SHOP- Small Employer -> 50 employees-Marketplace/Exchange

The Small Business Health Options Program (SHOP) is a new program that simplifies the process of buying group health insurance for small businesses.

For 2014, the SHOP Marketplace is open to employers with 50 or fewer full-time-equivalent employees (FTEs).However, HHS recently announced that employer’s ability to enroll their employees in the new health insurance plans will be delayed to 1st November, 2013– BUT they can review the plan ( only a bronze designated plan with many variations thereof ,will be available for the 2014 year, we are advised),the employees can do everything necessary to be enrolled and wait to 11/15/13 for final enrollment, etc.

The advantages of using SHOP include:

i)-You control the coverage you offer and how much you pay toward employee premiums.
ii)-You can compare health plans online on an oranges-to-oranges basis, which helps you make a decision that’s right for your business.
iii)-You may qualify for a small business health care tax credit (* for employers of up to 25 employees whose employees receive wages of less than $50,000 per year) worth up to 50% of your premium costs as of 1/1/2014. You can still deduct from your taxes the rest of your premium costs not covered by the tax credit.
iv)-While the individual marketplace/exchange is open from 10/1/2013 to 3/31/2014 the SHOP marketplace/exchange is open year round!

Beginning 2014 employer’s tax credit on their insurance premium payments  is available only for plans purchased through SHOP.

Compare plans and apply online

The Small Business Health Options Program (SHOP) is designed for small employers with 50 or fewer full-time equivalent employees. With one online application, on your own or with the help of a qualified agent/broker, you can compare price, coverage, and quality of plans in a way that’s easy to understand.

You can enroll starting November 1, 2013 for coverage starting as soon as January 1, 2014. You can also enroll and begin coverage any time after January 1, 2014 throughout the year.
You decide what you’ll pay toward employee premiums, and then your employees can enroll on the SHOP marketplace/exchange.
There will be a SHOP Marketplace in each state. You must have an office or employee work site within the SHOP’s service area to use that particular SHOP. The online application will guide you to the right SHOP for you.

How do my employees sign up for SHOP?

Once you choose SHOP health insurance coverage that works for your business, your employees can sign up for it online through the SHOP marketplace/exchange.

After you choose your health insurance plan, you or the marketplace will notify your employees and tell them how to sign up. There are tools to help you create an employee roster, set up an employee email distribution list, or download the offer of coverage and distribute it to your employees manually.

Steps your employees take to get SHOP health insurance

Once your employees get the offer, they follow a few steps:

Verify their information to confirm that the name, date of birth, and Social Security information you provided are correct.

Provide additional information like address, contact preferences, tobacco use, and whether they have dependents that need coverage. This information will give them a better idea of what their costs will be.

Review the plan to see if it meets their needs. Your employees can see how much they will pay each month as a premium, what their deductible will be, and how much their total out-of-pocket costs could be. All of these steps can be done directly through the Marketplace.

Employees decide whether to accept coverage

Next, employees decide whether they want to accept or decline coverage for themselves and their dependents. If they accept the plan, they can view, download, and print a summary of the plan coverage.

Coverage won’t take effect until you approve the plan. Once the employee enrollment period is over, you can see who accepted coverage (including dependents if you’re offering dependent coverage). You can calculate the total costs to your business and decide if the plan you’ve chosen works for you. At this point, you can decide to approve the plan or explore other SHOP options.

What if employees decline the coverage I’m offering?

They can buy coverage in the individual Marketplace/exchange or elsewhere. But as long as the coverage the employer offers is affordable and meets minimum value, your employees won’t qualify to save money on monthly premiums or out-of-pocket costs on Marketplace plans.

You don’t have to pay a portion of the premiums of employees who get insurance outside of the plan you’re offering.

How to know if you qualify for the SHOP Marketplace

In 2014, SHOP is open to employers with 50 or fewer full-time equivalent (FTE) employees. Beginning in 2016, all SHOPs will be open to employers with up to 100 FTEs.
If you’re self-employed with no employees, you can get coverage through the individual market Health Insurance Marketplace, but not through SHOP.
If you plan to use SHOP, you must offer coverage to all of your full-time employees–generally those working 30 or more hours per week on average.
In many states, at least 70% of your full-time employees must enroll in your SHOP plan but states will set their own parameters.

You will be able to use a licensed agent/broker authorised by CMS to use the marketplaces to provide help or handle your SHOP business. You won’t pay more if you use a SHOP agent or broker.

Our SHOP FFM ID is EWALTERS37 and our NPN is-8594684

Get SHOP help from experienced and qualified agents or brokers

The premiums you pay will be the same with or without the help of agents or brokers.

Small businesses working with a broker will need to apply online (so they can enter their broker’s ID and NPN number).

For 2014 we are told by HHS that all HHS managed SHOP Marketplaces/Exchanges will only have 1 health insurance plan but with its various alternatives from various insurance providers to offer to employers/employees but will be offering the complete range of metallic designated plans for 2015 and beyond!

For further information including cost/premium estimates for your group contact:

Eric Walters.
Eric Walters Insurance Services, 14482 N 100th Place, Scottsdale AZ 85260
TeL: (480)-657-8595
FaX: (888)-739-0796
CELL: (602)-616-1660/ Email: / Eric’s WEB site


Get your SHOP quote

Remember to use our FFN ID: EWALTERS37 and NPN: 8594684 when setting up your account!

Leave a Reply

Your email address will not be published. Required fields are marked *