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Small Business Migration to DC Health Link

Migrating your Health Benefits to DC Health Link

One Big Market for Small Businesses

As of July 1, 2016, small businesses in the District of Columbia purchasing health insurance directly from an insurance company will now renew through DC Health Link. DC Health Link is working closely with the health insurance companies to coordinate the transition to ensure a smooth process for small employers, employees, and their Brokers.

What you need to know:

For Employers

A DC Health Link account was created for your small business from the information provided by your health insurance company. This account has a draft application based on your current plan offerings. When you receive your renewal notice from DC Health Link, 90 days prior to your coverage renewing, follow the steps below to access your account:

  1. Create an account, login and link to the pre-populated DC Health Link Account for your business.

    • Create login credentials
    • Enter basic company information
    • DC Health Link will match your company with your DC Health Link account
  2. Review and update employee information on your roster. Your Broker can help with this process.

    • Employees and dependents who are currently enrolled will already be included on your roster
    • Add basic information on eligible employees who aren’t currently enrolled to your roster
  3. Review and finalize plan offering(s), contributions, and eligibility rules. Your Broker can help with this process.

    • Displayed plan offerings will be the same or most similar to your current plan(s)
    • Review other plan options, including offering coverage from multiple health insurance companies – an option not previously available to small businesses outside of DC Health Link
    • Determine employer contributions using the cost estimates provided in your account
    • Select an open enrollment start and end date for employees
    • Finalize and submit your plan year options so employees can begin plan shopping

Please utilize this Checklist for Migrating Employers to assist with your renewal.

DC Health Link and your health insurance company have been working closely together to make the transition to DC Health Link as smooth and seamless as possible. Your health insurance company has provided information to DC Health Link about your current plan, so that we can establish your renewal option to match your current plan as closely as possible.

  • If you’re currently offering a single plan, your DC Health Link renewal will be set up for you to renew into the same plan or a comparable plan.
  • If you currently offer more than one plan, your DC Health Link renewal will be set up to offer all small group health plans from your current health insurance company.
  • You can quickly renew coverage with the default renewal plan(s), or review all health plan options available to your business, including offering health plans from multiple health insurance companies.

Your insurance company provided DC Health Link with information for all employees and dependents with active coverage. If an employee isn’t enrolled in coverage through the insurance company but is an eligible employee, you’ll need to add them to your employee roster. When you review the information in your DC Health Link account, please be sure each employee has an accurate email address on file.

New Hire Coverage Effective Date Options

Small businesses that use DC Health Link can choose the coverage effective date for new hires from these options:

  • First of the month following or coinciding with date-of-hire
  • First of the month following 30 days after date-of-hire
  • First of the month following 60 days after date-of-hire

Coverage effective dates equal to the date-of-hire are no longer an option to employers, per federal regulations.

Reference Plan and Employer Contribution Model

Employers that offer plan participants a choice of plans (by metal level or insurance company) choose one plan among them to cap costs. This is the reference plan. Your contribution will remain fixed based on the percentage contribution set for your reference plan. Employees enrolling in any other available plan will pay the difference in premium to “buy up” or “buy down”.

Your reference plan keeps costs predictable. It NEVER costs you more to let employees choose by metal level or insurance company. Employers must contribute at least 50% of the reference plan premium for employees. Optionally, employers can offer coverage to employees’ dependents, but are not required to make a contribution towards dependent coverage.

For employers migrating to DC Health Link, the initial reference plan will be determined based on the plan in which the most employees are presently enrolled. When an employer or Broker reviews the renewal application, the reference plan can be changed.

Monthly Invoices

Invoices are mailed by DC Health Link to the employer’s address of record around the first of each month for the next month’s coverage. For example, an invoice mailed on August 1 will be for coverage for the month of September. Premiums must be paid directly to DC Health Link by the last day of each month.

The first invoice mailed to employers migrating to DC Health Link will be sent by mail the month preceding the plan year start date. Invoices are also available within the employer account under “Billing” after the close of employee open enrollment.

Employers may receive up to two final invoices from their insurance company after renewing coverage through DC Health Link. These invoices will address any necessary reconciliation or changes made prior to the renewal plan year start date.

Employers whose plan year renews on or after July 1, 2016 will renew through DC Health Link.

Timeline:

  • 90 days before renewal- All small employers and Brokers will receive a notice from DC Health Link informing them that their renewal plan year information is available on DC Health Link. The notice will instruct employers on how to create and manage their account on dchealthlink.com.
  • These groups will follow the renewal deadlines under Renewal Employer Application.

    Example:

    • Renewing coverage 10/1/2016
    • Notice sent to employer and Broker on or around 7/1/2016 alerting them they are now able to create their DC Health Link account and access the renewal benefits and make any edits.
    • Employer must finalize their renewal plan year by 9/5/2016
    • Employees have until 9/13/2016 to review their plan options and either make a plan selection or waive coverage. Employees who do not take any action will be automatically re-enrolled into the comparable version of their current plan, if it’s available to them.
  • New Member Materials are sent by the health insurance companies on or around the coverage renewal date.

Employee plan selections can only be made within the employee’s account and can be done so by the employee themselves or the Broker for the group. An employee’s status must say “Employee Role Linked” in order for a Broker to assist an employee.

Groups migrating onto DC Health Link will not have dental benefits setup as part of their benefit offerings on DC Health Link. These groups are able to add dental coverage as part of their benefit offerings on DC Health Link. If a migrating group has existing dental coverage, adding dental coverage on DC Health Link is not a renewal of this existing dental coverage, even if the group selects the same dental carrier and plan. Any groups that currently have dental coverage and add dental coverage as part of their benefit offerings on DC Health Link will need to contact their dental carrier to terminate their existing dental coverage.

Vision will continue to be handled directly with the carrier, outside of DC Health Link.

After a small business migrates to DC Health Link, DC Health Link will assist with the processing of COBRA and DC Continuation medical benefits. When an employee elects COBRA or DC Continuation, please reach out to our small business specialists at employer.hbx@dc.gov for assistance.

For Brokers

Brokers assisting small businesses with 1-50 employees migrating to DC Health Link must be registered with DC Health Link. See the Broker Registration Walkthrough Guide. Brokers must submit an application, complete training through the National Association of Health Underwriters and obtain all necessary carrier appointments.

When a registered Broker’s employer client’s renewal is ready, the Broker will receive notice. The Broker is then able to access the employer’s account to review plan offerings and update the employee roster. Brokers can complete all renewal activities on behalf of their employer clients.

Yes. All Brokers seeking to become approved by DC Health Link must obtain all carrier appointments, depending on which market they are applying to assist. The Producer Advisory Committee’s resolution provides additional context on the requirements.

To access an employee’s account through your Broker portal, search for the employee’s name on the “Families” tab. By selecting their name, you’ll be able to access their account and make any changes, including making a new plan selection, on their behalf. We also have many walkthrough guides, forms and resources that may be helpful for both you and your clients.

Please utilize this Checklist for Migrating Employers to assist with your renewal.

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