Payment Plan Options for Purchasing Health Plans on DC’s New Exchange

The board governing DC’s implementation of federal health reform will soon decide how individuals will purchase insurance plans from what’s known as the DC Health Benefits Exchange. The Affordable Care Act mandates that individuals must have the option of paying their premiums directly to insurers, but DC is also considering allowing individuals to make payments to the Exchange. With this approach, the Exchange could become a one-stop shop for a family’s health insurance needs’and streamline the payment process. Currently, the Exchange board is taking public comment on how to collect payments, with a formal proposal forthcoming.    

Payment to the Exchange is known as “individual premium aggregation” ‘ in which the Exchange would collect premiums from consumers, aggregate them, and then forward them to the plan issuer.  For small employers in the Exchange, proposed federal regulations already require the Exchange to collect all payments, so the premium aggregation decision only will affect individual consumers.  

Allowing consumers to choose payment through the Exchange could add additional convenience.  After shopping and enrolling in a plan, the online portal would offer a consistent and streamlined billing process. Individuals could go to the same place for all health insurance functions. The Exchange’s customer service system would be available to answer questions on an array of topics spanning from initial enrollment to late payment fees.   

There are costs, however, to adding this option. The board will have to weigh the benefits to consumers against the costs associated with monthly billing, tracking payments, and contracting with a vendor who will aggregate and forward premiums to insurers. However, the Exchange will face these costs and administrative burdens for small employers no matter what they decide for individuals, which suggests that applying it to individuals may not add much to these costs.  Moreover, the additional costs of enhancing the payment options could substantially increase individuals’ ability to maintain coverage on the Exchange, especially among those who are new to the private insurance market.  

DCFPI encourages the Exchange board to consider adding this option. Unless there is evidence that allowing individuals to pay for their insurance through the Exchange is overly costly or burdensome, we believe this is the approach DC should take. Public comment on individual premium payments ends at 5:00 pm on Friday, December 14th.  To send comments, contact Rekha Ayalur at