The Vermont Vaccine Purchasing Program (VVPP) operates to ensure that all Vermonters have access to immunizations recommended for children and adults. Authorized by 18 V.S.A. § 1130 and launched on April 1, 2011, the program establishes an insurer-funded vaccine purchasing pool that enables the Vermont Department of Health (VDH) to purchase pediatric and adult vaccines at the lowest possible price and to distribute them to providers free of charge. The program serves two main goals: to lower health care costs and to improve Vermonters’ health by raising immunization rates.
These advisory FAQs offer guidance about the program to payers and providers. The Vermont Department of Health invites anyone having suggestions or additional questions about these advisory FAQs to direct inquiries to info@VTvaccine.org.
The advisory FAQs are divided into five broad categories:
1. “A” means questions related to Assessments.
2. “C” means questions related to Covered Lives.
3. “G” means questions related to Government Programs.
4. “P” means questions related to Providers.
5. “V” means questions related to Vaccines.
A1. Why did the Vermont legislature form the Vermont Vaccine Purchasing Program (VVPP)?
VVPP was formed to fund and manage Vermont’s universal vaccine purchasing program. This program enables Vermont to purchase vaccines for the state’s entire population and distribute them to health care providers free of charge. In states without such universal programs, providers must purchase vaccines with money out of their own pockets, then await reimbursement from insurance companies
The program also saves money. By purchasing vaccines in bulk at federal contract rates, Vermont qualifies for the largest discount available from the pharmaceutical industry. VVPP funds vaccine purchases with assessments collected from assessed entities.
A2. Are insurance carriers the only ones paying for vaccines administered in Vermont?
A3. What does “Assessed Entity” mean?
A4. Must both the employer and the insurer or TPA administering the plan pay the assessment for a given covered life?
A5. Must ERISA plans pay the assessment?
Yes. Any health benefit plan that covers child or adult residents of Vermont is required to participate. The VVPP legislation encompasses plans that offer Administrative Services Only (ASO) for ERISA employers. It also includes traditional Third-Party Administrators (TPAs).
A6. Are any plans excused from paying assessments?
A7. How are an entity’s assessments determined?
A8. What are the VVPP assessment rates for child and adult covered lives?
Information on the assessment rates for child and adult covered lives is posted under the “FOR PAYERS” tab. Assessments are calculated based on estimated vaccine costs, program expenses, and the total number of covered lives reported to VVPP. The assessments are intended to cover the costs of the program for the calendar year, with some modest reserves. The rates are also programmed into VVPP’s self-reporting assessment system so that the system will apply the correct rate each quarter and calculate the amount owed by each payer. The rate is set each year by the Commissioner of Health, after considering the recommendations of the Immunization Funding Advisory Committee.
A9. What method will be used to: a) determine the number of children and adults with private insurance and b) determine the VVPP program costs that will be factored into the assessment?
a) The total number of children and adults with private insurance will be determined based on the most recent data available through the assessment system when the rate is set.
b) The program costs include costs incurred by the Vermont Department of Health in administering the program, as well as the cost of KidsVax® services such as the VVPP website creation and assessment administration.
A10. Where can I find more details about the VVPP assessment rate calculation?
The spreadsheets used to compute the VVPP assessment rate are posted under the “FOR PAYERS” tab.
A11. When are assessment payments due?
A12. What if VVPP collects too little?
If VVPP’s estimates produce funds which are too low to meet the needed vaccine costs, VVPP may issue a supplemental assessment. VVPP’s reserve methodology has been designed so that no supplemental assessment should be needed, but that cannot be guaranteed in advance.
A13. What if VVPP collects too much?
A14. What if a beneficiary gets a vaccine in a neighboring state—can the payer get a discount
A15. Are payments made by assessment payers accountable as medical expenses?
A16. Does the Patient Protection and Affordable Care Act (ACA) preempt any provisions of the VVPP?
A17. Where do I go to complete the online assessment?
A18. Are there any tutorials on the use of this system?
A19. What if I have registered in the assessment system, but I need to change some of my information?
Simply log back in to your account and made any changes needed. This should not create any problems for you or the system.
A20. If I make a mistake in my report, how can I correct it?
Please email help@VTvaccine.org with an explanation of the mistake and the Federal EIN used to file the report. VVPP will provide assistance so that you can print a corrected remittance form.
A21. I accidentally overpaid. Can I be reimbursed?
A22. How do I submit my payment?
A23. Am I required to pay by ACH transfer?
A24. What if I submit a late report or payment?
A25. When is my remittance considered paid?
A26. How do I create a Password for the Assessment System on this Site?
A27. What should I do if my company has created a password for the assessment system on this website, but I no longer have it?
A28. Are payers double paying for a vaccine when a private provider administers a vaccine that was not purchased through the state system?
C1. Must entities report only child covered lives, or should adult covered lives be included as well?
C2. What are “adult covered lives”?
C3. What are “child covered lives”?
C4. What if I do not know the specific address where a child resides, and am unable, therefore, to determine with certainty whether he or she is a Vermont resident?
C5. What if a child of a Vermont primary insured attends school out of state—is that life counted?
C6. Must an entity file reports even if it does not provide medical benefits and therefore has zero covered lives?
C7. If an entity files a Permanant Zero Covered Lives Report, but it later has covered lives, what should it do?
C8. If my company has filed an Annual Zero Covered Lives Report, when should we file our next report?
G1. Has VVPP changed anything for the federally-funded Vaccines for Children (VFC) program or state-sponsored medical plans?
No. VVPP is a financing mechanism for a portion of Vermont’s universal vaccine purchasing system for children and adults. Neither the federally-funded Vaccines for Children program, nor the state’s purchase of vaccines for children in state-sponsored medical plans is affected by the Vermont Vaccine Purchasing Program. All providers receiving vaccine through this program must enroll annually in the VFC and/or VFA program and adhere to all program requirements.
G2. Do providers still need to screen for VFC eligibility?
P1. Does this program affect how providers receive vaccine?
P2. What are the benefits to my practice if we enroll in the VFC and/or VFA program?
P3. Can VDH require all providers to enroll in the VFC and/or VFA program?
P4. Can VDH provide a list of participating providers in “real time”?
P5. How will this program affect patients?
P6. What if my office no longer wants to participate in the VFC and/or VFA program and wants to privately purchase and bill for vaccines?
P7. Should providers bill $0.00 or $0.01 for state-supplied vaccines?
V1. Does VVPP set vaccine policy?
V2. What vaccines are covered by VVPP?
V3. Is the cost of seasonal flu vaccine included in the vaccine cost estimates?
V4. Does this program establish a vaccine mandate?
V5. What is the Immunization Registry?
V6. How does VVPP impact my taxes?
These FAQs were last updated on January 2, 2016. (FAQ C2 updated).