This section contains answers to frequently asked questions on a variety of topics. You may select one of the topics or questions below, or simply scroll down to read all of the questions and answers.
Enrollment
Contact
Advantages
Release of Information
Web Site Issues
If you need answers to other questions, or need to ask about a specific plan and benefits please contact us.
Enrollment
How do I become appointed/licensed to sell Optima Health products?
Optima Health Plan (OHP) and Optima Health Insurance Company (OHIC) require that all Agents/Brokers and Agencies be appointed before the release of any marketing materials, proposal quotes, or information regarding new and existing business. Appointments with OHP and OHIC are not guaranteed. All requests are subject to review and approval of designated OHP and OHIC management. Contact Us for more information
What products do you offer?
Optima Health offers a full suite of commercial products including consumer-driven, employee-owned and employer-sponsored plans, individual plans, employee assistance plans and plans serving Medicare and Medicaid enrollees.
- Plans for Large Groups: We define large groups as employer groups with 100 or more eligible employees. Our standard Optima Vantage (HMO), POSA, Optima Plus (PPO) as well as Consumer Directed Health Plans (CDHPs) plan designs and funding arrangements may be offered, or they may be customized depending on the size, needs and resources of the group.
- Plans for Small Businesses: Small businesses are defined as companies with two to 99 eligible employees. Our standard plans listed above are available with a range of coverage levels, deductibles and copays. Optima eBroker empowers small group brokers with the tools they need to manage Optima Health small group business.
- Referral Products: You may be able to help employers who have low wage earning employees find a way to provide coverage for their eligible children through the State of Virginia's FAMIS program. Optima Health pays no commission or referral fee connected with this program. If you uncover this need, have them call 757-552-8975 or 800-881-2166.
- Individual Plans
- Medicare Plans
*Optima Health is the trade name of Optima Health Plan, Optima Health Insurance Company, and Optima Health Group, Inc. Optima HMO products, related Patient Optional Point-of-Service products, Point-of-Service products, and Open Access products are underwritten by Optima Health Plan. Optima Preferred Provider Organization products are underwritten by Optima Health Insurance Company. Self-funded plans are administered by Sentara Health Plans, Inc.
More information about Optima Health Products can be found on the Health Plan Products page.
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Contact
Who are the appropriate contacts for large and small, peninsula and southside business?
Brokers who have been assigned to a general agent should contact that agent with any questions or concerns. See our Contact Us page for all other inquiries.
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Advantages
What is your commission schedule?
Optima Health will pay commission to any broker who is appointed with Optima Health, in good standing with the Bureau of Insurance and is designated as the agent or broker of record by an employer group. For more information refer to Optima Health’s Broker Guide or contact your general agent.
Do you offer bonus programs?
Yes.
What cities/areas are included in your service area?
Use our search tools to determine health plans offered in your area.
How do you accommodate members located outside of Hampton Roads?
Employees who reside and work outside of the service area, or spend more than 90 consecutive days for business purposes outside of the service area, (foreign travel excluded) can be included in the quote and will be offered an Out-of-Area PPO plan. See your Broker Guide or contact your general agent for more information.
How can I get marketing materials?
Many of our broker marketing resources are available online. Appointed small group brokers can use eBroker or contact their general agent to secure marketing materials. Due to the unique nature of large group sales, large group brokers may obtain marketing materials from their Optima Health account representative.
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Release of Information
What is a Release of Information and why is it required?
Federal and state privacy laws require us to obtain a Release of Information/Authorization of Designated Agent form whenever anyone other than the member needs to obtain and/or change the member’s health information. This form must be signed, witnessed and returned in order for it to be in effect.
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Web Site
What is eBroker?
eBroker is the interactive, secure portal that enables Optima Health small group brokers to manage their book of business, access proposals, and stay informed about the latest issues affecting Optima Health and the health insurance industry.
What forms can I get on the Web site?
Visit Broker Resources or eBroker for a complete list of forms available.
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