§ 4–634. Program benefits; affordability.

(a) The Program shall provide, at a minimum, health and medical benefits that are equal to those provided to individuals enrolled in the DC HealthCare Alliance.

(b) The Program shall limit annual premium costs for program participants as follows:

(1) For a program participant with a gross household income of 300% of the federal poverty guidelines or less, the annual premium shall not exceed 3% of the participant’s gross household income; and

(2) For a program participant with a gross household income that exceeds 300% of the federal poverty guidelines, the annual premium shall not exceed 5% of the participant’s gross household income.

(Aug. 16, 2008, D.C. Law 17-219, § 5044, 55 DCR 7598; Feb. 4, 2010, D.C. Law 18-104, § 3(b), 56 DCR 9182.)

Effect of Amendments

D.C. Law 18-104 rewrote subsec. (b), which had read as follows: “(b) The Program shall limit annual premium costs to 3% or less of a Program participant’s gross income.”

Emergency Legislation

For temporary (90 day) amendment of section, see § 3(b) of Hospital and Medical Services Corporation Regulatory Emergency Amendment Act of 2009 (D.C. Act 18-277, January 11, 2010, 57 DCR 935).

For temporary (90 day) amendment of section, see § 2(c) of Healthy DC Emergency Amendment Act of 2010 (D.C. Act 18-528, August 3,

Temporary Legislation

Section 201(a) of D.C. Law 17-326, in subsec. (a), substituted “October 1, 2009” for “July 1, 2009”.

Section 402(b) of D.C. Law 17-326 provided that the act shall expire after 225 days of its having taken effect.

Section 3(b) of D.C. Law 18-134 amended subsec. (b) to read as follows:

“(b) The Program shall limit annual premium costs for program participants as follows:

“(1) For a program participant with a gross household income of 300% of the federal poverty guidelines or less, the annual premium shall not exceed 3% of the participant’s gross household income; and

“(2) For a program participant with a gross household income that exceeds 300% of the federal poverty guidelines, the annual premium shall not exceed 5% of the participant’s gross household income.”.

Section 6(b) of D.C. Law 18-134 provided that the act shall expire after 225 days of its having taken effect.

Section 2(c) of D.C. Law 18-270 rewrote subsec. (a) and added subsec. (c) to read as follows:

“(a) The Program shall provide health and medical benefits comparable to the DC Employee Health Benefits Program.”

“(c) Subsection (b) shall not apply to program participants receiving premium subsidies.”.

Section 4(b) of D.C. Law 18-270 provided that the act shall expire after 225 days of its having taken effect.