News

For up-to-date information related to COVID-19 coverage, please view our COVID-19 site.  Looking for a previous newsletter? Contact employernews@optimahealth.com

1095 Documents for 2022 Tax Year

For the 2022 tax year, Optima Health will mail 1095-B tax form to all individuals covered by our fully insured health plans, including employer-sponsored and Individual & Family Plans sold off the Health Insurance Marketplace.

Welcoming Valley Health Back To Our Network

We are happy to announce that Valley Health is re-joining our Optima Health commercial and individual product network starting on January 1, 2023.

Employer News 4th Quarter December 2022

A quarterly newsletter about your health plan benefits.

Exciting Vendor Changes

Optima Health continuously looks for ways to improve benefits and services and increase cost efficiencies for its employer groups and members. As a result of these efforts, we have made the strategic decision to change our pharmacy benefit manager (PBM) from OptumRx® to Express Scripts (ESI) and our vision services vendor from Eyemed to VSP Vision Care (VSP) for all lines of business, effective January 1, 2023 (regardless of the group’s effective date).

Employer News 3rd Quarter August 2022

A quarterly newsletter about your health plan benefits.

Medical Loss Ratio Rebates for 2021 Tax Year

Based on our final assessment, we will not issue rebates for our regulatory fully insured small and large group clients for plan year 2021.

Inova is Joining Our Network

We are pleased to announce that effective September 1, 2022, Optima Health includes all Inova® Health System hospitals, facilities, physician practices, and providers as in-network for our commercial group and Individual & Family Plan members.

Employer News 2nd Quarter June 2022

A quarterly newsletter about your health plan benefits.

Machine-readable Files Available Soon

The machine-readable file (MRF) requirement under the Transparency in Coverage (TiC) rules goes into effect July 1, 2022. This part of the rule requires that insurers and self-funded group health plans must begin to publicly post machine-readable files with detailed information on the costs of covered services and prescription drugs.

Employer News 1st Quarter February 2022

A quarterly newsletter about your health plan benefits.