COBRA Third-Party Administrator FAQ

  • Group Market News
    Published January 25, 2021

    For groups enrolled in OptiFlex plans. This FAQ will help you educate your OptiFlex clients on COBRA coverage.

    Who is Vimly? Vimly Benefit Solutions is a third-party administrator (TPA) supporting the Optiflex program. Vimly manages all enrollment, billing, and payments on behalf of Premera Blue Cross for both Active and COBRA membership. As an employer group you may administer COBRA yourself or elect to have a TPA administer COBRA on your behalf. Vimly collects all payments on behalf of Premera Blue Cross.
    What you need to understand when choosing a COBRA TPA? When you sign up with a COBRA TPA, it is important that you:
    • Understand all your contractual requirements.
    • Share and confirm the appropriate COBRA rates ahead of doing business with them.
    • Understand how to assure eligibility is accurate and current (ask about communication paths).
    • Ensure your COBRA participant(s) know where payments should be submitted.
    What is my responsibility as an Employer as it relates to COBRA? As the employer, your responsibility as it relates to COBRA includes:
    • Informing your COBRA TPA, if applicable, the changes in your employee’s qualifying events timely in compliance with the carrier rules.
    • Validate all monthly billing and eligibility statuses as it pertains to COBRA.
    • Decide whether you want to manage COBRA administration yourself or choose a COBRA TPA to help comply with all government requirements for your COBRA participants.
    • Ensure your participants have a way to check their COBRA status and eligibility regularly.
    How are COBRA enrollments handled?

    Once you have your first COBRA member, you need to ensure both Vimly and your COBRA TPA, are informed timely with the necessary paperwork, rates and plans.

    If you are using a COBRA TPA who will be communicating with Vimly directly, please make sure they know to send enrollment data and payments to Vimly each month. If these steps are not followed, your participants could experience claims or coverage issues.
    What does my COBRA TPA need to do to ensure my COBRA member is covered? It is critical the COBRA TPA submits the initial COBRA enrollment update as soon as they’ve verified all necessary election information and payment has been received. Ongoing eligibility issues can be avoided by making sure your TPA sends fully detailed remittance reports with their payments. This is especially important if the agreement with your TPA states they will send premium to Vimly directly. If full remittance info is not provided to Vimly, the payment will be returned and eligibility for your COBRA participant could be at risk.

    Billing and Payment Information

    How do I submit enrollment and payment? COBRA enrollment and payment updates must be provided to Vimly on a monthly basis.
    • If you use a COBRA TPA who provides enrollment and payment updates to you on a monthly basis, you must keep Vimly informed of enrollment changes and remit premium for COBRA enrollees along with your monthly payment.
    • If you use a COBRA TPA who provides enrollment and payment updates directly to Vimly each month, you do not need to remit premium for COBRA enrollees with your monthly payment.
    • COBRA eligibility and payments should not be submitted directly to Premera Blue Cross. All payments must come through Vimly.
    • Eligibility changes can be emailed to: LWA@vimly.com
    • Checks for payments should be mailed to: Vimly Benefit Administrators, PO Box 65, Mukilteo, WA 98275-0065.
    What steps do I need to take if my billed COBRA employee doesn’t pay?

    If payment has not been received timely by you or your COBRA TPA, Vimly must be notified of the termination of coverage within 30 days.

    During the COVID Outbreak Period (related to the National Emergency as declared by President Trump on Mar 15, 2020), there are special COBRA extensions you can read about here. We also encourage you to contact your legal counsel or your COBRA TPA, if applicable, for guidance.

    Why am I being billed for COBRA when I have a COBRA TPA? As an employer you hold the contract with your COBRA TPA. On behalf of the Optiflex program, Vimly must collect and process payments in a timely manner. To ensure you remain informed of COBRA payments and coverage changes your monthly bill will include both Active and COBRA enrollees.
    Why can’t Vimly bill my COBRA members directly? Since Vimly is not your COBRA administrator, participants can’t be billed directly. If needed, Vimly can provide billing reports to your TPA to assist in payment reconciliation.

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