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Exclusions and Limitations

2018

Employer Plans

Small Group, 2-50 Employees

  • Plus Products — Off SHOP
  • Vantage/POS Products — Off SHOP

Mid-Market Group, Large Group 51+ Employees

  • Plus (PPO) Products
  • Vantage (HMO) Products
  • Vantage (POS and POSA) Products

Individual & Family Plans

  • OptimaFit® and OptimaFit® Select HMO Products - Off Exchange
  • OptimaFit® and OptimaFit® Select HMO Products - On Exchange
  • OptimaFit® PPO Products - Off Exchange

2017

Employer Plans

Small Group, 2-50 Employees

  • Optima Plus Products - Small Group (2-50) Off SHOP
  • Optima Vantage/POS Products - Small Group (2-50) Off SHOP

BusinessEDGE®

  • Plus (PPO) Products
  • Vantage (HMO) Products

Mid-Market Group, Large Group 51+ Employees

  • Plus (PPO) Products
  • Vantage (HMO) Products
  • Vantage (POS and POSA) Products

Individual & Family Plans

  • OptimaFit® and OptimaFit® Select Individual Product - OFF Exchange
  • OptimaFit® and OptimaFit® Select Individual Product - ON Exchange

Association Plans

  • Plus (PPO) Products
  • Vantage (HMO) Products
  • Vantage (POS and POSA) Products

SUMMARY OF BENEFITS

  • 2017 Summary of Benefits
  • 2018 Summary of Benefits
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© Optima Health 2018, 4417 Corporation Lane, Virginia Beach, VA 23462-3162

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 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.