Enrollment Not An Option In 2014 For SHOP Marketplaces

Small businesses in states with a federally-facilitated Small Business Health Options Program (FF-SHOP) will only be able to enroll in coverage through an agent, broker, or insurer that offers a certified SHOP plan, according to recently released frequently-asked-questions from the Centers for Medicare and Medicaid Services (CMS). The CMS is calling this process “direct enrollment,” and notes that it is similar to how most small employers currently purchase and provide health insurance coverage to employees.

The Patient Protection and Affordable Care Act (ACA) created SHOP marketplace. To use the direct enrollment option, small employers do not need to apply for SHOP eligibility before enrolling or use Healthcare.gov. Small employers can use Healthcare.gov if they would like information on plan options. However, small employers will not be able to enroll in coverage through Healthcare.gov at this time, according to the CMS. The agent, broker, or insurer will enroll employees, and the SHOP Marketplace will review the application and can determine later whether the small business and employees are eligible for SHOP coverage.

CMS noted that this change to direct enrollment in states with a FF-SHOP marketplace does not affect the process for getting SHOP coverage in states running their own SHOP marketplace. Small businesses that want coverage to begin for employees on Jan. 1, 2014, should enroll by December 15 in states that are running a SHOP marketplace, and by December 23 for states with the FF-SHOP marketplace.

For more information, visit http://marketplace.cms.gov/getofficialresources/publications-and-articles/faqs-on-shop-enrollment.pdf.

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