Medical Loss Ratio Rebates Fall Update

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.

For the 2020 tax year, Optima Health regulatory large group clients &mdsash; fully insured groups with 51 or more total employees &mdsash; who paid premiums in 2020 will receive a premium rebate check from us. In addition, both Optima Health and Virginia Premier Individual & Family Plan subscribers who paid premiums in 2020 will receive rebate checks from us.

Our regulatory small groups will not receive a rebate, as a larger percentage of premiums was spent on healthcare services for 2020.

Notifications will go out as follows. Click on the link to view the sample notification.

Employer Group

Optima Health Individual Product
Subscriber Notification/Check - Week of September 20

Virginia Premier Individual Product*
Subscriber Notification/Check - Week of September 20

Please review our list of Frequently Asked Questions for more information.

If you have any questions, please contact your Optima Health representative.

* In 2020, Virginia Premier became part of Sentara Healthcare and joined Optima Health Plan as a separate health plan issuer under Sentara Healthcare. Virginia Premier no longer offers individual plans and beginning January 1, 2021, outstanding operations transferred to Optima Health.

09/15/2021

Brokers Updates