VSP Provides ARPA COBRA Premium Subsidy Update

At VSP the wellbeing of their clients, members, partners, and VSP network doctors is at the heart of everything they do. They are available to help members access the vision care they need, when they need it most. As you’ve likely already heard, the American Rescue Plan Act of 2021 (ARP) provides temporary premium assistance for continuation of coverage for qualified individuals who lost their coverage due to COVID-19 through tax credits for employers and insurance carriers, as appropriate. The premium assistance will be available from April 1, 2021 – September 30, 2021. 

For employers in states with mini-COBRA laws*

For employers with 2-19 employees, in states with mini-COBRA laws*, VSP will continue to cover these qualified individuals, will issue a premium credit on your clients’ accounts, and will collect the tax credit to cover the subsidized premiums. 

How VSP is notifying VSP clients

During the week of June 14, 2021, VSP will email their clients with 2-19 employees, in states with mini-COBRA laws* to share how VSP will partner with them to support this premium assistance. Clients will be responsible for determining if they have qualified individuals who are eligible for this premium assistance, and notifying them of its availability.

Clients who do not have qualified individuals

If your clients determine that they do not have any qualified individuals who are eligible for the premium assistance, no further action is needed from them.

Clients with qualified individuals who have elected coverage

To ensure that credits for those qualified individuals who are eligible for premium assistance are applied correctly to clients’ accounts, VSP is asking clients to do the following:  

• Determine their qualified individuals and notify them that they’re eligible for this premium assistance.
• VSP included a model notice created by the IRS that they can use if they have not already contacted these individuals. VSP also included a copy of the Summary of the COBRA Premium Assistance Provisions under the American Rescue Plan Act of 2021 document that should be shared along with the model notice. 
• Ensure all eligible members are enrolled using Client Portal or by submitting an EDI file.
• Send an email to [email protected] and include the following in the subject line, “COBRA Subsidy ARP, Client ID.” Attach an excel file that contains the following information for all qualified individuals who have elected coverage:
  • Client ID and Division Number
  • Qualified Individual’s Full Name
  • Qualified Individual’s Member ID Note: This is not the member’s social security number. Member IDs can be found in the Manage Eligibility section at vsp.com. 
  • Mini-COBRA coverage effective date. Note: The premium subsidy is only available beginning April 1, 2021 through September 30, 2021. 

Statement Credits for Premium Subsidy

Clients will still be charged the full premium due based on the total number of enrollees. Once they’ve notified VSP how many qualified individuals eligible for the premium assistance are enrolled, VSP will issue a statement credit for the premium due for those individuals. Clients will still be responsible for paying the premiums for their employees or other individuals who are ineligible to receive the premium assistance through the ARP subsidy. 

For example, a client with a total of 15 enrollees in the Member Only coverage tier billing at the rate of $30.04 per person, will have a statement balance of $450.60. If 5 of those enrollees are eligible for the premium assistance through the ARP subsidy, then VSP will issue a statement credit of $150.20, making the remaining balance due from the client $300.40. 

Should you or your clients have questions please contact VSP at [email protected].

For questions, please contact a member of your B&P Sales Team — 888.722.3773.

*At this time, the following states are the only ones without mini-COBRA laws: AL, AK, ID, IN, and MT. This is per the most recent information available to VSP, but if you are or become aware of any mini-COBRA laws in these states, please adjust accordingly.