SHOP stands for Small Business Health Care Options Program. The SHOP allows small business owners to be able to offer Health Care coverage to their employees. In this article, we will go over SHOP basics so that you can successfully enroll in a plan for your small business.
Eligibility
The first step is to determine if you are even eligible for SHOP coverage. To qualify you must meet the following requirements:
- Have 1-50 full-time equivalent employees
- Offer coverage to all full-time employees. Full time is considered working an average of 30 or more hours a week.
- Enroll at least 70% of eligible employees you offer insurance to.
- Have an office or work site in the state whose SHOP program you plan on using.
Visit healthcare.gov for more information on this.
Considerations
Once you determine that you are eligible to enroll in a SHOP plan, you will need to give some consideration to the coverage you are going to offer. Do you want to have one plan choice or multiple plan choices? Are you going to offer dental coverage as well? Are you going to cover a portion of employee premiums? Will you offer coverage to employees’ dependents, and if so will you cover a portion of these premiums? How long must someone be employed for coverage to kick in? Once you have determined the answers to these questions you will be ready to begin shopping for coverage.
Coverage
There are four categories of coverage to choose from on the SHOP marketplace. The categories are based on the percentage of services the insurance company will pay for and the percentage of services that covered employee will pay for. For the lowest plan level, bronze, the insurance company covers 60% and the insurance is responsible for the remaining 40%. Silver plans have 70% coverage from the insurance company, 30% responsibility for the insured. Gold is 80%/20% and platinum is 90%/10%. The better the coverage is, the higher your premiums will be, so you will need to determine what type of plan you can afford to offer.
Enrollment
If you have everything sorted out, now all that is left is to enroll. After January 1, 2018, you will not use healthcare.gov to enroll. You will need to contact a SHOP registered insurance agent or broker that will be able to facilitate your enrollment. Or you will need to contact the private insurance companies you have interest in working with. Typically, they will collect your contact information and then have a representative call you and go over what they offer in your area. Once you choose what plan(s) you wish to offer, you will just need to complete the enrollment process with your insurance agent or company representative.
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