Eligibility Management FAQs

VSP's online Eligibility Management tools are available to authenticated client contacts with group level (all divisions) or division level (specific divisions) access. If a division/class combination does not appear, please contact the Client Support Center at (800) 216-6248.

• Adds, terms and changes can be entered up to 5 months in the future.
• Transfers can only be entered up to 2 months in the future.

Example: If you process an add, change, term or reinstate in the month of September, you can use an effective date up to February of the following year.
Example: If you process a transfer in the month of September, you can use an effective date up to November of the current year.

• Updates can have a retroactive effective date retro to 2 months plus the current month. This includes adds, changes, terminations, reinstates and transfers.

Example: If you process a retroactive update in September, you can use an effective date retro to July.

A member's coverage start date cannot be changed using Manage Eligibility. Please contact the Client Support Center at (800) 216-6248 for assistance.

A member’s id cannot be changed using Manage Eligibility. Please contact the Client Support Center at (800) 216-6248 for assistance.

In the First Name field, enter the first name, a space and the middle initial.

• First reinstate the member under the previous division and then transfer the member to the new division/class on the Member Details Screen. Reinstate the member with the same effective date you wish to transfer to the division.

Example: If the member should be in the new division effective September. Reinstate the member under the previous division effective September and transfer the member to the new division effective September.

First reinstate the member and then update the member's information.

• COBRA benefits elected by a member require no changes to eligibility, unless one of the following apply:

1. If you have a separate COBRA division, transfer the member to the active COBRA division.
2. If the member was previously terminated, reinstate the member.

If you have questions or need assistance, please contact the Client Support Center at (800) 216-6248.

It is not necessary to send paperwork to VSP. With VSP's online Manage Eligibility tool, your changes have already been saved to our system.

Please contact the Client Support Center at (800) 216-6248 for assistance.

Update the member's level of coverage on the Member Details screen.

The "coverage start date" is the date a member's coverage originally became effective under your plan. The field is read-only and cannot be changed using the VSP Resource Center.

The "effective date of change" is the date a member's information will go into effect. VSP uses this date to ensure that the changes you make to a member's information are available on the appropriate date.

The gender and date-of-birth are required to assist VSP with member identification.

New Member information sent to VSP without a gender designation automatically defaults to a Female gender type. To correct the gender, go to the Member Detail page and submit the change by selecting Update.

1. Select Add/Reinstate Member
2. Enter the member ID in the Member ID box.
3. Click Search .
4. Within the Add member page, select a Division/Class from the drop-down list.
5. Enter the member information.
6. Enter the address information.
7. Click Add. You'll receive a Member Added confirmation.

If you track dependents, you will have the additional option to add dependent information (i.e. View Dependent in the task menu).

1. Select Manage Member Details .
2. Enter the last name or member ID in the Member ID box.
3. Click Search . If you have multiple members with the same last name, a list of members will appear. Select the member you want to view, otherwise, the only member with the last name will appear in the member detail screen.
4. Within the Member Details page, select Update from the task menu.
5. Make your updates.
6. Select the effective date from the drop down list.
7. Click Update . You'll receive a Member Updated confirmation.

1. Select Add/Reinstate Member .
2. Enter the last name or member ID .
3. Click Search . If you have multiple members with the same last name, a list of members will appear. Select the member you want to view, otherwise, the only member with the last name will appear in the Member Details page.
4. Within the Member Details page, select Reinstate from the task menu.
5. Select the reinstate date from the drop down list.
6. Click Reinstate . You'll receive a Member Reinstated confirmation.

If the member has been terminated for more than 13 months, you will need to add the member.

1. Select Manage Member Details .
2. Enter the last name or member ID.
3. Click Search .
4. If you have multiple members with the same last name, a list of members will appear. Select the member you want to view in the member detail screen.
5. If you search by member id, the member will appear in the member detail screen.

You can also search for a member by selecting Manage Eligibility then the Division and Class the member is in, and then by name.

1. Select Manage Member Details .
2. Enter the last name or member ID.
3. Click Search .
4. If you search by last name and have multiple members with the same last name, a list of members will appear. Select the member you want to view in the member detail screen.
5. If you search by member id, the member will appear in the member detail screen.
6. Or you can search for a member by selecting Manage Eligibility then the Division and Class the member is in, and then by name.
7. Within the Member Details page, select Terminate from the task menu.
8. Select the termination effective date from the drop down list.
9. Select the termination reason from the drop down list.
10. Click Terminate . You'll receive a Termination confirmation. Click Yes to continue.

• The transfer function is only available if you have more then one division.

1. Select Manage Member Details .
2. Enter the last name or member ID.
3. Click Search .
4. If you search by last name and have multiple members with the same last name, a list of members will appear. Select the member you want to view in the member detail screen.
5. If you search by member id, the member will appear in the member detail screen.
6. You can also search for a member by selecting Manage Eligibility then the Division and Class the member is in, and then by name.
7. Within the Member Details page, select Transfer from the task menu.
8. Select the new Division-Class from the drop down list.
9. Select the transfer effective date from the drop down list.
10. Click Transfer . You'll receive a Member transferred confirmation.

• Dependent tracking is a membership reporting option that allows VSP's system to track the names, relationships, genders, and date of birth of a member's eligible dependent(s).

If you are interested in setting up your plan for dependent tracking, or if you want to find out if your plan is already set up for dependent tracking, please contact the Client Support Center at 800-216-6248.

• This feature is only available for Dependent Tracking clients

1. Within the Member Details screen click the Update button in the Dependents section of the member.
2. Select an Add action on any blank row.
3. Enter the data for the blank fields in the row.

Click the Save button or press the Enter or Return key on your keyboard when you've made all your edits.

*Note: In order to add a dependent, the member's coverage code must be a code other than C-Member Only

• This feature is only available for Dependent Tracking clients

1. Within the Member Details screen click the Update button in the Dependents section of the member.
2. Select the Update action on any row with existing data you would like to make the update to.
3. Enter the updated data for any of the fields in the row.

Click the Save button or press the Enter or Return key on your keyboard when you've made all your edits.

• This feature is only available for Dependent Tracking clients

1. Within the Member Details screen click the Update button in the Dependents section of the member.
2. Select the Reinstate action on any row that's been termed that you would like to reinstate.
3. Enter the reinstate date in the Effective Date field in the row.

Click the Save button or press the Enter or Return key on your keyboard when you’ve made all your edits.

• This feature is only available for Dependent Tracking clients

1. Within the Member Details screen click the Update button in the Dependents section of the member.
2. Select the Terminate action on any row you would like to terminate.
3. Enter the date of the termination in the Effective Date field in the row.

Click the Save button or press the Enter or Return key on your keyboard when you've made all your edits.

The on-screen results of the Doctor Directory will include all of the doctors for the member's plan based on a 15 mile radius of the address we have on record in Manage Eligibility.

• If there is a complete address for the member listed in Manage Eligibility, you can generate a list of VSP doctors located near that member using the "Nearby Doctors" button on the Member Details page.

Otherwise, the link is not available.

• Upload Eligibility is a tool that enables bulk uploads of membership additions, termination, reinstatements, transfers and changes to member information using a Excel or CSV file.

The benefits include:

• processing member additions, terminations, reinstatements, transfers and changes in bulk for members, and additions, terminations, and reinstates for their corresponding dependents for dependent tracking clients.

1. Click on Upload Eligibility from the Manage your plan homepage.
2. Download the current eligibility file or a blank template.
3. Update the eligibility file to include all of your member adds, terms, changes, transfers or reinstates. You can include dependent adds, terms, changes or reinstates if you are a dependent tracking client.
4. Save your file in Excel or CSV format.
5. Click browse to locate your file and then double-click the upload file you saved.
6. Click upload to upload the file to process the membership updates.
7. Result: you will receive a confirmation that VSP has received the file and you will receive an email confirming the upload results.
8. If any records reject, a file will be attached to your email confirmation and will indicate which lines were rejected and why.
9. Update the original file that you created to correct the lines that rejected and repeat steps 4 -7.

Column Header	Min Field Length	Max Field Length	Field Values
Client Group) ID	1	8	Numeric
Division ID	1	4	Numeric
Class ID	1	4	Numeric
Member ID	1	9	Numeric
Last Name	1	20	Alpha
First Name	1	10	Alpha
Coverage Code	1	1	Alpha (A,B,C,D)
DOB	6	6	Numeric
Coverage Start date MM	2	2	Numeric
Coverage Start date CCYY	4	4	Numeric
Gender	1	1	Alpha (F or M)
Action Code	1	1	Alpha (A, T, R, X or C)

Column Header	Min Field Length	Max Field Length	Field Values
Client Group) ID	1	8	Numeric
Division ID	1	4	Numeric
Division ID	1	4	Numeric
Member ID	1	9	Numeric
Last Name	1	20	Alpha
First Name	1	10	Alpha
Coverage Code	1	1	Alpha (A,B,C,D)
DOB	6	6	Numeric
Coverage Start date MM	2	2	Numeric
Coverage Start date CCYY	4	4	Numeric
Gender	1	1	Alpha (F or M)
Action Code	1	1	Alpha (A, T, R, X, or C)
Relationship	1	1	Alpha (S, M, C, T, H, O or P)

• Address
• City
• State
• Zip Code
• Work Email Address
• Home Email

The relationship code identifies the relation between the member and the dependent. The relationship codes are:

• M – Member
• S – Spouse
• P – Domestic Partner
• C – Child
• H – Handicap Child
• T – Full-Time Student
• O – Other (not typically covered by most clients)
• D – Dependent Parent (not typically covered by most clients)

Yes, the Processed Term Date is a read only field and displays the termination date of the member or dependent.

The e-mail confirmation report will provide you with the record number, member’s last name and reason for the rejection. If, after reading this information, you still have any questions about why a record was rejected, please contact the Client Support Center at 800-216-6248 for assistance.

"Records left unchanged" are the member records that you submitted that included the same information we had in our system for those members. Thus, no changes were processed to the member information.

If you have not received an e-mail confirmation within 24 hours, please contact the Client Support Center at 800-216-6248 for assistance.

Download Eligibility is a tool that provides you with options to download an Excel, PDF, or CSV file of active members or active, termed, and future members.

• You can view and print a member list by following the steps below.

1. Select Download Eligibility from the Manage Your Plan homepage.
2. Click on the Divisions you wish to download or scroll to the bottom of the page and click ‘select all’ if you wish to download all divisions (if the transaction exceeds the maximum number of records supported by this tool, you may be able to select fewer divisions at a time to retrieve the download).
3. Select a report date (only applicable to "Active" member status report).
4. Click Active or Active/Termed/Future members.
5. Click Excel, CSV, or PDF as the file format (if the transaction exceeds 5000 records the only format available will be the CVS file type).

You will either receive an instant download or be prompted to receive an email within minutes from VSPResourceCenter@vsp.com (please ensure you’ve added VSPResourceCenter@vsp.com as a secure sender). Once you receive your email, click the link in the email, select your eligibility report in the drop-down box, and click the “Download Report” button.

• The time required to download an eligibility file depends on the size of the file and the speed of your Internet connection. The eligibility file is a complete list of all the members who are enrolled in the selected division(s). The longer this list, the larger the file size will be. Larger files take longer to move securely over the Internet.

Note: Downloading your list of All Members will typically be a larger file than downloading your list of Active Members.

The following message will appear if the download exceeds the maximum number of records supported by this tool. To get a copy of the membership list sent to you via secure email, please contact your Senior Client Specialist or Client Support Team for assistance.

Terminated members remain in our system for 13 months. After 13 months, the member's information no longer appears.