Changes in Health Coverage

• I am a Member of Congress or designated congressional staff.  My spouse will be covered under my DC Health Link plan as a family member. Can he or she continue coverage if I pass away while he or she is covered under my plan?  View more
  As long as your spouse is otherwise eligible for a survivor annuity, he or she will be eligible to enroll in an OPM-contracted FEHB plan.  Please contact your agency’s benefits officer for more information.
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• I am a Member of Congress or designated congressional staff. If I make a change to my DC Health Link plan based on a Qualifying Life Event, when will the new coverage take effect? View more
  For the birth or adoption of a child, coverage for the child (and other new enrollees) begins on the date of birth or adoption.  For other QLEs, coverage begins on the 1st day of the month following the date of the event (e.g., if you married 4/14, coverage for the new spouse starts 5/1).  If you are dropping coverage for yourself or a family member, coverage ends on the last day of the month in which the life event occurred (e.g., if an enrolled spouse gets a new job on 4/14 and gains employer coverage, the end date of the spouse's coverage is 4/30).
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• I am a Member of Congress or designated congressional staff. If I separate from service will I be eligible for Temporary Continuation of Coverage (TCC)? View more
  TCC will be available to enrolled Members of Congress and designated congressional staff who leave their jobs, as well as eligible family members, with the same rules that apply to TCC for other federal employees and eligible family members.  TCC will only be offered through OPM-contracted FEHB plans.  Please contact your agency’s benefits officer for more information.
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• May Members of Congress and congressional staff purchase plans via the DC Health Link that include coverage for elective abortion services? View more

  Yes.  However, all issuers offering such coverage must segregate federal funds to ensure the portion of the premium that goes towards elective abortion services and any associated administrative costs comes from premiums contributed by the employee, not from the government contribution. 

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• I am a Member of Congress or designated congressional staff. Once I am enrolled in a DC Health Link plan, will my coverage continue into the next year if I take no action during open enrollment (just as it does for OPM-contracted FEHB plans) or do I need to take affirmative action to continue coverage under the same plan? View more
  You do not have to take affirmative action to continue coverage under the same DC Health Link plan.  Note: You should always check during Open Enrollment to see that your current plan is continuing as a participating plan in DC Health Link for the following calendar year. 
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• I am a Member of Congress or designated congressional staff enrolled in a health benefits plan via the DC Health Link with a government contribution. Will I be entitled to a 31-day extension of coverage if my DC Health Link coverage is terminated for any reason? View more
  No.  Health benefits plans purchased via the DC Health Link do not have an extension of coverage provision in their benefits coverage
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• As a Member of Congress or designated congressional staff, how do I determine my monthly premium for a DC SHOP plan? View more
  You can determine your monthly premium by visiting www.DCHealthLink.com, creating an application and shopping for coverage.  When you shop for plans, you will be able to see the monthly employee contribution, as well as the employer contribution and total monthly premium.
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• As a Member of Congress or designated congressional staff, how will I know when I can view my plan options on the DC Health Link website? View more
  If you are a new hire, your Benefits Office will notify you when your plan options are available to view on www.DCHealthLink.com.
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• How is OPM ensuring compliance with the prohibition against the use of federal funds to provide and administer health plans that offer elective abortion coverage? View more
  OPM has notified all issuers on the DC Health Link of the requirement to segregate federal funds in order to ensure that no portion of the government contribution towards the health care premium for a Member of Congress or congressional staff goes toward the cost of providing or administering elective abortion services.  Issuers have been asked to follow the same segregation requirements as they do for the individual Exchanges, found in 45 C.F.R. §156.280. 
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• Will I continue to be covered by my DC Health Link plan if I go into ‘leave without pay to perform military service’? View more
  Generally employees in that status may continue their employer-sponsored DC Health Link coverage for up to 2 years.  The employer continues to pay the employer contribution for the first year and pays the employee contribution on the employee’s behalf. The employee encounters a debt for the employee portion.  For the second year, the employer pays the entire premium on the employee’s behalf.  The employee incurs a debt for the entire premium amount.  Based on USERRA, the employer may choose to waive this debt if the employee returns to service with the agency within the requirements set forth in USERRA. Check with your agency’s benefits officer if you have questions on this.  You may also choose to cancel your DC Health Link coverage based on LWOP-Military and you may choose to re-enroll upon your return from active duty
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