SHOP Marketplace

Does it impact my business?

The Small Business Health Options Program (SHOP) is an online marketplace where small businesses and their employees will have access to private health insurance coverage. On October 1, 2013, open enrollment generally begins for small businesses. Some states have delayed SHOP open enrollment. In the Federally Facilitated SHOP, employers can shop for coverage options but may need to wait until November to finish enrollment.


Features:

  • Employer Choice – employers can choose a single plan to offer employees.
  • Administration – one enrollment platform for your employees.
  • Qualified Health Plans (QHPs) – all plans on the exchange will offer minimum essential benefits.

New features expected by January 1, 2016:

  • Employee Choice – the option to choose a coverage value and employees will be responsible for shopping for the best plan and carrier for them.
  • Premium Aggregate Billing – even if your employees choose multiple carriers, you will only need to pay one bill to the exchange.

See below to learn how these new exchanges may impact your business:

Penalized for not providing affordable, minimum health care coverage* to your employees? Eligible for Small Business Health Options Program (SHOP) Marketplace? Eligible for Small Business Tax Credits worth up to 50% of what you pay toward the cost of providing health insurance to your employees for two consecutive years.
Small Business
<25 Employees
No Yes Yes, only if you offer employees health insurance coverage through the SHOP Exchange.
Small Business
25-50 Employees
No, except for employers with 50 employees starting in 2015. Yes No
Small Business
51-100 Employees
Yes, starting in 2015. Generally, no, not before 2016. For 2014 and 2015, states may cap SHOP participation at 50. No
Large Business
100+ Employees
Yes, starting in 2015. No. However, states may choose to open the SHOP Marketplace to employers with 100+ employees in 2017. No

*Affordable, minimum value coverage

  • Affordable – Employee portion of the premium for self only coverage is less than 9.5 percent of the employee’s household income.
  • Minimum Value – Employers must offer coverage that pays at least 60% of allowed expenses.

1 2013 Aflac WorkForces Report, a study conducted by Research Now on behalf of Aflac, January 7 – 24, 2013

Note: This chart has been shortened for your optimal online experience. Click download the article to download the full PDF

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