Wednesday, December 18, 2013

Direct Enrollment in the Federally Facilitated SHOP Marketplace


As noted in previous communications, the Small Business Health Options Program (SHOP) was created in the Affordable Care Act (ACA), and is a new way for small businesses to buy health insurance for their employees.  You can offer employee coverage through the SHOP Marketplace at any time during the year.  Included in this article is important information about direct enrollment.  If your small business is located in a state that is using the Federally Facilitated SHOP Marketplace, you can use HealthCare.gov’s new “direct enrollment” process to get coverage for your employees.  Here is how it works:

  1. Contact an agent, broker, or insurance company that offers plans through the SHOP Marketplace.
  2. Be sure you and your employees enroll in a SHOP Qualified Health Plan.
  3. Claim your tax credit.
According to the HealthCare.gov site, the insurance company can tell you exactly how much coverage will cost and can enroll your employees directly into the plan. If you prefer, you can opt to wait to enroll employees until after you receive an official notice of eligibility from the Federally Facilitated SHOP. You’ll need this notice before you file your tax returns, if you want to claim the enhanced Small Business Tax Credit.  If your business is located in a state that is running its own SHOP Marketplace, you’ll need to follow that state’s application and enrollment process.

All the federally facilitated exchanges are available for employers with less than 100 employees.  The State exchanges are available to those employers with less than 50 employees, and there are 16 state exchanges and 35 federally facilitated exchanges.  Employers that are eligible for SHOP can call the Health Insurance Marketplace Small Employer Call Center at 1-800-706-7893 to get general SHOP and small business questions answered by a customer service representative Monday through Friday, 9am to 7pm EST. 

If you have any questions relating to the ACA, please submit them to insurancecoverage@ahca.org, and be sure to check out AHCA/NCAL’s ACA website

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