Administration Delays Federal SHOP Exchange Online Enrollment

On November 27, 2013 the U.S. Department of Health and Human Services (HHS) announced that online enrollment in the federal Small Business Health Options Program (SHOP) exchange would not be available until the 2015 open enrollment period in November 2014.  HHS also released a series of questions and answers regarding how the federal SHOP exchange would function over the next year.

The Affordable Care Act (ACA) does not require small employers with fewer than 50 full-time or full-time-equivalent employees to offer health coverage to their workers. However, the ACA does provide small employers with access to a SHOP exchange in every state, offering coverage through qualified health plans that may take effect as early as January 1, 2014.  If a state has not elected to operate its own SHOP exchange, HHS operates an exchange on behalf of the state through the federal SHOP exchange.  There are currently 37 states in the federal SHOP exchange.

What does this really mean?  For small employers in states that use the federal SHOP exchange, small employers will not be able to use online enrollment until November 2014.  In lieu of online enrollment, affected employers will need to enroll through an agent, broker, or insurer.

The Impact:  Here’s what we know about the effects of the announcement:

  • It only applies to small employers in states that use the federal SHOP exchange.
  • Employers will not be able to use online enrollment in the federal SHOP exchange until November 2014 (2015 open enrollment).
  • Instead of enrolling online, affected small employers will need to enroll through an agent, broker, or insurer.  The agent or broker will also help the employer fill out a paper application for SHOP coverage which will be sent to the federal exchange.  Alternatively, employers may fill out the application form themselves or call a special SHOP exchange call center.  The federal SHOP will provide an eligibility notification within 3 to 5 days of receiving the application by phone or email, or by mail if requested.
  • Small employers may offer coverage through the SHOP Marketplace at any time during the year. If employee enrollments are submitted between the 1st and 15th day of the month, the group coverage begins the first day of the next month. After the 15th of the month, the group coverage begins on the first day of the second month.
  • For coverage beginning on January 1, the current enrollment deadline is December 15.  The November 27th announcement from Health & Human Services stated that for federally-facilitated SHOPs, the government intends to extend this deadline to December 23.

ThinkHR will continue to monitor developments in this area.