavement for two fast-paced, Ky 60-minute sprints. Team Health Net’s Garrett Peltonen placed first in the race, with other Team Health Net cyclists right behind in second, third and fourth place. For Health Net, sponsorship is more than banners and signage; it’s also an opportunity to involve associates and members in the action. Free helmets for kids Children and parents rallied to receive free bicycle helmets as part of HNOR’s Heads Up! Bicycle Safety Program. HNOR associate volunteers fit 175 children with the brightly colored helmets, complete with a Health Net reflective sticker. “We want Portland’s children to enjoy a safe bicycle ride this summer,” said Camille Cadran, HNOR volunteer and Quality Improvement manager. (Pictured right.) Camille Cadran, manager, Quality Improvement, fits an excited little boy with a free Health Bird’s eye view for business partners Net bike helmet. On the day of the big race, HNOR’s business partners gathered on the veranda of the Oregon Historical Society, one of the course’s prime viewing areas. HNOR treated local brokers, employer groups and community contacts to a reception that included a visit by Team Health Net. The race offered a unique opportunity to build relationships Sweeping the Criterium: Team Health Net with business contacts in a relaxed environment where Health Net rider Karl Menzies took 4th place after was prominently featured. “Oregon is an extremely competitive teammates Garrett Peltonen (1st), Kyle marketplace and the Criterium was a way for us to raise Health Gritters (2nd) and Greg Henderson (3rd). Net’s profile and show appreciation for our local partners,” says Janice Finley, manager, Cindy Fineran, vice president, HNOR Sales. Finance, buckles a girl’s free Health Net bike helmet. For more information: http://www.teamhealthnet.com/news/2006/HNCriterium.html 8 connections fall-winter 2006 summer 2006 connections 12
  • 11. GROWTH N Health Net Ramps Up OR to Attract Members Regional plans roll out innovative solutions While America is a nation of 50 united states, each member of this union is unique from a market perspective. It only makes sense, then, that our union of health plans – Health Net of Arizona, Health Net of California, Health Net of the Northeast and Health Net of Oregon – must develop strategies and products designed to dovetail with the unique needs of their NE OR local markets. As you will see on the pages that follow, each has done just that; and while their approaches vary, each plan shares the common goal OR of increasing commercial growth. Health Net also continues to focus on the growth of our other revenue- generating lines of business, such as Medicare, Medicaid, MHN, Pharmacy and Health Net Federal Services (HNFS). Look for upcoming coverage in subsequent issues of Connections. NE How the Regions Stack Up OR Medical Membership (as of September 30, 2006) Premium Revenues (in thousands) includes Commercial/ASO, Medicare and Medicaid (as of third quarter 2006) California Total Premium Revenues $1,647,806 Total Medical Membership $3,249,478 3,384,719 51% Other: MHN, HNFS and California Senior Products Oregon 2,298,160 $698,331 $145,823 68% 21% 5% Oregon Arizona Northeast 154,875 Northeast Arizona $162,524 776,836 154,848 5% $594,994 5% 23% 5% 18% Editor’s Note: Health Net’s HMO, POS, insured PPO and government contracts subsidiaries provide health benefits to more than 6 million individuals in 27 states and the District of Columbia through group, individual, Medicare, Medicaid, TRICARE and Veterans Affairs programs. Health Net’s behavioral health services subsidiary, MHN, provides behavioral health, substance abuse and employee assistance programs (EAPs) to approximately 7.3 million individuals in various states, including the company’s own health plan members. Health Net’s subsidiaries also offer managed health care products related to prescription drugs, and offer managed health care product coordination for multi-region employers and administrative services for medical groups and self-funded benefits programs. fall-winter 2006 connections 9
  • 12. HEAL NET of OREGON (HNOR) TH NE PA OR Originally founded in 1938 as PACC Health Plans, HNOR is today among the Pacific Northwest’s leading health plans, with one of the region’s strongest and most extensive health care networks. Commercial Market Strategy HNOR Medical Membership HNOR is entering the second year of a two-year (as of September 30, 2006) includes strategy to break into the Individual market. The Commercial/ASO, Medicare and Medicaid primary target is young families in the Portland area 154,875 = 5% of Health Net total (population 1.7 million). In addition, Individual and Family Plan (IFP) products will be marketed statewide through a television campaign and direct mail this winter targeting brokers, rural residents and early retirees. Because online shopping is so popular in Oregon, IFP products are sold through eHealth Insurance, which generates 20 to 45 percent of HNOR’s monthly applications – a unique situation in Health Net. Beyond good service, to attract new business HNOR relies on a broad network and value-added options, such HNOR Premium as extensive wellness program offerings, Decision Power, Revenues (in thousands) as of Q3 2006 Successes Web tools, and a new dental and vision package. $145,823 = 5% of Health Net total HNOR successfully expanded its commercial business statewide and into HNOR in the market Washington State in 2005. IFP is launching statewide in Oregon this winter. HNOR provides group, individual and Medicare health plans, including PPO, HMO, POS and traditional indemnity plans, as well as the region’s first Medicare Advantage PPO. HNOR offers alternative care (chiropractic, acupuncture, naturopathic medicine and massage therapy) as a core benefit in group and IFP. HNOR also offers group prescription drug, vision and dental coverage. HNOR is entering the second year of a successful two-year strategy to break into the Individual market. The primary target is young families in the Portland area (population 1.7 million). Online shopping is popular with this crowd, generating 20 to 45 percent of HNOR’s monthly IFP applications. 10 connections fall-winter 2006
  • 13. SALES ENVIRONMENT HEADQUARTERS Tigard, Ore. Sales Network: 622 appointed independent brokers 300 associates Major competitors: Blue Cross Blue Shield of Oregon, Kaiser, Providence Health Plans, LifeWise ENROLLMENT Competitive Landscape: PPO is a very popular option in Oregon, with 79 percent of HNOR’s membership in PPO 154,875 medical members in plans. This market is extremely competitive, with eight Oregon and Washington State carriers fighting for commercial membership as of September 30, 2006 New or enhanced releases: LEADERSHIP Stephen Lynch, president, IFP Plans Regional Health Plans • Dental & Vision Plan Option – A unique combined $30 rider Chris Ellertson, regional health members can easily add to their IFP. It’s in demand, and plan officer competitors offer one or the other, but not both. • Gemstone Portfolio – Introduced in fall 2005 (Pearl 25 HMO, Diamond 15, Emerald 40, Garnet 50, Crystal HDHP). This IFP PHYSICIAN NETWORK portfolio offers a wide range of HMO and PPO options and is aggressively priced to draw new IFP members and migrate 23,000 physicians existing members. • Topaz First Dollar – For fall 2006, this competitively priced package features alternative care services and an immediate spending account of $250 – before the deductible applies – for chiropractic, acupuncture, massage therapy, naturopathy FA C I L I T I E S N E T W O R K and preventive care. 135 hospitals Commercial Plans 1,608 retail chain and • Rx Plus – Four pharmacy plans being introduced to groups of independent pharmacies 51+. Rx Plus’ primary selling point is that its plans have a “lighter” or less stringent prior-authorization requirement, for which a 10 percent additional premium will be charged. • PPO Fifty Plans – Targeted toward small groups, this is an C U S T O M E R S E R V I C E S TAT S employer’s most affordable option. These plans offer a simple design coupled with an affordable price and feature 50 percent cost share on all eligible services, On average, processes more than with no deductible for in- or out-of-network services. 4,500 claims and responds to The plans pay 100 percent of catastrophic expenses 1,500 calls per day after the out-of-pocket maximum is reached. fall-winter 2006 connections 11
  • 14. HEAL NET of CALIFORNIA (HNCA) TH Health Net’s largest health plan, HNCA is one of the largest network-model health plans in California. Health Net’s unique California model of organized care delivery drives physician behavior and allows for coherent management of care, quality and resources. HNCA Medical Membership Commercial Market Strategy (as of September 30, 2006) includes Commercial/ASO, Medicare and Medicaid 2,298,160 = 68% of Attracting smaller businesses (2 - 250 employees) is a top Health Net total goal, along with building the PPO network and increasing the number of PPO members. HNCA is focused on: • Retaining membership in organized care delivery. • Developing products emphasizing patient choice: Health Savings Accounts (HSA) banking arrangements and consumer directed/organized care. NE • Building broker relationships. OR Successes • Continuing targeted advertising. PA After several years of commercial membership losses, HNCA HNCA Premium has seen a return to growth in Small Group, Mid-Market and Revenues (in thousands) as of Q3 2006 Individual and Family Plans (IFP), since the end of 2005, both $1,647,806 = 51% of organically and due to the Universal Care acquisition. Health Net total • IFP is up 14 percent to nearly 92,000 members. • Small Business Group is up 12 percent to nearly 320,000. • Mid-Market is up 9 percent to just over 404,000 members. • Commercial, POS and Medicare lines of business received NCQA “Excellent” accreditation status. After several years of commercial membership losses, HNCA has seen a return to growth in Small Group, Mid-Market and Individual and Family Plans (IFP), since the end of 2005, both organically and due to the Universal Care acquisition. 12 connections fall-winter 2006
  • 15. SALES ENVIRONMENT HEADQUARTERS Woodland Hills, Calif. Sales Network: 10,000 appointed independent brokers and agents; 8,500 have business placed with HNCA More than 2,700 associates in 17 locations throughout Major competitors: Blue Cross of California, Kaiser, California Blue Shield of California, PacifiCare/United Health Care, Aetna, Cigna ENROLLMENT Competitive Landscape: While the majority of 2,298,160 medical members California businesses are small (2 - 250 employees), a as of September 30, 2006 significant number of people are employed by mid-sized and large companies. Both HMO and PPO health care costs in California are significantly lower than in most other parts of the country. This attracts employers as a LEADERSHIP good value, even with the state’s higher housing costs. HNCA is the state’s fourth largest health plan Stephen Lynch, president, Regional Health Plans Patricia Clarey, chief operating HNCA in the market officer, HNCA HNCA offers coverage for vision, dental, life insurance*, chiropractic and alternative medicine; HMO, POS, PPO, PHYSICIAN NETWORK Medicare, Healthy Families and Medi-Cal plans in the individual and family, senior, small (2 - 50), mid-market (51+ distributed 51,000 physicians by brokers) and large group (those groups represented by New or enhanced releases: consultants, including Labor & Trust) markets. • Small Business Group (SBG) – In May 2006, launched four FA C I L I T I E S N E T W O R K new benefit plans - HMO 10, HMO 30, PPO 25 and PPO 35 – resulting in 7,750 new members for SBG – an increase of 300 PPO hospitals 2.3 percent. 260 HMO hospitals • EZAccess HSA – Introduced in July, connects an HSA plan with 5,000 retail chain and a Wells Fargo HSA account via a debit card. Allows members independent pharmacies to take control of their health care purchases with a savings account they own and control. Builds on existing HSA plan membership, which has grown 183 percent since the begin- C U S T O M E R S E R V I C E S TAT S ning of the year, and now totals more than 9,000 members. • HMO Silver Network – In 2005, created a select network On average, processes 20,000 of cost-efficient providers. Enables employers to reduce claims and responds to 25,000 premiums by 8 to 15 percent. Concept continues to build calls each day sales momentum, as membership has grown to nearly 11,000, a 108 percent increase since the beginning of 2006. * Offered by HN Life Insurance Company and administered by Health Net of California. fall-winter 2006 connections 13
  • 16. HEAL NET of ARIZONA (HNAZ) TH Celebrating 26 years of meeting Arizonans’ health plan needs, HNAZ has been ranked the No. 1 HMO for two years running by Ranking Arizona magazine. Commercial Market Strategy HNAZ Medical Membership (as of September 30, 2006) includes Commercial/ASO, Medicare and Medicaid Overcoming a lack of name recognition and other market 154,848 = 5% challenges, HNAZ is in the second year of an effective three- Health Net total year period of recovery, organized around a strategy dubbed “Raising Arizona.” Committed to being innovative and offering a comprehensive product menu, HNAZ recognizes that maintaining a stable cost and pricing position is critical. To support growth, HNAZ is: • Making a significant investment in targeted marketing and advertising. NE • Keeping expenses in check. • Meeting membership goals. HNAZ Premium PA • Improving contracting and network medical management, products and services. Revenues (in thousands) as of Q3 2006 $162,524 = 5% • Segmenting the group market to identify areas that offer Health Net total the greatest opportunity for growth. • Focusing sales and marketing efforts on the brokerage community as it Successes controls more than 95 percent of targeted business. HNAZ has: • Undertaken significant community outreach efforts that are effectively building brand recognition. • Attained price stability and offers a portfolio of products that meet consumer needs. • Been rewarded with recaptured business due to discipline and operational improvements over the past two years, such as claims payment accuracy and timeliness. • Implemented UNITY, a software program that tracks Medical Management results. • Achieved an “Excellent” accreditation rating from NCQA. HNAZ is in the second year of an effective three-year period of recovery, organized around a strategy dubbed “Raising Arizona.” With more than 95 percent of desired business controlled by the brokerage community, the focus is on capturing this audience as a means to gaining membership. 14 connections fall-winter 2006
  • 17. SALES ENVIRONMENT HEADQUARTERS Tempe, Ariz. Sales Network: 3,000 appointed independent brokers 300 associates in Tempe and Tucson. Major competitors: Blue Cross Blue Shield of Arizona, Operations (claims, membership, Humana, LifeWise, Aetna, Cigna, United member and provider calls, etc.) are handled out of the Shelton, Competitive Landscape: Arizona, with two major Conn., office by 250 associates metropolitan centers – Phoenix and Tucson – is America’s second fastest growing state. It is home to a large, underserved population, as fully one-third of Arizona’s ENROLLMENT residents are either uninsured or on Medicaid. HNAZ is the state’s fourth largest health plan 154,848 medical members as of September 30, 2006 HNAZ in the market LEADERSHIP HNAZ offers coverage for vision, dental, life insurance*, Stephen Lynch, president, chiropractic and alternative medicine; Individual and Family Regional Health Plans (HMO and PPO); Employer-sponsored Plans (HMO, PPO, POS Mark El Tawil, president, HNAZ Plus and Indemnity); Medicare Advantage HMO; Medicare Supplements; Multiple Option and National Provider Network PHYSICIAN NETWORK New or enhanced releases: access for PPO and POS Plus products. 5,673 physicians • Empowerment for a Healthier Life Style HMO and PPO plans: Includes Decision Power SM to help members be informed and confident in their medical care decisions; and It’s Your Life to help members deal with personal or family challenges. • High-Deductible Health Savings Account-compatible PPO: FA C I L I T I E S N E T W O R K With lower premiums, tax benefits and control over health care dollars, this product is designed to appeal to a variety of 57 hospitals health care consumers. 1,000 retail chain and • Broker tool kit: Created as part of an initiative to strengthen independent pharmacies broker communications and to make doing business with Health Net easier, this kit includes a CD loaded with forms, collateral, streamlined underwriting guidelines and other useful tools, including a handy palm-sized tool kit that C U S T O M E R S E R V I C E S TAT S brokers can keep in their glove boxes. • eHealth online search tool: In an effort to increase its On average, processes 5,000- opportunity for selection, HNAZ contracted with eHealth 6,000 claims per day and to obtain priority placement in search results for Individual responds to more than and Family Plan shoppers. 2,000 calls each day *Offered by Health Net Life Insurance Company and administered by Health Net of Arizona. fall-winter 2006 connections 15
  • 18. HEAL NET of the NORTHEAST (HNNE) TH NE For the past 30 years, HNNE – one of the PA largest health plans in the Northeast – has offered a wide array of full-service health plans in the tri-state area. Commercial Market Strategy HNNE Medical Membership (as of September 30, 2006) includes Commercial/ASO, Medicare and Medicaid Facing intense competition, HNNE’s goal is to become a 776,836 = 23% leading local health plan with an overall emphasis to execute Health Net total a “customer solutions” strategy. HNNE returned to profitability and renewed growth in 2005 and 2006 through brand investment, an updated product portfolio, accurate pricing and leaner plan designs with lower price points and by focusing on fruitful geographies. Small and mid-size businesses remain the primary commercial targets in all three states, along with Medicare in Connecticut and New York. In New York, the focus is to build on momentum and return to growth. In New Jersey, the task is to achieve a competitive cost structure and return to growth. HNNE Premium Revenues To grow enrollment, HNNE is introducing an array of new, (in thousands) as of Q3 2006 highly competitive products and providing enhanced benefits $594,994 = 18% to members. Consumer-driven health plans also are in the mix, Health Net total Winning Priorities along with enhancing self-insured product capabilities. HNNE is successfully executing a multiple-year improvement plan by employing five winning priorities: 1. Achieve profitable growth through execution of superior “customer solutions” strategies. 2. Deliver excellent service to customers, providers, regulators and to each other. 3. Achieve competitive health costs. 4. Deliver the analytics that drive insightful business decisions. Successes 5. Establish HNNE as a great place to work. • Re-establishing gross margins in the business, a basis for stability and long-term growth. • Retaining customers, a sign of improved enrollment stability. • Recontracting with all hospitals and improving health care costs versus the competition. • Launching new products such as the integrated Health Savings Account (HSA) with Wells Fargo. • Growing membership in target segments. • Achieved an “Excellent” accreditation rating from NCQA and was awarded “Quality Plus Distinction” in NCQA’s Member Connections rating category for effectively engaging members in their own care, especially via the Web. 16 connections fall-winter 2006
  • 19. SALES ENVIRONMENT HEADQUARTERS Shelton, Conn., for business Sales Network: 3,400 appointed independent brokers conducted in Connecticut, and agents and 1,600 agencies New Jersey and New York. Major competitors: Approximately 1,800 associates Connecticut: WellPoint (Anthem); in five locations in Connecticut, Oxford/UnitedHealthcare; ConnectiCare New Jersey, and New York New Jersey: Oxford/UnitedHealthcare; Aetna; Horizon Blue Cross Blue Shield of New Jersey ENROLLMENT New York: Oxford/UnitedHealthcare; Aetna; WellPoint (Empire Blue Cross Blue Shield of New York) 776,836 medical members as of September 30, 2006 Competitive Landscape: In the New York market, Connecticut 368,900 HNNE’s focus is on small businesses. In New Jersey, New York 239,547 both small- and mid-size businesses are prevalent. New Jersey 168,389 In Connecticut, mid-size businesses have been the primary target, but now attention is being turned to LEADERSHIP the small-business market as well Steve Nelson, president, HNNE HNNE in the market Bill Lamoreaux, chief operations officer, HNNE The Northeast health plans offer HMO, POS, PPO and self- insured options to local and multi-region employers with small, mid-sized and large businesses, and Medicare and Medicaid for New or enhanced releases: individuals, families and seniors. PHYSICIAN NETWORK 80,000 physician and professional • Outlook - Portfolio of preferred plans characterized by higher providers representing more than member cost sharing, stringent underwriting guidelines and 150,000 office locations competitive pricing that provide solid, basic coverage at extremely attractive price points. Launched EPO and POS plans for small group in New York and will add for re-entry FA C I L I T I E S N E T W O R K into New Jersey and update of products in Connecticut. 250 hospitals • HSA - Implemented for small group in Connecticut and New York. Expanded portfolio of consumer-directed plans and offers 5,500 retail chain and low-cost alternative for employers. An HSA debit card also was independent pharmacies instituted across the tri-state middle-market segment. • Health Reimbursement Arrangement (HRA) - Integrated HRA product in the tri-state region that will allow HNNE to better C U S T O M E R S E R V I C E S TAT S compete with major market players. To be launched first quarter of 2007. On average, processes 40,000 claims per day; responds to HNNE returned to profitability and renewed growth 10,000 phone calls per day in 2005 and 2006 through brand investment, an updated product portfolio, accurate pricing and leaner plan designs with lower price points and by focusing on fruitful geographies. fall-winter 2006 connections 17
  • 20. PERFORMANCE Debunking the myth of Health Insurance Company Profits People perceive health care profits to be 51 percent of skyrocketing costs. Fact is, profits are only 3 percent. ccording to a recent study conducted by Public Opinion Strategies, consumers believe the profits of health A insurance and pharmaceutical companies are a main factor driving increases in health care costs. A survey of 800 adults revealed that Americans estimated typical health insurance company profits at a whopping 51 percent of health care spending – a gross misperception. The truth, as illustrated below, is that health insurance industry profit is only 3 percent; that’s 3 cents on the dollar. Health Net is working to bust the 51 percent myth by partnering with America’s Health Insurance Plans (AHIP) to educate decision makers and the public about the realities of rising health care costs, and by doing our part to stem the tide of rising costs with innovative solutions. Profit Where Does 1 Dollar of a Health Net Selling costs Member’s Premium Go? The answer is, Health Net* spends 85 cents of each G&A premium dollar on patient medical care. Only 3 cents (cost of running the company) is company profit. Ancillary Services Drugs 38¢ Hospital 33¢ Physicians 10¢ 4¢ 10¢ 2 3¢ 85¢ 12¢ 3¢ Member health care costs SG & A Profit costs * Health Net is in line with benchmarks in the industry based on a PricewaterhouseCoopers’ analysis for AHIP, Factors Fueling Rising Healthcare Costs 2006. 18 connections fall-winter 2006
  • 21. mhn still aiding recovery efforts After the killer storm struck America’s Gulf Coast, the U.S. Navy relied on the ready resources of Health Net’s behavioral health division, MHN T rying not to panic her two preschoolers, the young mother hurriedly loaded her mini-van with bare essentials – clothes, blankets, water, a family photo album. It was Aug. 29th of last year, and Hurricane Katrina was barreling toward the Biloxi home that she and her husband – a petty officer in the U.S. Navy – had Actual MHNGS cases purchased just weeks before he shipped out to Iraq. Recently MHNGS’ Gulf Coast team shared some actual cases they encountered post-Katrina. Here are just two When the young mom returned days later, she of their many stories: discovered that Katrina had devoured their home. She wasn’t alone. In fact, hundreds of Navy families • Just months after losing his house to Katrina, this A Year After Katrina had to simultaneously contend with the uncertainty that looms when a loved one is at war coupled with the overwhelming devastation brought to the southern MHNGS client lost his wife to a terminal illness. Adding further stress was the fact that his wife passed away out of town, but was buried locally. Tracking down her MHN Still Aiding Recovery Efforts U.S. by three hurricanes, Katrina (August), Rita (September) death certificate – which the man urgently needed for and Wilma (October). Fortunately, they had somewhere her life insurance policy and to apply for financial aid to to turn: Health Net’s Managed Health Network rebuild his house – thus became a significant challenge Government Services (MHNGS). that only added to the man’s psychological and Navy turns to MHNGS financial stress. Although it wasn’t part of her job, The Navy, which has installations throughout the hard an MHNGS case manager ran interference and quickly hit Gulf Coast region, quickly realized that its internal solved the problem. She also referred the man to a resource – called Fleet and Family Service Centers – grief counselor and continues to monitor his progress. couldn’t alone respond to the massive need left in Katrina’s wake. The Navy turned to MHNGS. • For this MHNGS client – a 26-year-old marine – Katrina left him with both an aching heart and a bulging And MHNGS, which operates under a Department of waistline. His heart ache stemmed from separation. Defense subcontract, readily responded. In short order, MHNGS initially dispatched 25 clinicians and financial The storm shredded the house he shared with his counselors to installations throughout the Gulf Coast, wife; until they could rebuild, he had to live on base, Florida and Tennessee (many hurricane victims were and she with her parents some distance away. The evacuated to the latter). combined stress of Katrina’s devastation and his wife’s absence led the marine to munch more than “This team of associates is still working with the Navy usual. In fact, he packed on enough pounds to threaten in the Gulf Coast, and will continue to do so through his continued enlistment. A skilled MHNGS clinician the end of the year,” explains Elaine Shelub, manager, armed the young man with an arsenal of stress- MHNGS. These associates’ hard work hasn’t gone unnoticed. “Directors of the Fleet and Family Service reduction techniques that enabled him to cope Centers have repeatedly commented what an outstanding while simultaneously cutting calories. job our people have done, particularly in relation to outreach and being a great source for referrals.” Clients can take comfort While it will likely take years for the battered Gulf Coast to completely rebound, at least those hurricane victims who are MHNGS clients can take comfort in See HN Connect for an update on the Health Net associate who lived knowing that caring clinicians and counselors stand through the storm, Karen Williams, MHNGS victim advocate in ready to serve. Gulfport, Miss., and more MHNGS case stories from the recovery zone. fall-winter 2006 connections 19
  • 22. GROWTH Rolling Out an Array of Senior Products: New plans, new geographies, new advertising A perspective from Sam Srivastava, chief senior products officer Our continuing strategy is ‘Simplicity is the pathway to trust’... meaning, if we can make it simple for seniors where no one else can, we will build their trust in us and encourage them to consider Health Net. We are taking the consultative approach – let us help you understand what you have today, how our plans compare, and let us do it in a way that best meets your needs – at a group seminar, over the phone, or we’ll even come to your house if you’d like, in our core markets. For 2007 and beyond, Health Net will expand its markets and, based on our success in Arizona, plans to develop more retail storefronts in California, Oregon, New York and Connecticut. We’ve enhanced and streamlined our products with revised and improved collateral that is color-coded and easy to understand. We’re introducing new fall advertising to boost name recognition and generate qualified leads that will drive sales. Color-coded plans make it simple Available in all 50 states and Arizona, California, the District of Columbia Oregon Orange - Stand-alone Prescription Brown - Medical Coverage Drug Plan features generic and brand- Medicare Supplement Plan with name drugs. There are three plans to a slightly higher premium than choose from; two of the plans offered other plans in exchange for the come without a deductible so that convenience of not having to pay members are covered from their very charges when you visit the doctor first prescription, and one plan offers and the freedom to see any doctor generic drug coverage with no “doughnut who accepts Medicare. hole” gap. Oregon, Washington State Arizona, California, Aqua - Medical-only Plan that gives Connecticut, New York members the freedom to see any doctor Amber - Medical and Drug nationwide who accepts Medicare. Coverage Plan for Medicare/Medicaid dual-eligible individuals who qualify under the government’s financial guidelines; features costs that may be greatly reduced or even eliminated. 20 connections fall-winter 2006
  • 23. Arizona, California, Arizona, California, Connecticut, New York Connecticut, New York Green - Comprehensive HMO Medical Ruby - HMO with combined Plan with a $0 monthly plan premium medical and drug coverage. and minimal copayments for doctor visits and other services. Connecticut Arizona Navy - Medical and Prescription Drug Sage - Medical and Drug Plan Plan with affordable copayments for with automatic enrollment into in-network services; for a higher cost, our disease management program allows subscribers to see physicians for members with coronary artery outside Health Net’s network who disease or high cholesterol, at no accept Medicare. extra cost. California, Connecticut, Arizona, California, Hawaii, New Mexico, New Oregon, Washington State York, Texas, Washington State Violet - Combines medical Pearl - Our newest offering, a Private and drug coverage with simple Fee-for-Service Medical Plan that gives copayments for doctor and members the freedom to see any hospital visits, no matter which doctor who accepts Medicare. Only doctor you see. Connecticut has an option that also includes drugs for a higher premium. Why nearly half-a-million people already have chosen Health Net Medicare plans. — Excerpted from the new Medicare Collateral “We tailor “We show our services “We make you what “We give you understanding your costs may “We strive for to Medicare Decision our plans easy.” be before you the highest beneficiaries Power SM.” quality care like you.” sign up.” possible.” fall-winter 2006 connections 21
  • 24. The Making of a Great Place to Work Beginning our journey – and why it’s important. Thanks to you, Health Net is building a better company. Our solid performance and budding growth prove it. Now, we’ve set our sights even higher. Jay Gellert, president and chief executive officer, stated as much with the launch of this year’s associate survey, saying, “Becoming better is important. Becoming great is our goal.” We want to become a great company – and a Great Place to Work. “These two goals are very interconnected,” says Karin Mayhew, senior vice president, Organization Effectiveness for Health Net. The proof: “The companies that earn a place on Fortune magazine’s ‘100 Best Companies to Work for How are we making Health Net a Great Place in America’ consistently outperform their competitors.” 1 to Work? Research aside, it seems obvious that the way people “It begins with our attitude – we must be willing to are treated makes a difference in how they perform. It’s exchange ideas, and not be afraid to ‘show our work’ not surprising then, that studies have shown that over and share honest evaluations of what we are striving time, companies appearing on the “100 Best Places to to accomplish,” says Karin. “We need to be willing to Work” have competitive advantages. examine and identify where we are now – and see how What are these competitive advantages? it matches up to where we need to go.” Besides being a place employees look forward to going “Remember,” notes Jay, “becoming great is a journey every day, being a Great Place to Work has a host of that all of us at Health Net are undertaking to achieve up sides: the goal we’ve agreed upon: to be a great company that • more qualified people want to work there supports associates and serves customers well. We’ve • lower turnover begun, but we aren’t there yet. My personal goal is that we won’t have to ask ‘are we there yet?’ for long – the • higher levels of customer satisfaction and customer loyalty results will speak for themselves.” • greater innovation, creativity and risk taking Here are just a few examples of what Health • higher productivity, and Net is doing to build a Great Place to Work. • reduced health care costs Focus on people: We pay for performance, and we What makes a Great Place to Work? single out examples of outstanding associates and “At the heart of it is creating a work environment praise their good work. where associates trust the people they work for, have • Examples: The Heart & Soul Recognition Awards pride in what they do and enjoy the people they work program; SPOT Awards; HNFS STAR Program; with,” explains Karin. Associate Place features on HN Connect; Service The common theme: quality relationships ... relationships Anniversary Awards; and numerous other department between associates and management … between associates and business unit recognition programs that let and their jobs … and among associates themselves. associates know they are valued and appreciated. 1 2006 Great Place to Work® Institute, Inc. 22 connections fall-winter 2006
  • 25. Focus on tools and processes: Health Net is improving ance reviews, while others are online like the TALEO its tools to manage our work and support our people. staffing system. COMPASS will link all of this together Many initiatives are facilitating greater performance electronically. Health Net will have a centralized, and growth, as well as improving associate engagement. easy-to-use, desktop resource that lets us evaluate • Examples: ITG’s Workstation Refresh Program; the the strengths of our people, provide development new Macess.EXP electronic document management opportunities to grow their careers – and enable us system; UNITY case management system; the to see what other talents need to be honed to make TALEO applicant tracking system; Connections us great. There will be tools for managers, and tools magazine and video capability on HN Connect. for all associates. “Setting our 2007 goals using COMPASS is a key step,” Look for more examples from the regions Andy explains. “It will allow Health Net to capture, in future issues. compare and share what we’re doing individually, Next: COMPASS, our Talent Management within business units and across the enterprise – to System ‘align our goals’ – so that we’re all rowing in the same Having the right people … making sure we support direction and not duplicating effort.” one another and our performance goals … developing Ultimately, this will help us make the best use of our our skills … paying for performance … planning and associates’ talents and achieve our performance goals. building for future talent needs – these are the Being able to identify and integrate associate components of Talent Management. goals and clarify accountability is something “Associates are our talent, and we need to be able associates have consistently mentioned in Health to make the most of what you offer and your Net’s Annual Associate Survey. Addressing this development potential,” says Andy Ortiz, vice concern also directly responds to recommendations president, Talent Management and Leadership from the work teams from last year’s Leadership Development. “To help us do that, this fall we’re Summit. introducing Compass, a comprehensive, integrated This is another reason for associates to participate Talent Management System. It will be rolled out in in the annual survey process – to make sure you phases – we’ll all begin using Compass for our 2007 share your perspective and ideas about how to goal-setting process.” make Health Net a Great Place to Work. Right now, Health Net has separate tools, separate Look for more about COMPASS, the new Talent processes for managing our people. Some processes Management System, on HN Connect. are paper-based, such as goal setting and perform- fall-winter 2006 connections 23
  • 26. Defining what we stand for Community: Health Net and our associates care about the communities they serve … How? Katrina Walking the Talk relief support, contributions to the Pentagon Memorial Health Net is demonstrating the value we place Fund, sponsorship of Celebration of Children, Kick It on the lives of our associates, our customers and With Health Net in California, Habitat for Humanity our communities. in the Northeast, United Way in Arizona, and many Associates: We provide a wide range of benefits more. See page 8, We Live Here, Too, and Capturing to meet associates’ diverse needs, including medical, Kindness at Health Net on page 2. dental, life and disability insurance, PTO, a brand- new online discount program to support work-life balance, educational reimbursement, health club Health Net is determined to reimbursement, referral bonuses, as well as a 401(k) Savings Plan with match and new investment be a company with lasting options. Enhancements to several of these programs will be announced in 2007. performance in the industry, Customers: iBilling for Individual and Family Plan and companies that achieve customers on www.healthnet.com is just the latest example of our “customer solutions” strategy – to this pay attention to those become the health care company that uniquely who make it happen – their understands and serves its customers with the solutions they need. employees. Health Net is committed to doing just that. Imagine … here’s the associate experience we aspire to create by improving our work climate and building our reputation as a Great Place to Work … “The company takes care of the people, and “Management truly encourages and expects the people in turn take care of the profits.” individuals to care for themselves outside of “Personal and professional opportunities are work. They understand that quality personal many. The company is always striving to improve lives contribute to doing a good job.” itself and at the same time giving individuals the “This is a great place to work because people motivation and encouragement to achieve their care about each other. It doesn’t seem so much desires.” like work when you are surrounded by people “Every morning I wake up excited to get to work who care about you as an individual.” and do the best I can for a company that really “I feel I make a difference. My job allows me appreciates it.” latitude to make decisions and implement them “I always strive for the best results, but I am not in order to get the job done. At the end of the afraid to make mistakes, which allows me to be a day, I can look back and see what I have been able risk taker. I am able to explore my ideas at this to accomplish with a great feeling of satisfaction.” company.” 24 connections fall-winter 2006