In 2014, Health Insurance Marketplaces (also known as Exchanges) will operate a Small Business Health Options Program (SHOP) as an option for qualified small employers to purchase employee health coverage. The federal government will run the program in states that choose not to do so.
Below are five questions and answers related to SHOPs that may be of interest to employers.
- When does open enrollment begin?
Online enrollment for small employers to purchase employee health coverage through the federally-facilitated SHOP Marketplace will not be available until November. Small employers will be able to start the application process and get an overview of available plans and premiums beginning October 1, 2013.
- Which employers qualify for SHOP?
Beginning in 2016, all SHOPs will be open to businesses with up to 100 employees. In most states, SHOP participation will be limited to employers with 50 or fewer full-time equivalent employees in 2014.
An employer must have an office or employee work site within the SHOP's service area to use that particular SHOP. The employer also must offer coverage to all of its full-time employees (generally, those working 30 or more hours per week on average). In many states, at least 70% of an employer's full-time employees must enroll in the SHOP plan.
- Can an employer offer multiple plans to its employees?
Employers can choose from a number of plans from multiple insurance companies in the SHOP. However, once the employer has selected a plan, in most states employees will have only that one plan as an option in 2014. Certain states may allow employers to offer multiple plans. In 2015, employers will be able to offer multiple plans from all SHOPs.
- Are employers allowed to use a broker for SHOP?
Regardless of whether an employer buys coverage inside or outside of SHOP, the employer can use its current agent or broker. Health insurance brokers can help employers:
- Apply for insurance for their employees;
- Review and compare price, coverage, quality, and other important features; and
- Choose a plan that works for the employer's budget, business, and employees.
Employer premiums for SHOP coverage will be the same whether or not the employer uses a broker.
Can a business owner cover itself through a SHOP plan it offers to employees?
Yes. Note that self-employed individuals with no employees can get coverage through the individual Health Insurance Marketplace, but not through SHOP.
Let Sound Benefit Solutions help you with the new Health Care Reform act in California. Call us today at 925-244-1330.