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Vendor Management, Payments, and Collections (VMPC) FAQ

Guidance for FAQ regarding Payment Processing and Payment Adjustments/Payments

Program Area: Vendor Management, Payments, and Collections (VMPC)

Question: How will issuers receive information on subsidy amounts and cost-sharing reduction (CSR) plan variations?

Answer: The 834 will indicate the plan variation or standard plan in which the enrollment group should be enrolled. This will be indicated by the QHP ID, which will include a 14-digit standard component ID with a 2-digit variation component. With this QHP ID, the issuer will know which CSR plan variation or standard plan to enroll the enrollment group. The advance CSR payment amount that will be paid to the issuer on behalf of that enrollment group per month will be included in the 2750 loop. The monthly advance payment of the premium tax credit (APTC) amount for the enrollment group will also be captured in the 2750 loop. The 2-digit Variation Component has the following values and description: 00 - Non-Exchange variation 01 - Exchange variation (standard plan - no CSR) 02 - Zero cost-sharing plan variation 03 - Limited cost-sharing plan variation 04 - 73% AV silver plan variation 05 - 87% AV silver plan variation 06 - 94% AV silver plan variation The assigned Qualified Health Plan Identifier is a concatenation of the 2. An example of both the Plan Id and Variant Component ID is as follows: 12345VA002002104

Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: May 29, 2013

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