Employer Information for COVID-19

Optima Health is working hard to respond to the impacts of COVID-19 on your business and employees. We are committed to providing you with important updates, while ensuring that your employees get the care they need during this unprecedented time.

Resources for Employers

Learn about employee coverage, workforce changes, pharmacy benefit changes, and more:

Always Innovating

Optima Health continues to evolve and find new solutions for our business partners during the COVID-19 pandemic. We are adapting and improving the way we support employers, brokers, members, and the communities that we serve.

Watch this video to see how we are innovating.

Rebuild VA Small Business Grant Program

Starting August 10, applications will be available for Rebuild VA, a $70 million grant program that will assist small businesses and nonprofit organizations during the COVID-19 pandemic. This program will help cover costs such as existing or unpaid expenses, payroll, rent, and utilities.

The first approved 7,000 businesses or nonprofits can apply for up to $10,000. Eligible companies include campgrounds, entertainment and public amusement establishments, exercise and fitness facilities, personal care or grooming services, restaurants, and retail. To be eligible, Virginia businesses must:

  • have no more than 25 employees
  • earn less than $1.5 million in annual gross revenue
  • be able to certify that they haven’t received other aid through the CARES Act

To learn more about the Rebuild VA grant fund, please visit www.governor.virginia.gov/rebuildva.

The Coronavirus Aid, Relief, and Economic Security (CARES) Act

The Coronavirus Aid, Relief, and Economic Security (CARES) Act allocated $350 billion to help small businesses keep workers employed amid the pandemic and economic downturn. Known as the Paycheck Protection Program, the initiative provides 100% federally guaranteed loans to small businesses. Learn more about how these programs can assist you at the links below.

As part of the CARES application, employers must provide copies of invoices showing paid health insurance premiums. Optima Health employer groups with access to our secure Employer Portal can view and download current and historical billing statements.

Employers who do not currently have access should complete and submit our Confidentiality Agreement and Portal User Profile Form to request an account. Be sure to check the box at the top of the form to “View Billing Statements.”

Once the account has been established, employers can sign in and select Billing Statements on the left-hand navigation pane under “Payments and Billing” to view their statements.

Note: Optima Health is providing this to brokers and employers for informational purposes only. The information posted on our website is not intended to provide compliance, tax, or legal advice, or to be relied upon for these purposes. Brokers and employers should be advised to consult with legal and tax experts to understand how the Act will affect their individual or business circumstances.

COBRA Relief and Guidance Deadlines Extended

The U.S. Department of Labor (DOL) and IRS have extended election timeframes for special enrollment periods and the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) plans. This includes an extension for plan participants to elect to receive coverage under COBRA and the timeframe participants have to file claims or submit appeals. Until the end of the COVID-19 national emergency, the typical deadlines and timeframes will be disregarded for the following:

  • The 30-day period to request special enrollment for loss of coverage, or adding a new dependent
  • The date for employers to provide COBRA election notices
  • The 60-day election period for COBRA
  • The Premium due date, usually 45 days after election, for COBRA
  • Timely filing dates for claims for covered services under group health plans
  • The date within which claimants may file and complete internal and external appeals

For more information, please visit the U.S. Department of Labor website.


COVID-19 Vaccine Availability

Now that the COVID-19 vaccine has been approved, we plan to continue updating Optima Health members about how and when they can receive one.

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New Balance Billing Protection

Beginning January 1, 2021, Virginia state law protects members from balance or “surprise 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. Employers can choose to opt in effective January 1 or effective on the first day of the group’s plan year.

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