What This Means for Payers
- Participation in one of the most efficient and cost-effective systems in the country for purchasing and distributing
childhood vaccines. - Vaccine costs that are below those of private purchase alternatives, as documented by the Centers for Disease
Control and Prevention (CDC).
The 2023 Assessment Rate is now determined annually during the second quarter of the calendar year by the MVB. Click here to view the
Assessment Rate Notification to Payers.
- 2024 Interim Assessment Child Rate: $10.04
Frequently Asked Questions
By purchasing vaccines in bulk at federal contract rates, the State qualifies for one of the most significant discounts from the pharmaceutical industry. The program funds vaccine purchases from assessments collected from insurers and other payers.
If you are a first-time user, you must register first at https://file.mevaccine.org/login. Please note: due to security features of the system, it may take up to 30 minutes after a new account is created before it can be accessed for data entry. This delay occurs only at the initial creation of the account.
No. Most self-insured employers, HMOs, TPAs and others subject to Title 24-A are subject to assessment. Substantial portions of the total cost are paid by the federal government. Additionally, by returning to universal childhood immunization, Maine receives the largest discount available from the pharmaceutical industry. No State of Maine general funds go to pay for childhood vaccinations for privately-covered children. Similarly no assessments are to be applied for vaccine purchases by Maine for children not covered by the assessments. A new Childhood Immunization Fund held in Trust by the Maine Treasurer of State assures that funds are properly used.
Assessments are based upon the estimated vaccine costs, program expenses and the number of covered lives reported by the entity to the MVB. Payers are required to accurately report the number of covered lives of children each quarter. Children are covered until age 19. The assessment is intended to cover the costs of the program for the fiscal year and fund some modest reserves. Any excess funds will be applied to reduce next year’s assessments.
Yes. Maine’s Superintendent of Insurance may apply sanctions and penalties and take other action under Title 24-A of Maine law.
On the web at www.MEvaccine.org.
You must report all of your child covered life months within 45 days of the end of each quarter.
Please email info@mevaccine.org and we will be happy to assist you.
Please go ahead and prepare your report ASAP. Then include the interest in the remittance at a rate of 12% per annum for each day from the due date to the date your check is mailed.
Start reporting regularly beginning with the first quarter in which you have covered lives.
No. If you are a TPA, special benefits plan, or any type of insurer that does not provide basic health care and therefore has zero child covered lives, you are only required to report once a year, in the first quarter of each year. MVB’s fiscal year starts July 1, so that means this zero covered lives report is due November 15 for the quarter ending September 20.
Quarterly. Within 45 days of each July 1, October 1, January 1, and April 1, payers must pay the assessment for the preceding quarter.
Yes. That will help us make sure your check is properly credited to your account.
Maine Vaccine Board
c/o KidsVax.org
PO Box 1885
Concord, NH 03301
The date of the postmark on your envelope or the date on the check, whichever is dated later.
No. Regular is fine. We will consider your remittance as paid on the date of the postmark.
No. The Maine State Treasurer does not allow us to receive MVB assessments via wire transfer at this time.
“Assessable entity” means any health carrier or other entity that contracts or offers to provide, deliver, arrange, pay for, or reimburse any of the costs of health services.
Yes. ERISA does not prevent the state from assessing payers. To the extent allowed by federal law, ERISA plans are required to participate along with all other payers. Third-party administrators (TPAs), who are often contracted to perform claims processing activities for ERISA plan trustees, will also be included in the mandatory assessment.
Yes. Assessment payments are properly accountable as medical expenses because they fund the cost of vaccines administered to beneficiaries. As such, assessable entities like third-party administrators are anticipated to pay the assessment costs on behalf of their clients.
Yes. Each state program is built to meet the needs of its stakeholders. There are various assessment methodologies, adult and children programs, and services that KidsVax® offers. KidsVax® customizes its services to fit each state’s specific needs.
When you file your report in the assessment system on the website, the program will generate a “Remittance Form” that you can print and save. This form will contain a unique reference number. You must include this reference number with your payment. The Form will also include detailed instructions for submitting your payment by ACH transfer, which is the preferred method.
Yes. Every insurer and TPA having a license in the State of Maine, along with certain other entities specifically identified in the statute, must report once each a year. A “zero-covered-lives” shortcut has been added to MVB’s self-assessment reporting system so that a report can be completed, literally, in less than five minutes.
No. For entities such as the one described in the preceding Q&A, if it has zero covered lives and continues to have zero covered lives for the balance of the year, then an initial zero-covered-lives report is required for the first quarter, with a brief explanation such as the one above. In that event, so long as no child covered lives arise in the balance of the year, no other report is required until the first quarter of the following year.
Most college plans will require reporting, because typically some of the students are under age 19. Every person resident in the State of Maine under age 19 must be reported as a child covered life.
Generally, yes. Unless the plan (i) definitively knows (a) the child’s PCP is out of state and (b) the child is out of state year-round, and (ii) also adopts a practice of counting students attending schools in Maine whose parents reside out of state, that covered life should be counted. Accordingly, the default rule for college age children, where a specific year-round residence address is unknown, will be to utilize the state of the primary insured under the plan.
Yes. See answers above. Generally, a licensed entity will be required to pay assessments for all child (i.e., under age 19) covered lives for dependents of any primary plan beneficiary resident in the State of Maine. However, as noted above, an entity which reports as Maine child covered lives children attending college in the State of Maine who reside in the State of Maine from plans created outside the State of Maine may be permitted to exclude from Maine covered lives counts some children of primary beneficiaries in the State of Maine who are full-time, year-round residents at a college outside the State of Maine. However, this would require clear demonstration as to the uniform application of commercially reasonable residency determination rules. (See prior Q&As.) The recommended, and generally more straightforward approach, is to determine child residency based on the residency of the primary plan beneficiary.
Yes. However, in many cases there may be contractual arrangements in place whereby another assessable entity also is involved in processing of medical benefits claims. In that case, if the entity is able to confirm, in writing, that another entity will be paying the assessment, then the lives would not be counted. It is the policy of MVB to avoid double counting of child covered lives and to work cooperatively whenever multiple entities are involved in a particular benefit package. Generally, MVB will accept the determination among those entities as to which of those entities is responsible for reporting and paying the assessments on the respective child covered lives.
Zero. If there are no medical benefits afforded by the plans administered, then the entity would report “0” as its covered lives for each month. This is true even if some persons under the age of 19 have benefits under the plan. For example, if a TPA is administering an eye-care-only benefit plan, then it would report “0” covered lives to MVB.
No. The MVB, in accordance with statutory guidance, desires that steps be taken to avoid paying the assessment more than once for any child covered life. Generally speaking, the MVB will look first to the entity which would have written the check paying for the administration of the vaccines as the responsible entity for payment of the assessment. However, to avoid double counting, and to accommodate the needs of specialty plans and private contractual arrangements, MVB will allow another entity to make payment of the assessment if that is confirmed in writing as part of the self-assessment reporting system.
MVB operates on a fiscal year basis running from July 1 to June 30. The assessment year begins July 1. Each quarterly assessment is due forty-five days following the close of the quarter. Accordingly, the first assessment due under the program is due on or before November 15 based upon child covered life months in the months of July, August, and September. Assessments continue to be due each quarter thereafter.
The Maine Vaccine Board (“MVB”) is a State of Maine governmental agency established by 22 MRSA §1066 to oversee Maine’s Universal Childhood Immunization Program.
If MVB’s estimates produce funds which are too low to meet the needed vaccine costs, MVB is allowed to issue a supplemental assessment. Initial experience and MVB’s reserve methodology indicate that no supplemental assessment should be needed, but that cannot be stated with absolute certainty.
MVB funds may be used only to purchase childhood vaccines for free distribution for the benefit of Maine’s children, pay its reasonable expenses and build the reserve allowed by 22 MRSA §1066. The statute prohibits use of MVB funds for other purposes. If MVB collects more than is needed in any given fiscal year, that amount automatically is carried over and used to reduce the next fiscal year’s assessment rate.
MVB’s statutory assessment, which funds childhood vaccine purchases, is based upon the number of child covered life months. The assessment amount is determined each quarter based upon the total child covered life months of that entity in the previous quarter multiplied by the MVB assessment rate.
Just child covered lives. The assessment is based upon child covered lives of children residing in the State of Maine. A “child” is defined by the statute as any person under age 19. Accordingly, if the insurer or TPA (or other covered entity) would pay for health care benefits for administration of a vaccine to that child, that is a child covered life for purpose of the assessments under the statute.
Yes. Legislative history concerning the statute on this point is very clear. All childhood vaccines administered in the State of Maine will be free under the Universal Childhood Immunization Program established by 22 MRSA §1066. This assessment is the means by which costs are recovered for children whose benefits are funded by private (i.e., non-federally funded) vaccine plans for children.
Plans are permitted to use a commercially reasonable methodology to estimate the number of child covered lives. A brief description of the methodology should be afforded in the interrogatories section of the self-reporting system whenever an estimate is used. For example, some plans may want to use the address of the primary insured as the address for purposes of determining the residence of the child. So long as that is uniformly used in a manner which does not bias the report towards a lower child covered lives number for MVB, such a reasonable estimate is acceptable.
Yes. However, the entity may be eligible to file an Annual or Permanent Zero Covered Lives Report instead of the typical quarterly reports. Please note that if an entity has zero covered lives for one quarter only, then it should file a normal quarterly report with “0” values. If, however, an entity does not administer medical benefits and therefore has zero covered lives, it should file one of two types of Zero Covered Lives Reports. For example, this type of report would be appropriate for entities such as those administering eye care or dental benefit only plans. If the entity has zero covered lives and will continue to have zero covered lives for the balance of the year, then it should file an Annual Zero Covered Lives Report during the first quarter of the calendar year. No other report will be due until the first quarter of the following calendar year. If the entity has zero covered lives and expects to never have covered lives, it should file a Permanent Zero Covered Lives Report to eliminate the need for further compliance follow up. A guide to Zero Covered Lives Reports is available here.
If annually, you have no lives to report, you may file a permanent zero. At that point, you will not be required to file annually unless you begin to have covered lives to report.
Please email info@mevaccine.org with an explanation of your mistake and the correct covered lives number. An MVB staff person will provide assistance so that you are able to print a corrected remittance form.
By purchasing vaccines in bulk at federal contract rates, the State qualifies for one of the most significant discounts from the pharmaceutical industry. The program funds vaccine purchases from assessments collected from insurers and other payers.
If you are a first-time user, you must register first at https://file.mevaccine.org/login. Please note: due to security features of the system, it may take up to 30 minutes after a new account is created before it can be accessed for data entry. This delay occurs only at the initial creation of the account.
No. Most self-insured employers, HMOs, TPAs and others subject to Title 24-A are subject to assessment. Substantial portions of the total cost are paid by the federal government. Additionally, by returning to universal childhood immunization, Maine receives the largest discount available from the pharmaceutical industry. No State of Maine general funds go to pay for childhood vaccinations for privately-covered children. Similarly no assessments are to be applied for vaccine purchases by Maine for children not covered by the assessments. A new Childhood Immunization Fund held in Trust by the Maine Treasurer of State assures that funds are properly used.
Assessments are based upon the estimated vaccine costs, program expenses and the number of covered lives reported by the entity to the MVB. Payers are required to accurately report the number of covered lives of children each quarter. Children are covered until age 19. The assessment is intended to cover the costs of the program for the fiscal year and fund some modest reserves. Any excess funds will be applied to reduce next year’s assessments.
Yes. Maine’s Superintendent of Insurance may apply sanctions and penalties and take other action under Title 24-A of Maine law.
On the web at www.MEvaccine.org.
You must report all of your child covered life months within 45 days of the end of each quarter.
Please email info@mevaccine.org and we will be happy to assist you.
Please go ahead and prepare your report ASAP. Then include the interest in the remittance at a rate of 12% per annum for each day from the due date to the date your check is mailed.
Start reporting regularly beginning with the first quarter in which you have covered lives.
No. If you are a TPA, special benefits plan, or any type of insurer that does not provide basic health care and therefore has zero child covered lives, you are only required to report once a year, in the first quarter of each year. MVB’s fiscal year starts July 1, so that means this zero covered lives report is due November 15 for the quarter ending September 20.
Quarterly. Within 45 days of each July 1, October 1, January 1, and April 1, payers must pay the assessment for the preceding quarter.
Yes. That will help us make sure your check is properly credited to your account.
Maine Vaccine Board
c/o KidsVax.org
PO Box 1885
Concord, NH 03301
The date of the postmark on your envelope or the date on the check, whichever is dated later.
No. Regular is fine. We will consider your remittance as paid on the date of the postmark.
No. The Maine State Treasurer does not allow us to receive MVB assessments via wire transfer at this time.
“Assessable entity” means any health carrier or other entity that contracts or offers to provide, deliver, arrange, pay for, or reimburse any of the costs of health services.
Yes. ERISA does not prevent the state from assessing payers. To the extent allowed by federal law, ERISA plans are required to participate along with all other payers. Third-party administrators (TPAs), who are often contracted to perform claims processing activities for ERISA plan trustees, will also be included in the mandatory assessment.
Yes. Assessment payments are properly accountable as medical expenses because they fund the cost of vaccines administered to beneficiaries. As such, assessable entities like third-party administrators are anticipated to pay the assessment costs on behalf of their clients.
Yes. Each state program is built to meet the needs of its stakeholders. There are various assessment methodologies, adult and children programs, and services that KidsVax® offers. KidsVax® customizes its services to fit each state’s specific needs.
When you file your report in the assessment system on the website, the program will generate a “Remittance Form” that you can print and save. This form will contain a unique reference number. You must include this reference number with your payment. The Form will also include detailed instructions for submitting your payment by ACH transfer, which is the preferred method.
Yes. Every insurer and TPA having a license in the State of Maine, along with certain other entities specifically identified in the statute, must report once each a year. A “zero-covered-lives” shortcut has been added to MVB’s self-assessment reporting system so that a report can be completed, literally, in less than five minutes.
No. For entities such as the one described in the preceding Q&A, if it has zero covered lives and continues to have zero covered lives for the balance of the year, then an initial zero-covered-lives report is required for the first quarter, with a brief explanation such as the one above. In that event, so long as no child covered lives arise in the balance of the year, no other report is required until the first quarter of the following year.
Most college plans will require reporting, because typically some of the students are under age 19. Every person resident in the State of Maine under age 19 must be reported as a child covered life.
Generally, yes. Unless the plan (i) definitively knows (a) the child’s PCP is out of state and (b) the child is out of state year-round, and (ii) also adopts a practice of counting students attending schools in Maine whose parents reside out of state, that covered life should be counted. Accordingly, the default rule for college age children, where a specific year-round residence address is unknown, will be to utilize the state of the primary insured under the plan.
Yes. See answers above. Generally, a licensed entity will be required to pay assessments for all child (i.e., under age 19) covered lives for dependents of any primary plan beneficiary resident in the State of Maine. However, as noted above, an entity which reports as Maine child covered lives children attending college in the State of Maine who reside in the State of Maine from plans created outside the State of Maine may be permitted to exclude from Maine covered lives counts some children of primary beneficiaries in the State of Maine who are full-time, year-round residents at a college outside the State of Maine. However, this would require clear demonstration as to the uniform application of commercially reasonable residency determination rules. (See prior Q&As.) The recommended, and generally more straightforward approach, is to determine child residency based on the residency of the primary plan beneficiary.
Yes. However, in many cases there may be contractual arrangements in place whereby another assessable entity also is involved in processing of medical benefits claims. In that case, if the entity is able to confirm, in writing, that another entity will be paying the assessment, then the lives would not be counted. It is the policy of MVB to avoid double counting of child covered lives and to work cooperatively whenever multiple entities are involved in a particular benefit package. Generally, MVB will accept the determination among those entities as to which of those entities is responsible for reporting and paying the assessments on the respective child covered lives.
Zero. If there are no medical benefits afforded by the plans administered, then the entity would report “0” as its covered lives for each month. This is true even if some persons under the age of 19 have benefits under the plan. For example, if a TPA is administering an eye-care-only benefit plan, then it would report “0” covered lives to MVB.
No. The MVB, in accordance with statutory guidance, desires that steps be taken to avoid paying the assessment more than once for any child covered life. Generally speaking, the MVB will look first to the entity which would have written the check paying for the administration of the vaccines as the responsible entity for payment of the assessment. However, to avoid double counting, and to accommodate the needs of specialty plans and private contractual arrangements, MVB will allow another entity to make payment of the assessment if that is confirmed in writing as part of the self-assessment reporting system.
MVB operates on a fiscal year basis running from July 1 to June 30. The assessment year begins July 1. Each quarterly assessment is due forty-five days following the close of the quarter. Accordingly, the first assessment due under the program is due on or before November 15 based upon child covered life months in the months of July, August, and September. Assessments continue to be due each quarter thereafter.
The Maine Vaccine Board (“MVB”) is a State of Maine governmental agency established by 22 MRSA §1066 to oversee Maine’s Universal Childhood Immunization Program.
If MVB’s estimates produce funds which are too low to meet the needed vaccine costs, MVB is allowed to issue a supplemental assessment. Initial experience and MVB’s reserve methodology indicate that no supplemental assessment should be needed, but that cannot be stated with absolute certainty.
MVB funds may be used only to purchase childhood vaccines for free distribution for the benefit of Maine’s children, pay its reasonable expenses and build the reserve allowed by 22 MRSA §1066. The statute prohibits use of MVB funds for other purposes. If MVB collects more than is needed in any given fiscal year, that amount automatically is carried over and used to reduce the next fiscal year’s assessment rate.
MVB’s statutory assessment, which funds childhood vaccine purchases, is based upon the number of child covered life months. The assessment amount is determined each quarter based upon the total child covered life months of that entity in the previous quarter multiplied by the MVB assessment rate.
Just child covered lives. The assessment is based upon child covered lives of children residing in the State of Maine. A “child” is defined by the statute as any person under age 19. Accordingly, if the insurer or TPA (or other covered entity) would pay for health care benefits for administration of a vaccine to that child, that is a child covered life for purpose of the assessments under the statute.
Yes. Legislative history concerning the statute on this point is very clear. All childhood vaccines administered in the State of Maine will be free under the Universal Childhood Immunization Program established by 22 MRSA §1066. This assessment is the means by which costs are recovered for children whose benefits are funded by private (i.e., non-federally funded) vaccine plans for children.
Plans are permitted to use a commercially reasonable methodology to estimate the number of child covered lives. A brief description of the methodology should be afforded in the interrogatories section of the self-reporting system whenever an estimate is used. For example, some plans may want to use the address of the primary insured as the address for purposes of determining the residence of the child. So long as that is uniformly used in a manner which does not bias the report towards a lower child covered lives number for MVB, such a reasonable estimate is acceptable.
Yes. However, the entity may be eligible to file an Annual or Permanent Zero Covered Lives Report instead of the typical quarterly reports. Please note that if an entity has zero covered lives for one quarter only, then it should file a normal quarterly report with “0” values. If, however, an entity does not administer medical benefits and therefore has zero covered lives, it should file one of two types of Zero Covered Lives Reports. For example, this type of report would be appropriate for entities such as those administering eye care or dental benefit only plans. If the entity has zero covered lives and will continue to have zero covered lives for the balance of the year, then it should file an Annual Zero Covered Lives Report during the first quarter of the calendar year. No other report will be due until the first quarter of the following calendar year. If the entity has zero covered lives and expects to never have covered lives, it should file a Permanent Zero Covered Lives Report to eliminate the need for further compliance follow up. A guide to Zero Covered Lives Reports is available here.
If annually, you have no lives to report, you may file a permanent zero. At that point, you will not be required to file annually unless you begin to have covered lives to report.
Please email info@mevaccine.org with an explanation of your mistake and the correct covered lives number. An MVB staff person will provide assistance so that you are able to print a corrected remittance form.
How do I get started?
If you don't yet have an account, click on this link to create the account for your FEIN. You will receive a confirmation email to the supplied email address. Remember your account could take up to 30 minutes to become active.
Once you have a login, click on the assessment self-reporting system link on the left of this page.
There are a couple of other notes that might be useful when working with the Self-Reporting Assessment System for the first time:
- Your email address is used as your ID or login.
- Your submitted data is available to you under your login after submission.
- If you have no covered lives in the state of Maine and have no expectation of any covered lives, you may file a permanent zero. If, at some point, you do have
covered lives to report, simply toggle off the permanent zero after logging into your account.
Please click this helpful guide to filing.
These pages show all input screens for the system and provide brief instructions. If you print out these 11 pages and review them in advance, gathering all required information, your time on the system should be very efficient for you.