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.

Elective (self-funded) Group Health Plans must opt-in to this balance billing law at least 30 days prior to their effective date if they would like to offer this protection to their employees. For December 1, 2021 groups, the deadline for submission is November 1, 2021.

To opt-in to the balance billing law, employers must complete and submit the Elective Group Health Plan Opt-In form, updated in March 2021, located on the State Corporation Commission (SCC) website; one form must be submitted for each group number. We have created these steps to help employers navigate the site and fill out the form.

Employer groups can track their election status on the SCC Elective Group Health Plan Search page. If they receive a follow-up email from the Bureau of Insurance (BOI) regarding their form submission, we encourage them to respond directly to the BOI to expedite the approval process.

If an employer group would like to change opt-in information, terminate from the opt-in, or make a change to previously submitted information, they must complete and submit the Elective Group Health Plan Opt-In Change/Request for Termination form.

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