OPTIMA Health Plan - Peninsula/Southside Hampton Roads

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General Information

Plan Name:	OPTIMA Health Plan
Service Area:	Peninsula/Southside Hampton Roads
Brochure:	PDF Version
Brochure:	Text Version
NCQA Accreditation:	Yes
JCAHO Accreditation:	No
URAC Accreditation:	No
Plan Type:	HMO
Enrollment Code-Self:	9R1
Enrollment Code-Self & Family:	9R2
Link to Plan Home Page:	http://www.optimahealth.com
Telephone:	800/206-1060
Summary results of the 2001 consumers assessment of health plans survey

Benefits

Doctor Care/ Primary Office Visits:	$10
Hospital Inpatient Room and Board Charges:	None
RX/ Generic/ Retail:	$10
RX/ Brand/ Retail:	$20
RX/ Brand/ NonFormulary:	$40

Rates

Non-Postal
___Biweekly	Self: $39.38	Self: & Family: $101.34
___Monthly	Self: $85.32	Self: & Family: $219.57
___Twice Biweekly	Self: $78.76	Self: & Family: $202.68
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Annuitants
___Monthly	Self: $85.32	Self: & Family: $219.57
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U.S. Postal Service Employees (Type A)
___Monthly	Self: $47.06	Self: & Family: $132.17
___Biweekly	Self: $21.72	Self: & Family: $61.00
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U.S. Postal Service Employees (Type B)
___Monthly	Self: $60.68	Self: & Family: $194.16
___Biweekly	Self: $28.01	Self: & Family: $89.61
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Worker's Compensation Recipients
___Twice Biweekly	Self: $78.76	Self: & Family: $202.68
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Certain Temporary Employees
___Biweekly	Self: $137.24	Self: & Family: $324.75
___Monthly	Self: $297.35	Self: & Family: $703.63
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Former Spouse Enrollees
___Biweekly	Self: $137.24	Self: & Family: $324.75
___Monthly	Self: $297.35	Self: & Family: $703.63
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Temporary Continuation of Coverage
___Monthly	Self: $303.30	Self: & Family: $717.70
___Biweekly	Self: $139.98	Self: & Family: $331.25
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FDIC
___Biweekly	Self: $21.72	Self: & Family: $61.00
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