Frequently Asked Questions

You may receive one or more forms that provide information about your health coverage. These forms (similar to a W2) are 1095-A, 1095-B and 1095-C. They contain information that is required for completing your taxes. You are likely to get more than one form if:

• You had coverage from more than one provider
• You changed coverage or employers during the year
• If different members of your family received coverage from different providers

Community Health Options provides a range of Small Group health plans designed for businesses with fewer than 50 employees. Our plans offer flexible coverage options, competitive rates, and comprehensive benefits, including medical, prescription drug, and preventive care.

You can view them here or download this PDF version of our 2026 Small Business Healthcare Plans.

Our PPO and HMO plans offer access to a broad network of 48,000+ high-quality providers, with options for both New England regional and national plans with our wrap network, as well as partnerships with Firefly Health and Amwell for virtual care. Employers can choose plans that balance affordability with access to high-quality healthcare providers. 

We offer dedicated broker support, online tools, and marketing materials to help you serve your clients effectively. Our team is available to assist with quotes, enrollment, renewals, and ongoing plan management: Get Started.

Yes! Employers can choose from different plan options, deductible levels, and coverage tiers to meet their specific needs.

Employers can select and offer multiple fully insured health plans to their employees.

• Businesses with 11 – 19 enrolled employees can offer 2 plan options, with no deductible spread limitation.
• Businesses with 20 or more enrolled employees can offer 3 plan options, with no deductible spread limitation.

Getting appointed is simple—contact our broker support team to start the process. Once appointed, you’ll gain access to quoting tools, commission structures, and sales resources to help grow your business.

Community Health Options offers 35 plans to select from for Large Groups - plus customized cost sharing on plans for groups with 85+ subscribers and 100+ Members. Our health plan administration options are available for self-funded businesses or those looking to move to a self-funded model.

A self-funded health plan allows large employers to control healthcare costs, customize benefits, and retain unused premium dollars. With Community Health Options, businesses can leverage data-driven insights, stop-loss coverage, and cost-saving strategies to optimize their plan performance.

We offer brokers a suite of sales tools, marketing materials, compliance updates, and dedicated account management to support your success. Our team ensures you have the latest information on fully insured and self-funded plan options, helping you provide value to your clients.

To receive a customized large group health insurance quote, contact our broker support team. We’ll analyze your client’s workforce needs and provide competitive pricing and plan design options tailored to their business.

Community Health Options provides comprehensive virtual care across all small and large group health plans, including virtual urgent care, primary care, and behavioral health services with Firefly Health and Amwell. These offerings help brokers present cost-effective, high-value health plans to their clients.

Our virtual care solutions are designed for seamless integration into employer-sponsored health plans, with low or no copays, expanded access to specialists, and dedicated telehealth networks. Brokers can confidently recommend our plans, knowing they include high-quality, cost-effective virtual care options tailored to diverse workforce needs.

View Small Group or Large Group plans

You can access detailed plan guides, benefit breakdowns, and employer-focused virtual care solutions through our broker portal or by connecting with a Community Health Options representative. We provide customized plan recommendations to help brokers meet their clients’ unique healthcare needs.

View Guides + Resources

Form 1095-A is a tax statement sent to consumers who purchase health insurance directly from the state-based marketplace CoverME.gov. This form is mailed by CoverME.gov to households where any household member was enrolled in a Marketplace plan. This form is issued by the Marketplace no later than mid-February.

Please note: On-Exchange Members on a Catastrophic plan will not receive a 1095-A form from CoverME.gov. Community Health Options will send a 1095-B form in mid-February.

Important: You must have your 1095-A before you file your taxes. You will use information from Form 1095-A to fill out IRS Tax Form 8962, when completing your tax filing. This is how you will find out if there’s any difference between the premium tax credit you used and the amount you qualify for. Be sure to carefully read the instructions on Form 1095-A.

If you have questions or concerns about this form, contact the CoverME.gov at 1-866-636-0355.

Community Health Options is not able to assist you with your 1095-A form. If anyone in your household was covered by a Marketplace plan, you’ll get Form 1095-A, the Health Insurance Marketplace Statement, from CoverME.gov. The 1095-A is sent by CoverME.gov, not the IRS or Community Health Options. The 1095-A includes information for all Marketplace plans held by people in your household, including:

• Premiums paid
• Premium tax credits used
• A figure called ‘second lowest cost silver plan’ or SLCSP

More information on Form 1095-A is available here: https://www.healthcare.gov/tax-form-1095/

If you have questions, do not agree with the information on your 1095-A, or did not receive a 1095-A and you think you should have, please contact CoverME.gov at 1-866-636-0355.

The 1095-B form is sent to consumers who purchase health insurance directly from a health insurance issuer (like Community Health Options) or who were covered through their employer who purchased insurance directly from a health insurance issuer or CoverME.gov. This form is sent by the health insurance issuer and contains information about your health care coverage.

More information on Form 1095-B is available here: https://www.irs.gov/forms-pubs/about-form-1095-b

Call Member Services if:

• You have received your 1095-B and you believe there is an error
• If you haven’t received your 1095-B by the end of February

Note that Community Health Options will not have the ability to print copies of the 1095-B forms until we receive the file from our vendor, which we expect will occur in late February at the earliest

We’ve collaborated with Cigna Healthcare to give Members on National plans access to more doctors and hospitals when they are outside Community Health Options’ service area. Cigna Healthcare PPO network* will replace First Health for national providers in care.

The Community Health Option’s network has not changed. Our network continues to include providers in Maine, New Hampshire, and in select locations in Massachusetts. When a plan Member is outside of Maine and New Hampshire, they can use any provider in the Cigna Healthcare PPO network. If they are within Maine and New Hampshire and looking for a provider in the area, they should continue to use the healthoptions.org provider search tool. Massachusetts is the only state where Members have access to both the Cigna and Community Health Options networks. For Massachusetts providers, Members should check the Community Health Options directory before visiting Cigna.com.

The bottom line? Members can choose from a broader network and get care wherever they are, making their coverage more flexible and convenient than ever.

The Cigna Healthcare PPO national network offers access to nearly1.6 million in-network providers across the country, including 6,400 hospitals and health system**. This means Members can easily find dependable, in-network care wherever they are—and wherever they work—providing confidence and convenience for their health needs.

Members on New England plans continue to have access to the full Community Health Options network.

July 1, 2026 — Self-funded (ASO) plan Members can start using the Cigna Healthcare PPO national network. These Members will receive their new ID card approximately three weeks in advance.

Sept. 1, 2026 — Fully funded plan Members with a national plan make the switch. These Members will receive their new ID card approximately three weeks before and can start using the new network on this date.

No, Community Health Options continues to serve as the health plan insurer and plan administrator. We're working with Cigna Healthcare to expand Members’ access to providers nationwide on national plans, giving them a broader network without any changes to their benefits.

Members should check the Cigna Healthcare PPO network to confirm whether their doctors remain in-network. In-network national providers can be found at Cigna.com.

If a provider is not in the Community Health Options or the Cigna Healthcare PPO network, Members can call Member Services at (855) 624-6463, from  8 a.m. to 5 p.m. Monday through Friday. We'll help to find a great in-network provider. 

Community Health Options is already working hard to minimize disruption of care. Members with a Prior Authorization for surgery scheduled after the transition to Cigna Healthcare PPO from First Health should contact Member Services at (855) 624-6463, between 8 a.m. and 5 p.m., Monday through Friday. Our team will review their authorization and ensure continuity of coverage with no interruption to their scheduled care.

Prior Authorizations approved for First Health providers for visits or procedures scheduled on or after July 1 for self-funded health plans or September 1 for our fully-funded health plans will be reviewed to confirm coverage continuity under the Cigna Healthcare PPO network. Employers with questions about a specific Member's authorization should contact Member Services at (855) 624-6463, from 8 a.m. to 5 p.m., Monday through Friday.

If a Member receives services through the Cigna Healthcare PPO network, they may see the Cigna Healthcare name listed in the remarks section of the Explanation of Benefits (EOB). This is normal and expected.

New Member ID cards will reflect the updated Cigna Healthcare PPO network information, giving providers what they need to manage Prior Authorizations and claims. Members do not need to take any additional steps. If a provider has questions regarding authorizations or claims, they should contact Member Services at (855)-624-6463, from 8 a.m. to 5 p.m., Monday through Friday.

Members should continue to use your Member portal to find a Community Health Options network provider. To search for a national provider:

1.       Go to Cigna.com and click "Find a Doctor" at the top of the page.

2.       On the next screen, select "Employer or School”.

3.       Enter the Member’s zip code, choose any other search options you'd like, then click "Search".

4.       When prompted, select "Continue as guest", then "Continue”.

5.       Select the PPO plan. You will now see national providers that are in-network.