March 9

Optima Health — How to do business

Optima Health offers comprehensive benefits, services, and new features help you live a healthy lifestyle, all backed by the support of their high-quality network of 35,000 providers including specialists, primary care physicians and hospitals. Medicare Advantage plans expand upon the basics offered by Original Medicare. 

2021 Special Enrollment Period Issued by Executive Order

  • February 15 - May 15
  • Special Enrollment Period so individuals who do not have insurance or individuals who want to change coverage can enroll in a health insurance plan on the Federal Marketplace Opens a new window or tab.

Optima Health Provider Network

As part of a not-for-profit, integrated delivery system, Optima Health has a unique approach to provider contracting. With more than 35,000 providers and facilities across Virginia, our committed, high-quality network includes the Optima Health statewide networks, PHCS®, MDLIVE®, EyeMed, and American Specialty Health®.

Key clinically integrated networks within the Optima Health provider network offer members the benefit of new models of care from a custom care team, to deliver the right care, in the right place, at the right time.

90.4% of providers would recommend Optima Health to family or friends
— 2020 Optima Health Annual Provider Satisfaction Survey

Appointments Requirements

  • Virginia Life and Health License or Virginia Health License (required)
  • Agency License (if applicable)
  • Optima Health Substitute W9 (SF-W9) Form
  • Broker Agreement (includes Business Associate and QHP Amendments)
  • Portal User Profile (access to OptimaHealth.com secure Broker Portal)
  • If an agent elects to sell Medicare, they will be directed to our training site to complete required training. If training is not completed, agents will not be paid on any Medicare business.
  • We require all new agents to work with a General Agency (GA) or Field Marketing Organization (FMO). GA's specialize in Commercial and IP, and FMO's focus on Medicare only. If you do not have a preference and do not select a GA or FMO, one will be assigned to you. Below is a list of our preferred partners.

Agent Resources

Brokers have 24/7 access to all of the information and sales resources necessary to be successful with eBroker. Our online portal gives brokers flexibility in working with us and serving clients, for every line of business you represent. You can request quotes, manage your groups, complete renewals, and view report activity.

With the Broker Book of Business Dashboard, access your current clients, membership by group segment, year-to-date total premiums paid, upcoming renewals, and historical client/membership growth for all lines of business.

Quickly and easily order supplies through Tidewater Management Group by giving us a call at 888-622-9122 or by filling out this form. 

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