Frequently Asked Questions
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. Interested brokers can start the appointment process by completing the Optima Health Broker Appointment Process. 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 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
Optima Health is the trade name of Optima Health Plan, Optima Health Insurance Company, Optima Health Group, Inc., and Sentara Health Plans,
Inc..Optima HMO and POS products are underwritten by Optima Health Plan. Optima PPO products are underwritten by Optima Health Insurance Company. Sentara Health Plans, Inc. provides administrative services for other employer benefit plans.
Who are the appropriate contacts for large, 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.
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?
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.
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.
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 Website?