Assessment Fund, Quarterly Forms, & Self- Insurer's Information

What is the Workers’ Compensation Assessment Fund?
The workers’ compensation administration fund was created to provide the funds necessary to administer Vermont’s Workers’ Compensation Program.

The fund consists of contributions from employers, based on the Workers’ Compensation Assessment Rate.

The statutory reference:  21 V.S.A. § 711. Workers' Compensation Administration Fund

Current Workers’ Compensation Assessment Rates:
Insurance Companies:

Effective July 1, 2018 the assessment rate remains at 1.4%.


1% of workers’ compensation losses during the preceding calendar year.

These assessment rates will remain in effect until further notice.

Please find " Self-Insurer's Report" form under Insurers link below

Assumption and Guarantee Form

EL-3 Surety Bond Form

Insurer’s Qtr Assessment Form Instructions and forms/reconciliation statements

Self Insured List 2018-2019