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If you have a Qualifying Life Event (QLE), you will have 30 days from the date of the event to change plans or change your type of enrollment.
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Once you enroll in a DC Health Link plan, your plan enrollment will continue indefinitely and will automatically renew for each calendar year if you take no action during Open Enrollment, unless an employment change occurs, such as a separation, break in service, or move to another agency with FEHB eligibility. If during a subsequent annual designation period, you are designated as NOT “official office” staff, your coverage would end 12/31 of that year and you would be eligible to elect an OPM-contracted FEHB plan during the Open Enrollment period.
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All DC Health Link plans must cover a comprehensive package of "essential health benefits" (EHB). DC Health Link’s benefits are based on those covered in the most popular small group health insurance policy currently sold in the District market. The benefits cover:
- Doctor visits
- Hospital stays
- Emergency room care
- Maternity and newborn care
- Prescription drugs
- Lab tests
- Preventive tests and services
- Rehabilitative and habilitative services and devices
- Chronic disease management
- Mental health care
- Substance use disorder services
- Dental care for children
- Vision care for children
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Your employer will begin withholding after DC Health Link notifies them of your enrollment and premium amount. Often this information is received well after the effective date, so any retroactive premium amounts will be withheld from pay. Employees should prepare for this retroactive withholding.
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When comparing plans on the DC Health Link, you will see a link to a list of providers in each plan’s provider network. It is very important that you evaluate the availability of each plan’s provider network in the area you live or the area you access healthcare prior to selecting a plan. Some plans may only provide benefits if you use in-network providers. If staying with your current doctors is important to you, check to see if they are included before choosing a plan. You may also contact the health insurance carrier for any questions about the provider network or whether a specific provider is covered by a particular plan.
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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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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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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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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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The “designation” process has no impact on FLTCIP eligibility. For more information, please contact your agency’s benefits officer.
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