110.1 Pursuant to Section 4(f) of the Act (D.C. Official Code § 31-3171.03(f)), the Health Benefit Exchange Authority (HBX) shall annually assess each health carrier defined in Section 2(6) of the Act (D.C. Official Code § 31-3171.01(6)).

110.2 For purposes of this chapter and under D.C. Official Code § 31-3171.01(6), an accident and sickness insurance company includes companies offering certain insurance products, including but not limited to:

1. (a) Major medical; and
2. (b) Excepted benefits as set forth in 45 C.F.R. § 146.145 and 45 C.F.R. § 148.220 unless otherwise specified in Subsection 110.3.

110.3 For purposes of this chapter and under D.C. Official Code § 31-3171.01(3A), health insurance carrier risks do not include each of the following:

1. (a) Coverage for on-site medical clinics;
2. (b) Coverage issued as a supplement to liability insurance;
3. (c) Credit-only insurance (including mortgage insurance);
4. (d) Federal Employees Dental and Vision Insurance Program, as set forth at 5 C.F.R. §§ 894.101 et seq.;
5. (e) Federal Employees Health Benefits Program, as set forth at 5 C.F.R. §§ 890.101 et seq.;
6. (f) Fraternal benefit societies, as set forth in Section 1202 of the Fraternal Benefit Societies Act of 1998, effective April 29, 1998 (D.C. Law 12-86; D.C. Official Code § 31-5301);
7. (g) Liability insurance, including general liability and auto liability insurance;
8. (h) Medicare Part D, as set forth at 42 U.S.C. §§ 1395w-101 et seq.;
9. (i) Stop-loss insurance; and
10. (j) Workers' compensation or similar insurance.

SOURCE: Final Rulemaking published at 63 DCR 9668 (July 22, 2016).