District of Columbia Employees’ Health Benefits (DCEHB) Program - Open Enrollment
November 13, 2023
Do I need to take any action if I want to remain with my current health insurance plan?
If you are satisfied with your current plan option, you do not have to do anything. Your coverage will continue throughout the 2024 calendar year.
What plans are available to me in 2024?
For all annuitants, the following plans are available:
· United HealthCare Open Access
· United HealthCare PPO (Coming soon)
Please note, starting in 2023, health plans are not allowed to charge you more than $35 for a one-month supply of each Medicare Part D-covered insulin product you are prescribed. In addition, charges in connection with insulin prescriptions will no longer be subjected to meeting the annual deductible requirement.
In addition, if you are age 65 or over and you are enrolled in Medicare Part A and Part B, you may be eligible to enroll in one of the Medicare Advantage plans sponsored by the District of Columbia Human Resources Department (DCHR):
· CareFirst Medicare Advantage
· United HealthCare Medicare Advantage
What are Medicare Advantage Plans?
Medicare Advantage plans are Medicare-approved plans from private insurance companies that offer an alternative to the original Medicare plan (Part A and Part B). To learn more about how Medicare Advantage plans work, click on the following link: https://www.medicare.gov/Pubs/pdf/12026-Understanding-Medicare-Advantage-Plans.pdf.
Who is eligible to enroll in the Medicare Advantage Plan?
Only annuitants who currently participate in a DCEHB plan and have Medicare Part A and Part B. Each enrollee must be Medicare-eligible. If a dependent is not Medicare eligible, the annuitant may not enroll in a Medicare Advantage plan and must stay in a current non-Medicare plan. For example, if you have a dependent not Medicare eligible, you may not enroll in a Medicare Advantage plan if you wish to insure your dependent.
What is the difference between the DCEHB program, Medicare, and Medicare Advantage?
Do I have to enroll in a Medicare Advantage plan?
No, you are not required to enroll in a Medicare Advantage plan. Enrolling in Medicare Advantage is optional.
Can I drop my Medicare Part B coverage and keep the Medicare Advantage plan?
No. Enrollment in Medicare Part B is a requirement of the District of Columbia Government. If you are considering enrollment in one of the Medicare Advantage plans, you must maintain your Medicare Part A and Part B coverages.
I’d like to change my current health plan; how do I complete the DCEHB Election Form?
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If you are making a change to your plan, you must complete Sections 1, 2, 3, and 4.
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If you are adding a spouse or domestic partner, you are required to submit a copy of the marriage certificate or domestic partnership registration.
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If you are adding a child, you must submit a birth certificate for each child.
If you are considering canceling your enrollment in the DCEHB program, you will not be allowed to re-enroll at a later date.
Where can I find the rates for the 2024 plan year?
Click on the following link to review the health insurance rates for the 2024 plan year: https://dcrb.dc.gov/node/943462.
How do I calculate my premium responsibility?
Annuitant contributions are based on a sliding scale. The percentage of your premium responsibility that you pay for health insurance coverage is based on the effective date of your retirement, your total years of District employment and in some cases, the type of retirement.
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If you are a retired teacher or the survivor of a retired teacher, your contribution percentage is determined by your years of employment and retirement date.
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If you are a retired police officer or firefighter or if you are a survivor, your contribution percentage is determined by your retirement plan tier, which is governed by your date of hire and years of service.
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If you are a police officer or firefighter who retired due to a disability incurred in the performance of duty or a survivor of a police officer or firefighter who died in the line of duty, your contribution percentage is 25%.
To find your contribution percentage, click on the box that fits you:
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After finding your contribution percentage, you will need to find the total monthly premium for your plan. To determine your premium responsibility for 2024, multiply the total monthly premium by your contribution percentage. Click on the following box to access the Open Enrollment calculation sheet.
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Here are four examples of how to calculate your monthly health insurance premium:
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If you are a retired police officer or firefighter hired on or after October 1, 1987, but before November 10, 1996, and you retired with 5 or more years of service, your contribution percentage is 25%. If you are selecting Kaiser HMO, the total premium is $2,121.97. To determine your monthly premium responsibility:
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$2,121.97 (total premium) x 25% (your percentage) = $530.49 (your monthly cost)
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If you are a survivor of a retired police officer or firefighter who was hired on or after November 10, 1996, and who had 23 years of service, your contribution percentage is 40%. If you elect United Healthcare Choice, Self Plus One, the total monthly premium is $1,708.58. To determine your monthly premium responsibility:
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$1,708.58 (total premium) x 40% (your percentage) = $683.43 (your monthly cost)
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If you are a retired teacher hired on or after October 1, 1987, and retired before October 1, 2009, with 5 or more years of service, your contribution percentage is 25%. If you select the Aetna HMO Self-Only plan, the total monthly premium is $973.63. To determine your monthly premium responsibility:
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$973.63 (total premium) x 25% (your percentage) = $243.41 (your monthly cost)
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If you are a survivor of a retired teacher who retired on or after October 1, 2009, and had 11 years of service, your contribution percentage is 77.5%. If you choose CareFirst PPO Self Plus Family, the total monthly premium is $2,657.57. To determine your monthly premium responsibility:
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$2,657.57 (total premium) x 77.5% (your percentage) = $2,059.62 (your monthly cost)
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How do I submit my Open Enrollment change?
For your convenience, you have 3 options to submit your Open Enrollment changes:
1. Member Services Online 24/7 - You can now visit dcrb.dc.gov to complete and submit your Open Enrollment election online directly to the DCRB Member Services team. Select “Member Services Online 24/7” and “Member Web Submission Forms” to access the online form.
2. DCRB Drop Box is a “no contact” tool. Between 8:30 am and 5:00 pm, you can drop off forms outside of the DCRB suite. Forms are collected and distributed at the end of each day.
3. U. S. Mail: District of Columbia Retirement Board
Attn: Member Services Center
(Open Enrollment)
900 7th Street, NW, Second Floor
Washington, DC 20001
Is there a deadline to submit my Open Enrollment form?
Yes. All forms and supporting documentation must be received by our office on or before Monday, December 11th. Forms received after that date must be postmarked for Monday, December 11th, and received in our office no later than Friday, December 22nd.
Who should I contact if I have a question regarding my health insurance coverage?
Our benefits administration team is here to serve you from 8:30 a.m. to 5:00 p.m., Monday through Friday (except District holidays). You can reach our office at (202) 343 3272, toll-free at (866) 456-3272 or TTY #711. Due to increased call volume during this busy time, members may experience longer than average wait times.
