Overview of SHOP: Health insurance for small businesses

The Small Business Health Options Program (SHOP) is for small employers who want to provide health and/or dental insurance to their employees — affordably, flexibly, and conveniently.

  • To purchase SHOP insurance, your business or non-profit organization generally must have 1 to 50 employees. See if your business qualifies for SHOP.
  • If eligible, you don't have to wait for an Open Enrollment Period. You can start offering SHOP coverage to your employees any time of year.

Self-employed or a business owner with no employees?

Learn more about your coverage options.

4 reasons to offer SHOP coverage

  1. SHOP insurance gives you choice and flexibility. You can:

    • Offer your employees one plan, or let them choose from multiple
    • Offer only health coverage, only dental coverage, or both
    • Choose how much you pay toward your employees' premiums and whether to offer coverage to their dependents
    • Decide how long new employees must wait before enrolling
  2. Get the information you need in one location. You can make an informed decision about your SHOP insurance options with the tools at HealthCare.gov:

  3. You can work with an agent or broker. You can use your current SHOP-registered agent or broker or find a new one to help you enroll in coverage.

  4. You may be able to get the Small Business Health Care Tax Credit. Enrolling in SHOP insurance is generally the only way for eligible small employers to take advantage of the Small Business Health Care Tax Credit. You may qualify if you have fewer than 25 full-time equivalent (FTE) employees making an average of about $56,000 or less.

Enrolling in SHOP insurance

Once you're ready to enroll in SHOP coverage, you have 2 options:

  • Contact your insurance company and enroll directly through them.
  • Enroll with the assistance of a SHOP-registered agent or broker.

Find out more about enrolling in SHOP insurance.

Questions?

More answers: Overview of SHOP: Health insurance for small businesses

Do I have to provide insurance to my employees?

If you have 1 to 50 full-time equivalent (FTE) employees, you're not required to provide insurance to your employees. You can choose to offer insurance through SHOP or any other source. But you don't have to, and there's no penalty if you don't.

If you have 50 or more employees, learn about the Employer Shared Responsibility Payment.

Can I enroll in the same SHOP coverage that I offer my employees?

Yes, as long as at least one of your employees (who isn't a business owner, partner or family member) also enrolls in your coverage.

If my only employee is my spouse or a family member, can I use SHOP to cover us both?

Generally, no. Spouses and family members don't count when determining if your business is eligible to use SHOP. To be eligible, you must have 1 to 50 full-time equivalent (FTE) employees who aren’t business owners, partners, or family members.

Can my employees enroll in SHOP coverage after the initial enrollment period?

Yes, but only if they qualify for a Special Enrollment Period due to a life change, like having a baby, adopting a child, or getting married.

For new employees hired after your initial SHOP enrollment period, you can decide on a waiting period before coverage can become effective. Waiting periods can't exceed 90 days.

SHOP coverage for multiple locations & businesses

If you operate a business with employees in more than one state

You'll enroll in a Small Business Health Options Program (SHOP) plan in the state where your primary business site is located.

You can offer your employees SHOP coverage 2 ways:

Option 1: Choose a single health plan for all employees. Be sure to choose a plan with a multi-state or national provider network. Offer it to all full-time employees in each business location.

  • If you choose this option, employees in all of your business locations will be counted when calculating your minimum participation rate and eligibility determination.

Option 2: Offer different SHOP plans in each state where your employees work. As long as your business meets all requirements to participate in the state's SHOP, you can offer coverage even if you have just one employee in a location. You'll still need to offer coverage to all your full-time employees in each state.

  • The employees on each location's employee roster will be counted separately when calculating your minimum participation rate.
  • You'll have to verify your eligibility for each state where you offer SHOP coverage separately.
  • If you have business locations in a state that runs its own SHOP, you can get coverage through that state's SHOP. Select the state where your business operation is located, and we'll take you to your state’s SHOP website.

If you operate multiple businesses in a state or in more than one state under the same EIN

  • You can establish only one SHOP offer per EIN in each state. Learn more about controlled group rules from the IRS.
  • When you count full-time equivalent employees (FTEs) to determine eligibility for SHOP, you must include FTEs from all your businesses.

If you operate multiple businesses in a state or in more than one state with different EINs

  • You must create unique SHOP offers for each EIN. Controlled group rules apply when establishing the FTE count for your businesses — whether your businesses are all in one state or in multiple states.
  • For each business with its own EIN, you’ll need to:
    • Meet SHOP eligibility criteria independently
    • Count all the FTEs in all your businesses using controlled group rules
    • Create separate SHOP coverage offers
  • If you have remote employees, you can use your primary business address for all your remote employees, or use each of the locations where your remote employees work as a separate business location.

Questions?

SHOP how-to guides, fact sheets, tools, and other resources for employers

For help with the Small Business Health Options Program (SHOP), check out these resources:

SHOP eligibility & prices

The Small Business Health Care Tax Credit

Applying & enrolling in SHOP insurance

Working with SHOP-registered agents and brokers

Choosing health insurance plans

Questions?

  • Contact the SHOP Call Center at 1-800-706-7893 (TTY: 1-888-201-6445).
Medicare & the Marketplace

If you qualify for Medicare, in some cases you can’t enroll in a Marketplace plan, and in other cases the cost of a Marketplace plan may be higher.

Get information about your options based on your situation:

How do I find my application ID?

Each Marketplace application has a unique identification number or application ID (sometimes called just an “APP ID” or “ID”).

Complete your enrollment & pay your first premium

Follow these tips to make sure your Marketplace health coverage enrollment process is complete

Required documents & deadlines

Find out how to verify info on health insurance application. Get lists of acceptable documentation, important deadlines. Avoid losing coverage

How to report a move

Tell the Health Insurance Marketplace® about changes to your income, household, or plan.

Uploading documents

There are times when you need to submit documentation to the Marketplace. Visit HealthCare.gov to submit documents in your Marketplace account.

Share Your Story

Have you enrolled in coverage using HealthCare.gov? Tell us why having health insurance is important to you.

Health plan categories: Bronze, Silver, Gold & Platinum

The health plan category you choose determines how you and your plan share the costs of care.

Catastrophic health plans

People under 30 and people with hardship exemptions may buy what's called a Catastrophic” health plan. It protects you from very high medical costs.


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