Optima Health
Optima Health is a Virginia Beach-based non-profit health insurer and subsidiary of Sentara Health, offering Individual & Family, Employer, Medicare, and Medicaid plans to Virginia residents through digital, broker, and direct sales channels.
- Company typePrivate
- Founded1998
- HeadquartersVirginia Beach, United States
- Headcount501–1,000
- GTM typeB2B and B2C
- OfferingServices
What Optima Health does
Optima Health is a US-based health insurance company headquartered in Virginia Beach, Virginia, operating as a non-profit subsidiary of Sentara Health (founded 1984; 501-1000 employees). The company provides comprehensive health insurance coverage across four core product lines: Individual & Family Plans, Employer Plans, Medicare Plans, and Medicaid Plans, plus an Employee Assistance Program. These are distributed regionally (primarily Virginia) through a multi-channel model combining a self-serve digital platform (sentarahealthplans.com), direct enterprise sales, a broker network for Medicare and Medicaid, and a branded mobile application.
Optima Health's product surface extends beyond traditional insurance into member engagement features: a 24/7 virtual care partnership with MDLIVE providing board-certified doctor access via video or phone, the MyLife MyPlan wellness program, a Treatment Cost Calculator for out-of-pocket expense comparison, member discount programs (massage, eyewear, hearing aids), and digital claims/ID-card access through the mobile app. Marketing is conducted via Facebook, YouTube, Instagram, and LinkedIn, with content marketing anchored on the company's website.
Note on data integrity: the input contains material conflict between the US firmographic profile (Virginia Beach, non-profit, insurance, parent Sentara Health) and a parallel UK-based narrative referencing £123M revenue, a £100M PAM Healthcare acquisition, and £1.6B UK occupational health market positioning. The two appear to refer to distinct legal entities sharing the "Optima Health" name. This analysis is grounded primarily in the US firmographic data; UK-specific strategic moves (PAM Healthcare acquisition, Cognate Health acquisition, HSBC/Barclays financing, ACA whistleblower investigation referencing former Sentara subsidiary) are flagged where relevant but should be validated against primary sources before investment action.
Optima Health firmographics
Firmographics- Name
- Optima Health
- Legal name
- Optima Health
- Website
- https://optimahealth.com
- Company type
- Private
- Founded year
- 1998
- Operating status
- Operating
- Headcount range
- 501–1,000 employees
- Short description
- Optima Health is a Virginia Beach-based non-profit health insurer and subsidiary of Sentara Health, offering Individual & Family, Employer, Medicare, and Medicaid plans to Virginia residents through digital, broker, and direct sales channels.
- Ownership category
- akta.pro rank
Optima Health industry classification
Industry- Product category
- Health Insurance
- NAICS
- Direct Health and Medical Insurance Carriers (524114), Direct Life, Health, and Medical Insurance Carriers (52411), Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds (524292)
- SIC
- Accident & Health Insurance (6321), Hospital & Medical Service Plans (6324)
- akta.pro primary industry
- Integrated Virtual-First Health Plans / ICHRA-Enabled Virtual Primary Care (HLALADAL)
- akta.pro secondary industries
- Commercial Vision Insurance Plans (Employer-Sponsored) (HLAEAJAA), MA-PD Plans (Medicare Advantage with Prescription Drug Coverage) (FSAIAGAG)
Keywords
Where Optima Health is headquartered
LocationHeadquarters
- HQ city
- Virginia Beach
- HQ country
- United States
- HQ region
- North America
Offices1 record
Markets served
Optima Health business model
Business model- GTM type
- B2B and B2C
- Offering type
- Services
- Cost components
- Personnel, Operations, Technology or R&D, Marketing or Sales, Others
Revenue model
- Healthcare Services Revenue: Revenue from occupational health services to employers, expected to grow from approximately £123 million to £204 million by 2027 following PAM Healthcare acquisition
- Health Insurance Premiums: Revenue from health insurance plans including Individual & Family Plans, Employer Plans, Medicare Plans, and Medicaid Plans
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Subscription | Monthly | Individual & Family Plans |
| Subscription | Monthly | Employer Plans |
| Subscription | Monthly | Medicare Plans |
| Subscription | Monthly | Medicaid Plans |
Go-to-market motion1 record
Distribution channels4 records
Marketing channels6 records
Optima Health product offering
Product offeringCore offering
Optima Health is the health insurance arm of Sentara Health Plans, offering Individual & Family, Employer-sponsored, Medicare, and Medicaid health insurance plans to U.S. consumers and businesses. The plans are delivered alongside 24/7 virtual care through an MDLIVE partnership, the MyLife MyPlan wellness programs, member discounts, and a mobile application for claims, scheduling, and ID card access.
Product overview
Optima Health is a UK-based occupational health services provider operating as a single unified product offering. The company offers occupational health services to employers, with recent expansion through the acquisition of PAM Healthcare for £100 million. The acquisition positions Optima Health as the clear leader in the UK's £1.6 billion occupational health market, with projected revenues growing from approximately £123 million to £204 million by 2027 and market share increasing from 10% to 15%. Note: A former Sentara subsidiary named Optima Health operated in Virginia's ACA insurance market, but the primary data refers to the UK-based occupational health company.
Differentiator
Problem solved
Functional benefit
Products and services
- Individual & Family Plans Health insurance plans designed for individuals and families seeking personal medical coverage.
- Employer Plans Group health insurance plans for businesses to offer employees as part of their benefits package.
- Medicare Plans Medicare health insurance plans targeted at individuals aged 65 and older.
- Medicaid Plans Medicaid coverage plans for people with low incomes and disabilities.
- Employee Assistance Program (Sentara EAP) Workforce support program designed to strengthen organizations by supporting their employees.
Quantifiable outcome
- Revenue growth from £123 million to £204 million by 2027
- +3 more outcomes
Companies that use Optima Health
Customer profileNamed customers1 record
Segments5 records
Ideal customer profiles4 records
Optima Health technology and API
TechnologyTechnology focussed No
API detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
Feature3 records
Optima Health partnerships and signals
Strategic signalPartnerships
One partnership is on record.
- MDLIVEcoreMDLIVE partnership provides 24/7 virtual care access through board-certified doctors via video conference or phone, integrated into Sentara Health Plans (parent company of Optima Health) offerings.
Scale indicators6 records
Recent moves5 records
Expansion highlights6 records
Optima Health competitors and assessment
Company assessmentDirect peers
- Kaiser Permanente Mid-Atlantic: Integrated payer-provider serving Virginia, Maryland, and DC with commercial and Medicare plans. Direct competitor for Virginia employer groups and individual buyers, with a distinct integrated-care delivery model.
- Molina Healthcare: Government-program-focused health plan with Medicaid managed care contracts in Virginia and multiple states. Directly competes with Optima on the Medicaid segment and pursues similar state contract growth strategies.
- Sentara Health Plans: Optima Health's parent organization and brand shell, offering identical Individual, Employer, Medicare, and Medicaid plans across Virginia. Directly comparable product portfolio, geography, and distribution model.
- Anthem Blue Cross Blue Shield of Virginia: Dominant commercial and Medicaid health plan in Virginia with overlapping employer-group and government program offerings. Directly competes for the same Virginia employer and individual buyer base as Optima.
Broad incumbents
- Humana: Medicare Advantage leader with growing commercial and Medicaid presence. Closely comparable on the Medicare segment that Optima serves, and increasingly competing on senior-focused employer retiree plans.
- UnitedHealthcare: Largest US health insurer offering commercial, Medicare Advantage, and Medicaid plans with national employer relationships. Direct overlap on all four of Optima's plan categories, particularly in self-funded employer contracts.
- Centene Corporation: Largest US Medicaid managed care company with marketplace and Medicare Advantage exposure. Overlaps with Optima on Medicaid and individual ACA marketplace segments in Virginia and adjacent states.
- Aetna (CVS Health): National carrier with strong employer-sponsored and Medicare Advantage presence, including Virginia. Competes with Optima in employer benefit decisions and Medicare shopping; broader portfolio but overlapping target customers.
- Cigna Group: Major national carrier with strong employer-sponsored and Medicare focus. Competes with Optima for mid-market and large employer group business across Virginia.
Regional players
- CareFirst BlueCross BlueShield: Mid-Atlantic regional carrier serving Virginia, Maryland, and DC with commercial and Medicare plans. Comparable regional carrier footprint and employer-group go-to-market motion to Optima.
Market position
Strengths4 records
Weaknesses5 records
Competitive moat4 records
Key risks6 records
Key highlights6 records
Customer concentration
Optima Health social profiles
Digital presenceOptima Health financial estimates
Financial estimateRevenue estimate
Valuation estimate
Optima Health leadership team
Management profileNumber of profiles
Profiles1 record
Optima Health funding detail
Funding detailFunding overview
Funding rounds
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
Optima Health M&A and investment
M&A and investmentM&A1 record
Investments
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about Optima Health
What does Optima Health do?
Optima Health is the health insurance arm of Sentara Health Plans, offering Individual & Family, Employer-sponsored, Medicare, and Medicaid health insurance plans to U.S. consumers and businesses. The plans are delivered alongside 24/7 virtual care through an MDLIVE partnership, the MyLife MyPlan wellness programs, member discounts, and a mobile application for claims, scheduling, and ID card access.
Is Optima Health a public or private company?
Optima Health is a private company. It is classified as nonprofit foundation owned and is currently operating.
When was Optima Health founded?
Optima Health was founded in 1998. It employs 501 to 1,000 people.
Where is Optima Health based?
Optima Health is headquartered in Virginia Beach, United States, in the North America region.
How does Optima Health make money?
Two revenue lines are on record. Healthcare Services Revenue is the primary driver. The others are health Insurance Premiums.
Who are Optima Health's main competitors?
Direct peers on record are Kaiser Permanente Mid-Atlantic, Molina Healthcare, Sentara Health Plans and Anthem Blue Cross Blue Shield of Virginia. Broad incumbents are Humana, UnitedHealthcare, Centene Corporation, Aetna (CVS Health) and Cigna Group. CareFirst BlueCross BlueShield is listed as a regional player.
Does Optima Health have an API?
No public API is recorded for Optima Health.
What industry is Optima Health in?
Optima Health's product category is Health Insurance. Its primary akta.pro industry code is HLALADAL, Integrated Virtual-First Health Plans / ICHRA-Enabled Virtual Primary Care, with a secondary code of HLAEAJAA, Commercial Vision Insurance Plans (Employer-Sponsored). Its NAICS code is 524114 and its SIC code is 6321.