News

For up-to-date information related to COVID-19 coverage, please view our Broker page.  Looking for a previous newsletter? Contact brokernews@optimahealth.com

Two Weeks Left to Earn up to 500 Points

You have until June 30 to sell new Small Group contracts and be in the running to earn Top Performer Rewards points!

Reminder on Action Required for Balance Billing Protection

As a courtesy to our self-funded groups, we have been sending reminders to our business partners that beginning January 1, 2021, many Virginians covered under health insurance plans have protection from “surprise billing” or balance billing.

COVID-19 100% Coverage Ending June 30

Thank you for choosing Optima Health. As you know, in an effort to support our clients and members, Optima Health began providing 100% coverage for many services related to the COVID-19 pandemic. We previously announced that we would extend coverage through May 31, 2021 for select services and have decided to extend coverage through June 30, 2021.

Marketing Campaign to Support BusinessEDGE® Plans

Beginning in June, we are launching a strategic marketing campaign to increase awareness of our BusinessEDGE® product offerings.

Medical Loss Ratio Rebates for 2020 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.

State Continuation Under the American Rescue Plan Act

The American Rescue Plan Act (ARP) provides for full premium subsidy for COBRA and for State continuation of coverage programs for periods of coverage between April 1, 2021 and September 30, 2021 for Assistance Eligible Individuals.

Reminder on Action Required: Balance Billing Protection

As a courtesy to our self-funded groups, we will be sending reminders to our business partners that beginning January 1, 2021, many Virginians covered under health insurance plans will have protection from “surprise billing” or balance billing.

Important Individual Product Updates

Please see this important update about Medical Loss Ratio Rebates and the American Rescue Plan Act.

Amendment for 2021 Legal Documents

For fully insured plans with an effective date of January 1, 2021 or later, we have issued an Amendment to our employer group contracts and member Evidence of Coverage (EOC) and Certificate of Insurance (COI) legal documents.

COVID-19 Coverage Extension May 31

Thank you for choosing Optima Health. We hope you are enjoying the start of the spring season. It has now been a year since the pandemic began in the United States and we want to continue putting our members first. We previously announced that we would extend COVID-19 coverage for Optima Health members through April 30. We are now extending COVID-19 coverage through May 31, 20211 for the following: