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Health and Welfare Fee (Childhood Vaccinations) Assessment Request

Health and Welfare Fee (Childhood Vaccinations) Assessment Request 2026

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The document is a request from the Connecticut Insurance Department for insurers, health care centers, and third-party administrators to report the number of insured or enrolled lives in Connecticut as of May 1, 2021, for the purpose of assessing a Health and Welfare Fee related to childhood vaccinations. The report is due by September 1, 2021, and includes specific instructions for reporting entities, certification requirements, and penalties for late or inaccurate submissions.

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Click ‘Get Form’ to open it in the editor.
Begin by selecting your filing status under 'FILLING AS'. Choose between Insurer, Exempt Insurer, or TPA. If you select 'Exempt Insurer', provide a brief explanation in the designated field.
In the 'REPORTING ENTITY' section, fill in your entity name, street address, city, state, zip code, contact person’s name, phone number, and email address. Ensure that the email provided is suitable for receiving invoices.
Next, report the total number of insured or enrolled lives in Connecticut as of May 1st, 2021. Make sure this number reflects only those covered under specified insurance types. If there are none, indicate 'NONE'.
Complete the 'CERTIFICATION' section by signing and printing your name and title. Ensure that you are authorized to certify this report on behalf of your company.
Finally, submit your completed form electronically via email to cid.vax@ct.gov or mail it to the Connecticut Insurance Department at the provided address.

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2021	4.8 Satisfied (122 Votes)
2019	4.2 Satisfied (72 Votes)

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

How to assess immunization status of a child?

Compare the childs immunization record with the recommended immunization schedule. Decide whether the child has had all the immunizations recommended for the childs age. On the recording form, check all immunizations the child has already received. Write the date of the immunization the child received most recently.

How to obtain your childs immunization records?

You can request a copy from the school nurse or administration. State Immunization Registry: Many states have immunization registries where vaccination records are maintained. You can check with your states health department or visit their website for information on how to access these records.

Who pays for childhood vaccinations?

Payments from private insurance and Medicaid vary widely and often fail to cover the full cost of administering vaccines. The federal governments Vaccines for Children program provides free vaccines but no payment for the associated costs.

What is vaccination assessment?

Full assessment of a vaccine consists of a scientific evaluation of documentary evidence for quality, safety and efficacy.