The Small Business Health Options Program (SHOP) Marketplace (also called an exchange), is an online marketplace where small businesses and their employees have access to private health insurance coverage.


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 2015 and 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:

Note: Download the article below to view the chart.

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.