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
- Employee Notification - Batched mailings from September 12 – September 30
- Employer Notification/Check - Week of September 13
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.