Some Virginians saw Sentara insurance spike by 265%; the DOJ is investigating
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Some Virginians saw Sentara insurance spike by 265%; the DOJ is investigating

NORFOLK, VA – The Justice Department is investigating whether Sentara Health and its subsidiary Optima Health unfairly raised insurance premiums and earned more than $655 million in federal subsidies.

For several years, starting in 2018, Sentara Health Plans led the market in Hampton Roads. This is because Anthem Blue Cross Blue Shield was out of the market for the Affordable Care Act open enrollment period at that time.

Sentara premiums increased an average of 81.8% in 2018 and 2019, up to 265% in some cases, and netted millions in federal subsidies, court documents report. Court documents also say Charlottesville customers saw premiums increase to the top of the range.


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“The rates for those Virginians were the highest in the country and the cost of the least expensive insurance option was more than double the national average,” court documents filed by the government said.

Last month a judge ordered former Optima executives to provide additional testimony. The DOJ said Sentara has not complied with all of its requests for documents and testimony.

Sentara spokesman Mike Kafka said Sentara has been working to comply with the investigation for the past three years. He sent News 3 this statement on Tuesday:

“Sentara has so far provided more than 27,000 documents and nearly 70 hours of interviews with seven former and current employees in response to DOJ inquiries. This recent decision on procedural matters will help clarify the process going forward. As has been the case for nearly three years, Sentara will continue to act in good faith and look forward to the resolution of this matter.

In 2017, when policymakers in Washington destabilized the health insurance markets, more than 350,000 Virginians were at risk of not having access to any insurance on the exchanges. Sentara had a choice: Follow the same path as some of the largest insurers and opt out, or work with state and federal officials to ensure residents of Charlottesville and other areas still have access to an ACA-eligible plan. At the urging of state and federal officials, Sentara produced rates in just 26 days that typically take six months or more to develop. These rates were verified by a leading independent actuarial firm and approved twice by Virginia regulators.

Sentara stood with Virginians then and now in our commitment to providing comprehensive, high-quality care to Virginia communities.

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