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Application for a Certificate of Quality Assurance (11-2019)
Questions to Exclude Based on NCQA Certification
The following contains up to date information regarding CQA Application Status.
If you have any questions, please contact Leslie Moore at leslie.moore@vdh.virginia.gov
| Insurance Plan Name |
MCHIP/PRA Current CQA Number |
Application Rec’d (Y/N) |
Review Completed (Y/N) |
Approved (Y/N) |
New CQA Number |
Mail & Scan Date | Additional Info. Required |
| Aflac (Vision) | M-215 (I-20) | Y | Y | Y | M-215 (R-20) | 09/11/2020 | |
| Magellan Rx Management. LLC | P-18-06 (I) | Y | Y | Y | P-18-06 | 08/21/2020 | |
| Optum Rx, Inc | P-12-05 (R-20) | Y | N | ||||
| Aflac (Dental) | M-216 (I-20) | Y | Y | Y | M-216 (R-22) | 09/11/2020 | |
| DentaQuest | P-09-15 (R-20) | Y | N | ||||
| UPMC Health Plan | P-18-05 (R-20) | Y | Y | Y | P-18-05 (R-22) | 09/18/2020 | |
| Hines & Associates | P-14-05 (R-20) | Y | Y | Y | P-14-05 (R-22) | 09/04/2020 | |
| Starmount Life Insurance (Vision) | M-164 (R-20) | Y | N | ||||
| Optum Rx, Inc | P-12-05 (R-20) | Y | Y | Y | P-12-05 (R-22) | 08/21/2020 | |
| Magellan Complete Care of Virginia | M-192 (R-20) | Y | Y | Y | M-192 (R-20) | 09/18/2020 | |
| Ingenio Rx, Inc | P-18-07 (R-20) | Y | Y | Y | P-18-07 (R-22) | 08/21/2020 | |
| Freedom Life Insurance | M-137 (R-20) | Y | Y | Y | M-137 (R-22) | 08/28/2020 | |
| Guardian Life Insurance | M-071 (R-20) | Y | Y | Y | M-071 (R-20) | 08/28/2020 | |
| Permanente Advantage, LLC | M-191 (R-20) | Y | Y | Y | P-10-10 (R-20) | 08/28/2020 | |
| WINFertility, Inc | P-14-03 (R-20) | Y | Y | Y | P-14-03 (R-22) | 09/04/2020 |
Last Updated: September 18, 2020