Using the DC Health Link, businesses and residents can shop for health insurance, comparing a variety of options and choosing the plan that best fits their needs. New insurance requirements for employers in Washington DC were put into effect on July 1, 2016. Employers in Washington, DC are now required to use the DC Health Link system for purchasing and/or renewing health insurance for their employees—regardless of where they had purchased health insurance in previous years. DC employers are only permitted to work with brokers who are certified and appointed to work through the DC healthcare exchange, forcing many employers to find new brokers.
Although the revamped system is designed to help businesses navigate this new process, finding a high-quality broker may require more than a cursory search of the DC Health Link database. It could be argued that because the DC Health Link system uses search criteria that are somewhat general, that employers may be choosing an insurance broker without considering key information. Essential details such as a broker’s customer-satisfaction ratings, ability to provide reliable technology-backed solutions, a capacity to offer year-round, and other valuable information are currently absent from the DC Health Link system. This gap in information may put DC employers at somewhat of a disadvantage when researching new broker options
What Is the DC Health Link?
After the passage of the Affordable Care Act (ACA) in 2010, the DC government set up a health care exchange program to ensure that all residents had access to healthcare, in accordance with the Act’s goals. The DC Health Benefit Exchange Authority created the DC Health Link and continues to oversee the system. Using the DC Health Link, businesses and residents can shop for health insurance, comparing a variety of options and choosing the plan that best fits their needs. Individuals and families can also apply for cost assistance through the Health Link, and can make changes to their plans when eligible.
How is the DC Health Link Organized?
The DC Health Link offers two separate types of aid for individuals and businesses looking to purchase insurance through the DC Healthcare exchange: licensed brokers and more than 500 Assisters.
What Are Brokers?
Employers who only use the DC Health Link system to research brokers may be missing out on some key information.
Brokers are licensed professionals with expertise in the health insurance field. An insurance broker works with clients to help them determine what their health insurance options are, and which plan or program would best meet their requirements and budget. Brokers usually have long-standing relationships with their clientele and can continue to analyze their existing plan(s) to ensure that it continues to meet their needs over time.
To participate in the DC Health Link System, a broker must have an active DC license and be in good standing with the licensing board. They must also complete training on the DC Health Link System, and have a contractual relationship with each insurance carrier in the system for the market in which the broker intends to conduct business in.
In other words, if a broker intends to sell health insurance to small business owners, he or she must have a contractual agreement with all health insurance companies in the Health Link System that offers plans to small businesses.
2016 Changes to the DC Health Link System
Starting July 1, 2016, businesses that had typically purchased health insurance directly from an insurer were required to renew their plans through the DC Health Link System. Employers can work directly with brokers who are certified and appointed to work through the DC healthcare exchange.
Who is Eligible to Participate?
To be eligible to participate in the DC Health Link, a business must have a business location within the District of Columbia, have 50 or fewer full-time equivalent employees (as of 2016), and offer healthcare coverage to all full-time employees working at least 30 hours per week.
Full-time Equivalent Employees
Full-time equivalent employees are a way of calculating an employer’s total number of employees that counts a part-time employee as a fraction of a full-time employee based on the number of hours that a part-time employee works each week. For example, if an employer has 40 full-time employees working 30 hours per week and 20 part-time employees working 15 hours per week, the 20 part-time employees would each be counted as .5 employees. This means that the employer has a total of 50 full-time equivalent employees.
How Do Employers Use the DC Health Link?
Eligible businesses must have a business location within the District of Columbia, have 100 or fewer full-time equivalent employees, and offer healthcare coverage to all full-time employees working at least 30 hours per week.
Employers who are required to renew their plans through the DC Health Link System must create an account through the Health Link site which begins by entering basic company information and creating log-in credentials. The system will then match companies with their Health Link accounts. Employers must review and update their employee information through the system, and then determine plan offerings, contributions, and employee eligibility.
How Can Brokers Help Employers Use DC Health Link?
A certified DC Health Link broker can work with employers to help them update employee information, select plans, and finalize the details of their health insurance offerings. When an employer logs into its Health Link account, the system will display plans that are similar to the current plan(s) offered by the company. This may include offering health insurance coverage from multiple health insurers, allowing employees to pick the plan that best fits their requirements—a choice that was not previously available to employers outside of the Health Link system.
Working within a company’s budget, a broker can help an employer to determine elements of the plan such as the contribution amount using estimated plan costs. Finally, the employer and broker can select open enrollment dates and determine employee eligibility for the plan, with the broker making certain that these choices comply with all applicable regulations.
Transitioning to the DC Health Link
Under the new guidelines, employers in the District of Columbia will be required to use the DC Health Link System. This change seeks to provide affordable insurance plan options, but the transition may be a great upheaval for some DC employers—especially in situations where a company must research and select a new insurance broker.
Finding a New Broker Through DC Health Link
Many employers already use an insurance broker to purchase health insurance. This is due in part to the complexity of the procedure which be complicated and requires specialized knowledge about health insurance carriers, trends, and plans. These organizations are likely to have an established relationship with their broker.
The DC Health Link System requires brokers to be certified and appointed, which includes the completion of a DC Health Link training program. If an employer’s previous broker does not meet requirements, then employers will not be able to continue to utilize them when purchasing or renewing health insurance plans moving forward.
Why DC Employers May Be At a Disadvantage
Transitioning to the DC Health Link System may be a great upheaval for some employers—especially in situations where a company must research and select a new insurance broker.
When searching for a new broker, the DC Health Link system allows for employers to research and identify potential broker options based on predefined criteria.
Specifically, employers can search for brokers based on their specialties, languages, resident zip codes, and the name of the brokerage firm. These selected search criteria provide some functionality, but ultimately may limit employers in their search for the right broker.
How Broad Search Tools Can Make It Hard to Find a Quality Broker
The current search functionality of the DC Health Link system may not provide all the information that DC employers need to make a well-informed decision. In some cases, search criteria may be too general to be of benefit to DC employers. For example, it is possible that if 100 brokers meet a broad search criteria (for example, a broker that specializes in group policies), that the search results could be returned without a clearly-defined order, making research more difficult.
Additionally, the DC Health Link search function currently does not help employers to find brokers who have higher customer satisfaction rates, and it does not direct companies to brokers that offer additional services such as technology-based systems and solutions, or the capacity for year-round support. This limited search functionality may create the idea that all brokers are the equal—leaving DC employers who are researching brokers/firms at a distinct disadvantage.
Researching a Broker Outside of the DC Health Link System
Not being aware of a brokerage firm’s history of customer satisfaction, access to technology solutions, or ability to provide year-round support puts DC employers at a disadvantage.
For any employer in the District of Columbia who will be required to use the DC Health Link System, the search for a quality broker should not end with the system’s tools. DC employers should make sure to examine all aspects of a brokerage firm’s performance and services before selecting one. Digging deeper into the performance history and service offerings of eligible brokers/firms will enable DC employers to make a more well-informed decision.
A Final Take Away for DC Employers
Although the DC Health Link system does provide a system for researching insurance brokers, the broker search function is based only on whether a broker fits into certain categories, not whether the broker provides quality services. Ultimately, DC employers need to perform additional research on potential brokers and should not make a decision solely off the results they receive from a DC Health Link search.