Health Care Reform

Key Facts for Small Employers Regarding the SHOP Marketplace

The Who, What, When & How of Purchasing SHOP Coverage

As of January 1, 2014, the Small Business Health Options Program (SHOP) is available as an option for qualified small employers to purchase employee health coverage. The federal government is running the program in states that chose not to operate their own SHOP Marketplace.

Who Can Purchase SHOP Coverage?
In general, small employers are eligible for SHOP if they:

  • Have 50 or fewer full-time equivalent employees;
  • Have at least one common law employee (self-employed business owners and sole proprietors must use the Individual Marketplace);
  • Offer coverage to all of their full-time employees (those working an average of 30 hours or more per week); and
  • Meet minimum participation rates (in the federally-operated SHOP, at least 70% of full-time employees must accept the employer’s offer of insurance, with certain exceptions) 

When Can Employers Purchase SHOP Coverage?
Eligible small employers can purchase SHOP coverage at any time during the year on a rolling monthly basis. The deadline to enroll is generally the 15th of the month for coverage to be effective the 1st of the following month.

How Do Employers Purchase SHOP Coverage?
For the federally-operated SHOP, employers must use direct enrollment in 2014. Employers may work with their agents or brokers to select a SHOP qualified health plan and enroll employees. It is anticipated that online functionality for the federally-operated SHOP will be available in 2015.

Employers located in a state operating its own SHOP Marketplace must follow that state’s application and enrollment process (many offer online enrollment).

To find out more about the SHOP Marketplace in your state, click here.

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