Overview

With DC Health Link, businesses with 1-50 full-time equivalent employees (FTE) can create a Health Benefits Program for their company and offer quality, affordable medical, dental or vision insurance to their employees. If your company offers a Health Benefits Program through DC Health Link, here’s what you can expect:

• Companies that offer coverage to their employees through DC Health Link make a generous contribution towards your monthly premium costs for medical insurance – generally, no less than 50% of the cost of at least one plan available through their Health Benefits Program. You’ll pay your share of the premiums directly to your employer, typically through payroll deductions.
• If your employer offers more than one plan in their Health Benefits Program, you’ll be able to compare plans side-by-side and choose the plan that best meets your needs and budget. You’ll also be able to use your employer’s contribution to “buy up” to a plan that offers more benefits but costs you more, or “buy down” to a plan that better meets your budget.
• While optional, some companies also elect to extend coverage to spouses, domestic partners or children. Some also provide an optional matching contribution towards family coverage.
• All plans available through an employer’s DC Health Link Health Benefits Program offer an essential health benefit package that includes: doctor visits, hospital stays, emergency room care, maternity and newborn care, prescription drugs, lab tests, preventive tests and services, rehabilitative and habilitative services and devices, chronic disease management, mental health care, substance use disorder services, and dental and vision care for children.
• There are no out-of-pocket costs for most preventive services like cancer screenings, immunizations, smoking cessation, and well-baby and well-child visits.

How to Sign Up

If your employer offers coverage through DC Health Link, you should receive notification when it’s time to sign up.

• You’ll sign up for health insurance during the annual open enrollment period established by your employer.
• If you’re a newly-hired employee or experience a qualifying life event such as but not limited to marriage, birth, adoption or losing eligibility for other health insurance coverage, you’ll be eligible to sign up for or modify your coverage within certain time limits. Make sure to talk to your employer early on so you meet deadlines.
• If you decline your employer’s coverage for whatever reason, or miss the deadline for a special enrollment period, you’ll be able to sign up during your employer’s next annual open enrollment period.

Other options for coverage

The Affordable Care Act requires most people to have health insurance. Depending on your circumstances, you or members of your family may have coverage options through another employer, a spouse or domestic partner’s employer, a parent (for children under the age of 26), a university plan or another source. Some or all of your family members may also qualify for Medicaid or Medicare.

Before you elect to decline or waive your employer’s coverage, you’ll want to make sure you have coverage through another source or qualify for an exemption so you won’t have to pay a penalty to the federal government. For 2016, the penalty for not having coverage is the greater of $695 per person or 2.5% of your income in 2016. For more information, please visit the IRS website to review Questions and Answers on the Individual Shared Responsibility Provision.