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Surcharges and Assessments


Currently, there are thirteen states with an assessment or similar reporting obligation that require Meritain to evaluate the Plan Sponsors membership in those states to determine whether a fee is owed. If we determine that a Plan Sponsor does in fact owe an assessment to one or more of these states, the Plan Sponsor will notice the assessment amount reflected on their monthly bill. The assessment amount represents the amount that Meritain will pay as a plan expense to the appropriate state(s) on the Plan Sponsor Groups behalf.

 

State Specific Summary

Provided to the right in the compliance materials is a high-level overview of each state requirement, listed alphabetically. We have provided you with information on what the assessment/fee is, how often it is due and the deadline by which the filing must be made. The information provided below is only intended to be a high-level summary as the assessment amounts may fluctuate up or down from year to year.

 

Each year, we will apply the appropriate assessment rate and follow any applicable payment schedule to stay in compliance with these requirements.

 

Meritain can assist client who elect with New York State Health Care Reform Act (HCRA), which governs hospital reimbursement methodologies and targets funding for a multitude of health care initiatives.

 

States that have the Childhood Vaccine Assessment:

 

State

Assessment Title

Frequency

Sponsor or TPA Liability

Alaska

Childhood Immunization Assessment

Quarterly

Sponsor Liability

Connecticut

Childhood Health and Welfare Immunization Fee Assessment

Annual

Sponsor Liability

Idaho

Pediatric Immunization Assessment

Annual

Sponsor Liability

Maine

Childhood Immunization Assessment

Quarterly

Sponsor Liability

Massachusetts

Pediatric Immunization Program Assessment

Monthly

Sponsor Liability

New Hampshire

Childhood Vaccine Assessment

Quarterly

Sponsor Liability

New Mexico

Vaccine Purchasing Assessment

Quarterly

Sponsor Liability

Rhode Island

Vaccine Assessment Program

Quarterly

Sponsor Liability

Vermont

Vaccine Purchasing Program Assessment

Quarterly

Sponsor Liability

Washington

Washington Vaccine Association Dosage-Based Assessment

Claims based

Sponsor Liability

 

Other Surcharge and Assessments:

 

State

Surcharge/Assessment Title

Frequency

Sponsor or TPA Liability

Maine

Health Data Organization Assessment

Annual

TPA Liability

Michigan

Health Insurance Claims Assessment

Quarterly

Sponsor Liability

Mississippi

Comprehensive Health Insurance Risk Pool Assessment

Quarterly

Sponsor Liability

Massachusetts

Child Psychiatry Access Project Assessment

Annual

Sponsor Liability

Massachusetts

Center for Health Information & Analysis Assessment

Annual

Sponsor Liability

Massachusetts

Safety Net Trust Fund Surcharge

Monthly

Sponsor Liability

Massachusetts

Acute Hospital and Ambulatory Surgical Center Assessment

Annual

Sponsor Liability

New Jersey

New Jersey Board of Education Surcharge

Annual

Sponsor Liability

New York

HCRA

Monthly

Sponsor Liability

Rhode Island

Children's Health Account

Quarterly

Sponsor Liability

Vermont

Health Care Claims Tax

Annual

TPA Liability

 

This content is being provided as an informational tool. It is believed to be accurate at the time of posting and is subject to change. It is recommended that plans consult with their own experts or counsel to review all applicable federal and state legal requirements that may apply to their group health plan. By providing this information, Meritain Health is not exercising discretionary authority or assuming a plan fiduciary role, nor is Meritain Health providing legal advice.