Consistent with the Patient Protection and Affordable Care Act and District of Columbia law, the DC Health Benefit Exchange Authority will assess health carriers annually to support its annual budget beginning with FY 2015. Below is information regarding the assessment.
HBX Health Carrier Assessment and Appeals Process
The Notice of Assessment is sent out to health carriers on an annual basis in the summer and payment is due 30 business days after the date of the Notice of Assessment. A health carrier seeking to contest the assessment in the Notice of Assessment issued pursuant to DC Code Section 31-3171.03 can submit a request for reconsideration consistent with the HBX Health Carrier Assessment Final Rule (2016). A health carrier can file a request for reconsideration by submitting a written request to the DC Health Benefit Exchange Authority at [email protected] specifying the basis for the request as specified in this rule.
The DC Health Benefit Exchange Authority (HBX) sets the assessment rate on an annual basis, based on reasonable projections regarding the amount necessary to support HBX operations under DC Code Section 31-3171.03(f)(2). The historical assessment rates are posted below:
Assessment Rate (by Year)
2025 – 0.80%
2024 – 0.80%
2023 – 0.825%
2022 – 0.80%
2021 – 0.825%
2020 – 0.9%
2019 – 0.9%
2018 - 0.9%
2017 – 1.0%
2016 – 1.0%
2015 – 1.0%
HBX Health Carrier Assessment Final Rule
The DC Health Benefit Exchange Authority (HBX) Assessment Final Rule, issued pursuant to the Health Benefit Exchange Authority Financial Sustainability Amendment Act of 2015 (D.C Law 21-0013), was published in the D.C Register on July 22, 2016.
Other Financial Sustainability Documents
- Report to the Mayor and Council on Financial Sustainability
- Financial Sustainability Report Comments
- Emergency Health Carrier Assessment Rule
- Assessment Proposed Rule - Comments Requested
- Assessment Proposed Rule - Comments Received
- Assessment Proposed Rule Amended
- Assessment Proposed Rule as Published in the DC Register
- Assessment Proposed Rule Formal Comment Letters
- Assessment Due Process Draft Proposed Rule - Comments Requested
- Emergency Health Carrier Assessment Administrative Appeal
- Health Benefit Exchange Authority Financial Sustainability Amendment Act
- 2014 Administrative Appeal Rights Regarding the Health Carrier Assessment