SHOP Marketplace and how to enroll in it

The Small Business Health Options Program (SHOP) Marketplace allows small business to provide qualified health plans for their employees. In 2014 you cannot create a Marketplace account, but you can use healthcare.gov to compare plans benefits and premiums. There is no online enrollment available in 2014, but you may use DIRECT ENROLLMENT through your agent, broker, or insurance company. Read more about SHOP Marketplace and how to enroll in it.

Are you qualified for the SHOP Marketplace?

For 2014 employers with 50 or fewer full-time equivalent employees will be qualified to use SHOP Marketplace. No later than January 1, 2016, SHOP will be available to employers with 100 or fewer full-time equivalent employees.

The following conditions should be met in order to be qualified for the SHOP Marketplace:

  • You must have at least one common-law employee on payroll (not including business owner or sole proprietor or their spouses if they are on payroll).
  • You must offer coverage to all your full-time employees – those working 30 or more hours per week.
  • In many states, 70% of your full-time employees must enroll in your SHOP plan. But employers applying for SHOP in the period between November 15 and December 15 are free from this requirement.

Am I eligible for Small Business Healthcare Tax Credit?

You may qualify for small business tax credit if:

  • You have fewer than 25 full-time equivalent employees making an average of about $50,000 a year or less.
  • You will pay at least 50% of your full-time employees’ premium costs.

If you plan to claim the Small Business Healthcare Tax Credit, you’ll need to get an official eligibility determination from the SHOP Marketplace.

Your tax credit is worth up to 50% of your contribution toward employees’ premium costs. It is highest for companies with fewer than 10 employees who are paid an average of $25,000 or less.

How to enroll in SHOP Marketplace?

Use the checklist below to verify that the following information is available:

  • Employer Identification Number
  • Tax ID
  • Number of employees
  • Date of birth for all employees (and their dependent, if you plan to offer dependent coverage)

Contact your agent, broker, or preferred insurance company:

    • To apply for SHOP eligibility.
    • To find and compare available SHOP plans – price, coverage, quality, and other important features. For this purpose, you may use government website healthcare.gov.
    • To get help in picking a plan you want to enroll in.

Your agent, broker, or insurance company will help enroll you and your employees. You do NOT need to wait for SHOP eligibility to enroll.

You may enroll in SHOP on a monthly basis. The deadline to enroll is the 15th of the month for coverage to be effective the 1st of the following month.

More about the role of agents and brokers in the SHOP can be found in Can I use an agent or broker to buy health insurance in the Marketplace?  Remember, you pay the same, with or without a broker.

Employer Options

  • You define a percentage that you would like to contribute toward premiums for employee-only coverage.
  • You do not have to offer the dependent coverage. If you do, you’ll need to define a percentage that you’ll contribute toward their premiums.
  • You can decide to have employees pay their premiums based on age, or have everyone to pay the same premium regardless of age.
  • You can change what plans you’ll offer to your employees and contributions amount ONLY during your Annual Enrollment period. But you may use Special Enrollment period (outside of your Annual Enrollment period) to sign up for coverage or make changes to the coverage for qualified employees or their dependents.

 

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For help finding the best Medicare or Individual Health Plan for you, please contact Liberty Medicare or call us at 877-657-7477.

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