DC| Bulletin 25-IB-003-09/17 from the DC Department of Insurance, Securities and Banking instructs insurers offering health benefit plans in the District of Columbia to continue providing coverage for all ACIP-recommended vaccines (as of December 31, 2024), including COVID-19 vaccines, without cost-sharing or obstructive management in individual, small, and large group markets. This interpretive guidance clarifies expectations under multiple local and federal laws, specifies that future updates may follow changes in medical organization immunization schedules, and notes exemptions for Medicare, self-funded arrangements, and limited-scope benefit plans.
Key Points:
- Insurers must cover all ACIP-recommended and DC-designated immunizations (including COVID-19), with no cost-sharing or restrictive management for eligible individuals in DC health plans.
- Exemptions apply to Medicare, self-funded plans, and limited-scope benefits; further DC guidance may follow medical organization schedule updates or public health designations.