Immunization Board FAQ

THE LAW

What is the purpose of this legislation?

The purpose is to ensure access to childhood vaccinations in Idaho, by decreasing costs and enabling the maintenance of a single distribution of vaccines available to health care providers in Idaho who administer the vaccines to program eligible children.

When was Idaho Code Title 41 Chapter 60 adopted?

The legislation implementing the immunization assessments was effective on February 1, 2010.

What is the purpose of the assessment board?

The Idaho Immunization Assessment Board was created pursuant to Idaho Code §41-6003. The board is responsible for management of the assessment process, and its duties include determining the method of assessment, assessing carriers and establishing policies and procedures. The board consists of nine (9) appointed members and one (1) ex officio member.

Who manages the vaccine fund?

The Idaho Immunization Assessment Board will manage the fund and provide payment to the Idaho Department of Health and Welfare for the sole purpose of purchasing vaccine for use in the Idaho immunization program.

THE ASSESSMENT PROVISION

Does this law apply to our company?

The law applies to all
“carriers”
which are defined to include insurers and administrators providing and/or administering health insurance or health benefit coverages in Idaho, with some exceptions.

What types of coverage are excluded from the provisions of this law?

For this purpose, health insurance or health benefit coverage includes all health coverage except for the following limited coverages:

coverage limited to a specific disease
hospital confinement indemnity
accident only
credit
dental
vision
Medicare supplement
long term care
disability income insurance
student health benefits only coverage issued as a supplement to liability insurance
worker’s compensation
automobile medical payment insurance
nonrenewable short term coverage issued for a period of twelve (12) months or less

Are carriers the only ones paying for Idaho Vaccines?

No. Federal funding pays for children with Medicaid, uninsured children, and some other groups of children.

Are adult vaccines covered?

No. Carriers, insurers and administrators providing and/or administering health insurance or health benefit coverage in Idaho, are paying the assessment for insured children up to the age of 19. Adult vaccines are not included in this program.

Will carriers benefit from the law?

Carriers (insurers and administrators) will be assessed based on the number of children with coverage for immunization in the plans they insure or administer. The assessments will fund the Idaho Immunization Program which is able to purchase vaccines at a reduced cost. The vaccines are then provided to health care providers at no cost; they cannot bill insurers for these free vaccines. As a result, carriers will benefit from the savings realized through the ability of the Idaho Immunization Program to access low cost vaccines. In addition, administrative costs for health providers will be reduced by eliminating the need to maintain separate stocks of vaccines.”

How does Idaho’s immunization record compare with other states?

This varies year to year, and by population group. Current childhood immunization rates.

How is a company’s assessment determined?

The board determines each carrier’s proportion of the assessment and the dates upon which the carrier must pay the assessment into the fund based on various reports deemed necessary by the board.

How often is this assessment paid?

The current plan of the board is an annual assessment to all entities insuring or administering health plans in Idaho.

When is the assessment due?

For the initial assessment, each carrier will receive a notice of assessment based on data received from the assessment survey, with payments due within sixty (60) days of the date of notice. The goal of the board is to have the assessment survey and initial assessment notice to be completed by July 1 of each year. See Idaho Code §41-6006.

Is the assessment voluntary?

No. Payment of the assessment is required by insurers and administrators providing and/or administering health insurance or health benefit coverage to residents of the State of Idaho.

Is participation by the carriers “voluntary”?

No. Every insurer and administrator providing and/or administering health insurance or health benefit coverage is required to participate in the assessment.

May a company pay in installments?

A quarterly payment option will be available for assessments totaling $50,000 or more per calendar year.

What if a company pays late?

According to Idaho Code §41- 6006(3)), the director may impose such penalties as provided in title 41, Idaho Code.

THE ASSESSMENT SURVEY

Instructions and Survey

What if we do not know the exact count?

Complete the survey with available data which will be reviewed by the immunization board.

What if we cannot specify the numbers of these identified subscribers and dependents having and not having coverage for childhood vaccines?

Carriers are required to report covered lives and are encouraged to further specify the numbers of these identified subscribers and dependents having and not having coverage for childhood vaccines.

We need more time for this survey. Can we ask for an extension?

Contact the Department of Insurance if an extension for completion of the survey is necessary.