Off-Anniversary Plan Changes​

To support groups during the COVID-19 crisis, Optima Health will allow off-anniversary plan changes to groups with effective dates between April 1, 2020 and June 1, 2020. These changes are only allowed for plan downgrades to assist our employers in reducing costs during this unprecedented period.

Plan changes must remain in the same product family – Vantage/POS or Plus. For example, a POS plan can be changed to an HMO plan, but a PPO plan must remain in the PPO family.

Any out–of–pocket expenses that members have incurred during the plan year (towards their current deductible and/or maximum–out–of–pocket (MOOP)) will be credited toward the deductible and MOOP in the newly chosen lower cost plan.

Groups can either add a new plan or they can replace current plan(s) entirely. The original group anniversary date will remain in effect and Optima Health will issue new benefit documents to the group and employees.

If you are interested in making any off–anniversary plan changes, please contact your Optima Health representative. We will require written documentation (email will suffice) with the plan change(s) and your preferred effective date.