Optima Health Program Documents - Virginia

COVID-19 Resource Links

• CD Services COVID-19 Fact Sheet
• CD Services Personal Care COVID-19 Fact Sheet
• www.optimahealth.com/covid-19
• VA CD Member Information
• VA CD Provider Information
• VA Government COVID-19
• VA Department of Health
• Guidance For Direct Service Providers, Caregivers, Parents, And People With Developmental And Behavioral Disorders CDC
• VA COVID 19 Vaccine Message March 2021

Attendant Enrollment Information and Instructions

• Attendant Application Request Form
• Attendant Application Request Instructions
• Attendant Application For Tax Exemption Form
• Application For Tax Exemptions Instructions
• Difficulty Of Care Employee Application
• Difficulty Of Care Exclusion Information
• Difficulty Of Care Instructions
• Difficulty of Care IRS FAQs for Caregivers
• USCIS Form I-9
• Checklist To Complete The I-9 Form
• USCIS Form I-9 Instructions
• USCIS Form I-9, Spanish (FOR REFERENCE ONLY)
• USCIS Form I-9 Instructions, Spanish (FOR REFERENCE ONLY)
• U.S. Citizenship and Immigration Services (USCIS) Form I-9 Changes
• Virginia Criminal History Record Name Search Request Form (SP 167)
• Virginia Criminal History Record Name Search Request Instructions
• Virginia DSS CPS Central Registry Release Form
• Virginia DSS CPS Central Registry Release Form Instructions
• VA-4 Attendant Tax Withholding Form
• VA-4 Attendant Tax Withholding Form Instructions
• IRS Form W-4 2021
• W-4 Attendant Federal Tax Withholding Form Instructions

Attendant Post-Enrollment Information and Instructions

• Attendant Change Of Address Form
• Attendant Change Of Information Form
• Attendant Payment Change Form
• Attendant Payment Change Form Instructions

Payroll Forms and Information

• FIPS Codes
• Virginia CCC Plus Pay Schedule A 2021 Central VA & Tidewater
• Virginia CCC Plus Pay Schedule B 2021 Northern VA, Piedmont & Southwest

Employer Enrollment Information and Instructions

• SS4 Employer Form Instructions
• 2678 Employer Form Instructions
• Authorized Representative Signatory Form Instructions
• Guide To An Existing EIN
• Attendant Application Request Form
• Attendant Application Request Instructions

Employer Post-Enrollment Information and Instructions

• Consumer Contact Information Change Form
• Employer Of Record Contact Info Change Form
• Notice Of Discontinued Employment
• Notice Of Discontinued Employment Instructions

MCO Information

• Optima Frequently Asked Questions For Optima Members And Attendants

Forms

• Virginia Formal Complaint Form

Guides and FAQ's

• Virginia CCC Plus Customer Service Quick Facts
• Virginia Consumeremployer FAQ
• Virginia Overtime FAQ
• Virginia Attendant FAQ
• Attendant Self Service Options
• Go Green Pay Stubs FAQ

*Some of the above links may take you to third-party operated websites.