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BusinessEDGE ®Now Available to Employers with 5-250 Enrolled
Optima Health BusinessEDGE products are now be available to groups with 5-250 enrolled employees. This is an opportunity for groups to take advantage of competitive pricing, stop-loss protection, and exemption from ACA requirements.
Learn About BusinessEDGE
Employer Group and Individual & Family Plan Guides for 2022
Plan guides for 2022 Employer Group and Individual & Family Plans can be ordered now.
Order Your Plan Guides
Balance Billing Protection
Effective January 1, 2021, Virginia state law protects members from balance or “surprise billing.” Elective (self-funded) Group Health Plans must opt-in to this balance billing law at least 30 days prior to their effective date if they would like to offer this protection to their employees.
Get More InformationNews
Medical Loss Ratio Rebates for 2021 Tax Year
Federal law requires that we spend a certain percentage of fully insured plan premiums on medical care. If we spend less during the three-year lookback period, we refund that money back to our customers.
Exciting Vendor Changes
Optima Health continuously looks for ways to improve benefits and services and increase cost efficiencies for its employer groups and members. As a result of these efforts, we have made the strategic decision to change our pharmacy benefit manager (PBM) from OptumRx® to Express Scripts (ESI) and our vision services vendor from Eyemed to VSP Vision Care (VSP) for all lines of business, effective January 1, 2023 (regardless of the group’s effective date).