D.C. Mun. Regs. tit. 26, r. 26-D9900

Current through Register Vol. 71, No. 49, December 6, 2024

Rule 26-D9900 - DEFINITIONS

9900.1

When used in this chapter, the following terms shall have the meanings ascribed:

Applicable plan- the lowest cost bronze plan available in the individual market through the exchange established pursuant to D.C. Official Code § 31- 3171.04(a)(1), without regard to whether the individual purchased that plan, or any plan, that would cover all individuals in the individual's nonexempt family, not including individuals treated as eligible for coverage under an eligible employer-sponsored plan under §210.3. The premium for the applicable plan takes into account rating factors (for example an individual's age) that the Authority would use to determine the cost of coverage.

Authority- the District of Columbia Health Benefit Exchange Authority established pursuant to D.C. Official Code § 31-3171.02.

Consumer Price Index or CPI- the same meaning as provided in 9 DCMR § 3999.1

Exchange - the Health Benefit Exchange established under section 5 of the Health Benefit Exchange Authority Establishment Act of 2011, effective March 2, 2012 (D.C. Law 19-94; D.C. Official Code § 31-3171.04) .

Health carrier - has the same meaning as provided in D.C. Official Code § 31-3171.01(6).

Household Income -

(1) For affordability exemption determinations under §210.3, household income has the same meaning as provided in 9 DCMR §3999.1.

(2) For affordability exemption determinations under §210.4, household income has the same meaning as provided in 9 DCMR §3999.1 increased by any amount of the required contribution made through a salary reduction arrangement that is excluded from gross income.

Maximum amount of any credit allowable under Section 36B- the maximum amount of the credit that would be allowable to the individual, or to the taxpayer who can properly claim the individual as a dependent, under Internal Revenue Code §36B if all members of the individual's family enrolled in a qualified health plan through the Exchange.

Nonexempt family-

(1) For individuals not listed as tax dependents for the applicable tax year, the individual and all individuals listed with the individual on their tax return, but not including individuals who are otherwise exempt under 9 DCMR § 3903.

(2) For individuals listed as tax dependents for the applicable tax year, the individual and all individuals listed with the individual on the tax return for the individual that claims them, but not including individuals who are otherwise exempt under 9 DCMR § 3903.

Plan Year-the eligible employer-sponsored plan's regular twelve- month (12-month) coverage period, or for a new employee or an individual who enrolls during a special enrollment period, the remainder of a twelve month (12- month) coverage period.

D.C. Mun. Regs. tit. 26, r. 26-D9900

Final Rulemaking published at 63 DCR 9668 (7/22/2016); amended by Final Rulemaking published at 67 DCR 001260 (2/7/2020)