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Small Business Employee Benefits and HR Blog

CMS Releases New FAQs for Small Business SHOP Exchange

On October 2, 2013, the Centers for Medicare and Medicaid Services (CMS) issued FAQ #6 for the federally-run small business SHOP Exchanges, also known as the SHOP Marketplaces or FF-SHOPs. Small employers with 50 or fewer employees are currently eligible to purchase group health insurance coverage through their state's SHOP Exchange. FAQs

SHOP Marketplace FAQs

The frequently asked questions (FAQs) included information about:

  • How premiums will be calculated in the SHOP Exchange

  • How premium rates for small employers with employees in multiple states will be calculated

  • Whether a small employer’s premium rate may be changed during the employer’s plan year 

  • Whether composite (or average) premiums may be used in the SHOP Exchange

  • How employers may contribute to employee and dependent premiums in the SHOP Exchange

  • Whether employers purchasing coverage through the SHOP Exchange may vary premium contribution amounts to different employee classifications (i.e. part-time vs. full time, hourly vs. salary)

  • How employees will be allowed to contribute to their premiums in a SHOP Exchange

  • What happens if an employer’s estimate of the number of employees who will participate (elect coverage) is different from actual participation, and the associated impact on premiums

  • Examples of contribution calculations:

    shop faq

Click here to read the full SHOP FAQ.

Online enrollment for the federally-run SHOP Exchanges will not be available until November 1, 2013 (see an overview of the delay in the SHOP online enrollment here).

  Health Insurance Exchanges 101