ExchangeAdministrativeMedium impact
22-927m Updated Letter Templates for Coverage Suspension for Enrollee Using APTCs
Health Net·CA·Prior Authorization
Effective date
Nov 4, 2022
We identified it
Jun 20, 2026
Summary
HealthNet California updated letter templates for notifying providers when coverage is suspended for enrollees using Advanced Premium Tax Credits (APTCs) who haven't paid premiums during the grace period. The update includes new Type 3B and Type 4 letter templates for claims look-back and authorization rescission processes.
Action Required
Immediately: Billing team should download and implement the updated letter templates (Type 3B–APTC Claims Look-Back and Type 4–APTC Authorization Rescind) from the HealthNet provider library. Use these templates when notifying about coverage suspensions for APTC enrollees during the three-month grace period. Update any existing template files in your system.