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Carrier Reference Manual


Monday, April 22, 2024

DCHBX and DISB have developed a Carrier Reference Manual to provide insurance carriers with details on the process for becoming certified to offer qualified health plans and qualified dental plans. This manual will be periodically updated as policy, operational, and IT decisions are made so that carriers can keep abreast of key requirements for offering plans in DC Health Link.

2025 Carrier Reference Manual

  Appendix A DC Age Factors and Rating Curve
  Appendix B Health Insurance Rate Filing Requirements
  Appendix C DISB Rate Filing Checklist
  Appendix C Consolidated Form Review Checklist
  Appendix C DISB Rx Guide Template
  Appendix D HBX Issuer Attestations
  Appendix E DISB Guidance on Nondiscrimination in Benefit Design
  Appendix F Evidence of Coverage Tracking Form
  Appendix G CCIIO Quality Improvement Strategy (QIS)
  Appendix H Dental Benefit Supplemental Form
  Appendix I DC Issuer URL Template
  Appendix J Adopted Board Resolutions
  Appendix K DC Carrier Template
  Appendix L Actuarial Memo Dataset

2024 Carrier Reference Manual

  Appendix A DC Age Factors and Rating Curve PY2024.pdf
  Appendix B Health Insurance Rate Filing Requirements PY2024.docx
  Appendix C Consolidated Form Review Checklist PY2024.docx
  Appendix C DISB Rate Filing Checklist PY2024.docx
  Appendix C DISB Rx Guide Template PY2024.xlsx
  Appendix D HBX Issuer Attestations PY2024.pdf
  Appendix E DISB Guidance on Nondiscrimination in Benefit Design PY2024.pdf
  Appendix F Evidence of Coverage and SBC - Benefit Brochure Tracking Form PY2024.docx
  Appendix G CCIIO Quality Improvement Strategy (QIS) PY2024.pdf
  Appendix H Dental Benefit Supplemental Form PY2024.xlsx
  Appendix I DC Issuer URL Template PY2024.xlsx
  Appendix J Adopted Board Resolutions PY2024.pdf
  Appendix K DC Carrier Template PY2024.xlsx
  Appendix L Actuarial Memo Dataset PY2024.xlsx

2023 Carrier Reference Manual

Appendix C - Consolidated Form Review Checklist
Appendix C - Rate Filing Checklist
Appendix C - Prescription Guide Template
Appendix F - Evidence Coverage and SBC-Benefit Brochure Tracking Form
Appendix H - Dental Benefits Template
Appendix I - Supplemental Template for Formulary and Network URLs
Appendix J - Adopted Board Resolutions

2022 Carrier Reference Manual

Appendix C - Consolidated Form Review Checklist
Appendix C - Rate Filing Checklist
Appendix C - Prescription Guide Template
Appendix F - Evidence Coverage and SBC-Benefit Brochure Tracking Form
Appendix H - Dental Benefits Template
Appendix I - Supplemental Template for Formulary and Network URLs

2021 Carrier Reference Manual

Appendix C - Consolidated Form Review Checklist
Appendix C - Rate Filing Checklist
Appendix C - Prescription Guide Template
Appendix H - Dental Benefits Template