ObamaCare SHOP Overview

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In 2014, small businesses that offer coverage through a FF-SHOP will be able to offer their employees a single qualified health plan (QHP) option. The FF-SHOPs will provide the flexibility in the amount that members of the small group contribute towards the total premium.

To qualify for a SHOP, a business must:

Be located in a SHOP's service area (generally a state)
Offer coverage to all full-time employees (those working an average of 30 or more hours per week)
Have at least one eligible employee on payroll
Have 50 or fewer full-time equivalent (FTE) employees on payroll in 2014
- This methodology includes part-time employees, but not seasonal employees (those working fewer than 120 days per year)
- While the FF-SHOP must determine eligibility using the definitions above, State-based SHOP Marketplaces have flexibility in their counting approaches in 2014

SHOP Overview

SHOP Marketplaces offer small employers several advantages, including:
- The ability to offer a QHP to all employees
- Choice of percentage contribution toward the health insurance premium of each employee
- Less financial uncertainty related to premium cost increases at plan renewal
- A plan compare tool to help employers compare plans
- Small business tax credits
All medical plans offered in a SHOP must be QHPs.
Pre-existing condition exclusions will no longer apply.
Premiums in the SHOPs will be built differently than prior to the enactment of the Affordable Care Act.
There are limitations on how premium rates may vary.
Participation in wellness programs can reduce premiums for individual enrollees.

Agent Resources:

To speak with an agent call: 862-262-2273

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