Assessment Rates are typically set on an annual basis. Each year, the Washington (WA) Pal Access Line (PAL) Fund (WAPAL Fund) recommends the assessment rates for the following state fiscal year. These recommendations are provided to the Washinton State Health Care Authority (HCA). Once the rates are approved, a notice containing the new rates will be posted to this website. The self-reporting assessment system is available for filing. Quarterly filings are due April 30, July 30, October 30, and January 30 for child, adult, and 65 years and older covered lives.
The 2023 Assessment Rate is determined annually in May by the WAPAL Fund Advisory Committee. Click here to view the
Assessment Rate Notification to Payers.
- 2023 Covered Life Rate: $ 0.06 (This rate applies to all ages of covererd lives)
Frequently Asked Questions
After the initial quarterly billing period, the assessments will be calculated quarterly and due 45 days after the close of each quarter, meaning reports and payments will typically be due on or before February 15, May 15, August 15, and November 15 each year. Quarterly payments are based on the number of covered lives an entity reports for the three months in each preceding quarter.
First-time users must register before they can log into the assessment system. After clicking here, you can register by entering your Federal Employer Identification Number, your e-mail address, and a private password of your choice.
Please note that because of the system’s security features, there may be a one-time delay of up to 30 minutes before a new account can be accessed for data entry.
Yes.
WAPAL Fund will set an assessment rate for each covered life.
Any aggregate over-payments for all payers, in total, above the statutorily set funding target in an assessment year will be applied to the next year’s assessment calculation to reduce that assessment rate.
Yes. However, if (a) there is a specific written agreement between two or more organizations responsible for the same covered life designating full responsibility for reporting and paying of the respective assessment and (b) that agreement is made available to WAPAL Fund for inspection and (c) the contractually designated organization reports and makes payment, other payer(s), if any, need not report and pay. If such a specific written agreement is filed with WAPAL Fund by all entities involved, then only one of the entities should report and pay assessments for the respective life. Generally, WAPAL Fund would expect that the entity responsible for payment on mandatory benefits under the federal Affordable Care Act will report and pay assessments for all covered lives which are the responsibility of that entity.
No. HCA will cover the proportionate share for those lives directly.
“Assessed entity” means any health care insurer or other entity that contracts or offers to provide, deliver, arrange, pay for, or reimburse any of the costs of health services. This includes:
a. a. Health carriers, as defined in RCW 48.3.005;
b. Self-funded multiple employer welfare arrangements, as defined in RCW 48.125.010;
c. Employers or other entities that provide health care in this state including self-funding entities or employee welfare benefit plans.
See RCW 710.24.064 and WAC 182.110-0400 for more information.
“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.
The term “covered life” means any individual residing in Washington with respect to whom the entity administers, provides, pays for, insures, or covers health care services, unless excepted by Washington statute.
Covered lives shall not include individuals whose health care services covered by programs administered pursuant to Chapter 74.09 RCW.
Yes, but 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 or is otherwise exempt by Washington statute so that it 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 so long as it continues to have no covered lives.
Contact Support@WAPALfund.org so its status can be changed and the entity can start reporting regularly, beginning with the first quarter in which it has covered lives.
An Annual Zero Covered Lives Report covers one 12-month period. You should plan to file your report again by February 15 of each calendar year. If, however, your company gains some covered lives during the year, it should start filing for each quarter in which it has covered lives.
An Annual Zero Covered Lives Report covers one calendar year. You should plan to file your report again by the end of the first quarter of each calendar or fiscal year.
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.
Please prepare your report as soon as possible. Voluntary compliance is important to assume equitable cost sharing and efficient program operation. KidsVax® is required to report non-compliant payers periodically to HCA and/or the Office of Insurance Commissioner which will follow up as they determine appropriate on any non-compliance which has not been promptly remedied.
You can have us reset your password by sending an e-mail to Support@WAPALfund.org. In the e-mail, please state that you have registered on the website and have forgotten your password and be sure to include your FEIN and a name and telephone number for us to reach you with questions.
Please contact KidsVax® by using the e-mail address Support@WAPALfund.org, explain what adjustments you need, and provide your contact information. A trained KidsVax® representative will follow-up on your request.
Please email Support@WAPALfund.org with an explanation of the mistake. WAPAL Fund will provide assistance so that you can print a corrected remittance form.
Yes. Please email Support@WAPALfund.org with an explanation of the mistake and the amount by which you overpaid, and WAPAL Fund will determine the best course of correction. Typically, overpayments are applied to reduce the next quarterly invoice.
Your payment can be submitted via mail to the PO Box on the remittance form or via Automated Clearing House (ACH) transaction. The addressing information can be found on the “WAPAL Fund Remittance Form” that appears after you submit your report. The WAPAL Fund remittance form can be printed and saved.
After the initial quarterly billing period, the assessments will be calculated quarterly and due 45 days after the close of each quarter, meaning reports and payments will typically be due on or before February 15, May 15, August 15, and November 15 each year. Quarterly payments are based on the number of covered lives an entity reports for the three months in each preceding quarter.
First-time users must register before they can log into the assessment system. After clicking here, you can register by entering your Federal Employer Identification Number, your e-mail address, and a private password of your choice.
Please note that because of the system’s security features, there may be a one-time delay of up to 30 minutes before a new account can be accessed for data entry.
Yes.
WAPAL Fund will set an assessment rate for each covered life.
Any aggregate over-payments for all payers, in total, above the statutorily set funding target in an assessment year will be applied to the next year’s assessment calculation to reduce that assessment rate.
Yes. However, if (a) there is a specific written agreement between two or more organizations responsible for the same covered life designating full responsibility for reporting and paying of the respective assessment and (b) that agreement is made available to WAPAL Fund for inspection and (c) the contractually designated organization reports and makes payment, other payer(s), if any, need not report and pay. If such a specific written agreement is filed with WAPAL Fund by all entities involved, then only one of the entities should report and pay assessments for the respective life. Generally, WAPAL Fund would expect that the entity responsible for payment on mandatory benefits under the federal Affordable Care Act will report and pay assessments for all covered lives which are the responsibility of that entity.
No. HCA will cover the proportionate share for those lives directly.
“Assessed entity” means any health care insurer or other entity that contracts or offers to provide, deliver, arrange, pay for, or reimburse any of the costs of health services. This includes:
a. a. Health carriers, as defined in RCW 48.3.005;
b. Self-funded multiple employer welfare arrangements, as defined in RCW 48.125.010;
c. Employers or other entities that provide health care in this state including self-funding entities or employee welfare benefit plans.
See RCW 710.24.064 and WAC 182.110-0400 for more information.
“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.
The term “covered life” means any individual residing in Washington with respect to whom the entity administers, provides, pays for, insures, or covers health care services, unless excepted by Washington statute.
Covered lives shall not include individuals whose health care services covered by programs administered pursuant to Chapter 74.09 RCW.
Yes, but 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 or is otherwise exempt by Washington statute so that it 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 so long as it continues to have no covered lives.
Contact Support@WAPALfund.org so its status can be changed and the entity can start reporting regularly, beginning with the first quarter in which it has covered lives.
An Annual Zero Covered Lives Report covers one 12-month period. You should plan to file your report again by February 15 of each calendar year. If, however, your company gains some covered lives during the year, it should start filing for each quarter in which it has covered lives.
An Annual Zero Covered Lives Report covers one calendar year. You should plan to file your report again by the end of the first quarter of each calendar or fiscal year.
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.
Please prepare your report as soon as possible. Voluntary compliance is important to assume equitable cost sharing and efficient program operation. KidsVax® is required to report non-compliant payers periodically to HCA and/or the Office of Insurance Commissioner which will follow up as they determine appropriate on any non-compliance which has not been promptly remedied.
You can have us reset your password by sending an e-mail to Support@WAPALfund.org. In the e-mail, please state that you have registered on the website and have forgotten your password and be sure to include your FEIN and a name and telephone number for us to reach you with questions.
Please contact KidsVax® by using the e-mail address Support@WAPALfund.org, explain what adjustments you need, and provide your contact information. A trained KidsVax® representative will follow-up on your request.
Please email Support@WAPALfund.org with an explanation of the mistake. WAPAL Fund will provide assistance so that you can print a corrected remittance form.
Yes. Please email Support@WAPALfund.org with an explanation of the mistake and the amount by which you overpaid, and WAPAL Fund will determine the best course of correction. Typically, overpayments are applied to reduce the next quarterly invoice.
Your payment can be submitted via mail to the PO Box on the remittance form or via Automated Clearing House (ACH) transaction. The addressing information can be found on the “WAPAL Fund Remittance Form” that appears after you submit your report. The WAPAL Fund remittance form can be printed and saved.
Filing Guides
These guides provide detailed instructions on how to file your report.
Guide to Quarterly Reports
This PowerPoint Presentation provides screenshots and reference information for quarterly filing. This Guide walks you through the assessment system step-by-step.
Guide to Zero Covered Lives Reports
This PowerPoint Presentation provides screenshots and reference information for both annual zero covered lives reports and permanent zero covered lives reports. This Guide shows you step-by-step how to file these reports.