CQA Application Status Report










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
CQA Number
Application Rec’d

Review Completed


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