Code of the District of Columbia

§ 47–5101. Definitions.

For the purposes of this chapter, the term:

(1) "Applicable entity" means:

(A) An employer or other sponsor of an employment-based health plan;

(B) The Department of Health Care Finance; or

(C) An insurance carrier licensed or otherwise authorized to offer minimum essential coverage.

(2) "Applicable individual" shall have the same meaning as provided in section 5000A of the Internal Revenue Code of 1986 (26 U.S.C. § 5000A), as the section and its implementing regulations were in effect on December 15, 2017; provided, that:

(A) An individual enrolled in the D.C. HealthCare Alliance program shall not be considered an applicable individual with respect to any month during which the individual was enrolled in the D.C. HealthCare Alliance program;

(B) An individual shall not be considered an applicable individual with respect to any month during which the individual was a resident of a jurisdiction other than the District;

(C) An individual shall not be considered an applicable individual if the individual is a member of a religious sect or division that is recognized by the United States Social Security Administration as conscientiously opposed to accepting any insurance benefits, including Social Security and Medicare; and

(D) An individual shall not be considered an applicable individual if the individual files a sworn affidavit with his or her District tax return attesting to a lack of minimum essential coverage on the basis of sincerely held religious beliefs during the entire taxable year for which the return was filed.

(3) "Authority" means the District of Columbia Health Benefit Exchange Authority, established by [§ 31-3171.04].

(4) "Chief Financial Officer" means the Chief Financial Officer of the District of Columbia, established by [§ 1-204.24a].

(5) "D.C. HealthCare Alliance" means the program established pursuant to [§ 7-1405].

(6) "Dependent" shall have the same meaning as provided in section 152 of the Internal Revenue Code of 1986 (26 U.S.C. § 152).

(7) "District shared responsibility payment" means the tax penalty incurred by a taxpayer for the failure to have the required minimum essential coverage required by this chapter.

(8) "Federal shared responsibility payment" means the tax penalty incurred by a taxpayer for the failure to have the required minimum essential coverage pursuant to the Patient Protection and Affordable Care Act, approved March 23, 2010 (124 Stat. 119; 42 U.S.C. § 18001, note) and section 5000(A) of the Internal Revenue Code of 1986 (26 U.S.C. § 5000A).

(9) "Immigrant Children's Program" means the program established pursuant to [§ 1-307.03(b)].

(10) "Internal Revenue Code of 1986" means the Internal Revenue Code of 1986, approved October 22, 1986 (100 Stat. 2085; 26 U.S.C. § 1 et seq.).

(11) "Minimum essential coverage" means:

(A) Except as provided in subparagraph (C) of this paragraph, minimum essential coverage as defined by section 5000A of the Internal Revenue Code of 1986 (26 U.S.C. § 5000A) and its implementing regulations, as that section and its implementing regulations were in effect on December 15, 2017;

(B) The Immigrant Children's Program; and

(C) Health coverage provided under a multiple employer welfare arrangement; provided, that the multiple employer welfare arrangement provided coverage in the District on December 15, 2017, or complies with federal law and regulations applicable to multiple employer welfare arrangements that were in place as of December 15, 2017.

(12) "Multiple employer welfare arrangement" shall have the same meaning as provided in section 3(40) of the Employee Retirement Income Security Act of 1974, approved September 2, 1974 (88 Stat. 833; 29 U.S.C. § 1002(40)).


(Oct. 30, 2018, D.C. Law 22-168, § 5002(b), 65 DCR 9388.)

Emergency Legislation

For temporary (90 days) creation of this section, see § 5002 of Fiscal Year 2019 Budget Support Congressional Review Emergency Act of 2018 (D.C. Act 22-458, Oct. 3, 2018, 65 DCR 11212).

For temporary (90 days) creation of this section, see § 5002 of Fiscal Year 2019 Budget Support Emergency Act of 2018 (D.C. Act 22-434, July 30, 2018, 65 DCR 8200).