Employer groups may now provide their most recent prior carrier billing statement as verification of prior coverage for their employees.
Any employees listed on the most recent prior carrier’s bill, and who are enrolling on the Optima Health plan in the same coverage tier (subscriber, subscriber + spouse, subscriber + 1 child, etc), will be given 12 months of credit towards the pre-existing condition limitation.
Optima Health will no longer require a 12 month prior bill be submitted in addition to the most current prior carrier bill.
If an employee is enrolling on the plan and is not listed on the prior carrier bill, certificates of creditable coverage will be required to verify periods of prior coverage.
This change applies to all small groups (2 – 99 eligible) for all plans; and large group (100+ eligible) PPO plans.
Questions? Contact Us.
