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Posted by on Aug 16, 2013 in D.C. | 0 comments

The District of Columbia


The DC Health Benefit Exchange Authority (HBX) is responsible for implementing and operating the health care exchange program in the District of Columbia in accordance with the PPACA. DC Health Link is the online marketplace that allows people to shop for health insurance by comparing health insurance plans, applying for financial aid, and enrolling in coverage.

I understand that the online marketplace should make it easier to compare health insurance options, but what if I want to compare my options on and off the exchange?

In the District of Columbia, the DC Health Link will act as the single source for small businesses and individuals to review and compare coverage options.

THE HBX Executive Board adopted recommendations to unify the commercial small group and individual plans into one marketplace; this means that carriers selling individual and small group products are required to do so through DC Health Link. Individual plans may only be offered through the Exchange beginning on January 1, 2014, while small group plans have until January 1, 2015 to transition to the Exchange.

Which companies will be offering plans on the exchange?

In May of 2013, four insurance companies submitted rates for approval with the DC Department of Insurance, Securities and Banking.  The January 2014 Rates for individual and small group health insurance products have been reviewed and over 300 products have been approved for DC Health Link.

Aetna will be offering both individual and small group plans. The company will be offering plans in both markets at the gold, silver, and bronze metal levels and there will be a catastrophic plan option available in the individual marketplace.

CareFirst BlueChoice, Inc. and CareFirst BlueCross Blue Shield, also operating as Group Hospitalization and Medical Services, Inc., will be offering a variety of plans in both the individual marketplace and the small business marketplace. Products will look very similar to the company’s current offerings with names like BlueChoice, HealthyBlue, and BluePreferred. There will be options for health savings accounts/health reimbursement accounts. Plans will be offered at the platinum, gold, silver, and bronze levels and there will be a catastrophic option for individuals who qualify.

Kaiser Permanente will also be offering both individual and small group plans through DC Health Link. While Kaiser will not have as many options available as some of the other carriers, there will be options at the platinum, gold, silver, and bronze levels for both individuals and small groups with a catastrophic product available for qualifying individuals.

UnitedHealthcare/Optimum Choice will only be offering products in the small group marketplace. A range of products will be offered at the platinum, gold, silver, and bronze metal levels.


Will premiums be the same districtwide?

In the District of Columbia, premiums will not be affected by where in the area one lives.

In many health insurance markets, insurers can charge different premiums depending on the geographic area in which a person resides. Many states are broken down into multiple geographic rating areas and the same individual could be looking at different premiums depending on where in the state they live. In the District of Columbia, there is only one rating area; so premiums will not vary across the area in regards to this factor.


What will the health insurance rates look like?

In order  for consumers to get a better idea of what to expect when the online marketplace opens on October 1, the Health Benefit Exchange Authority posted rates for bronze, silver, gold, and platinum products; here is a look at rates for the individual market as of July 19, 2013:


As of July 23, 2013, here is an example of what to expect for small group rates:


New information is being released every day. Follow this blog to receive updates as new information is released in the District of Columbia.

Jillian Carlile
Research Analyst & Health Exchange know-it-all

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