Why do I need to verify my identity?

Before you can enroll in health coverage through the Health Insurance Marketplace®, we need to verify your identity to protect you and your personal information.

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How HSA-eligible plans work

Learn how HSAs (Health Savings Accounts) can work with HDHPs to store pre-tax dollars for future medical costs - deductibles, copayments, more.

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Tools and calculators to help you apply

The Small Business Health Options Program (SHOP) has several tools to help you offer employee health insurance.

The SHOP FTE Calculator

  • Calculates if your mix of full-time and part-time employees equals between 1-50 full-time equivalent (FTE) employees. Generally, only businesses with 1-50 FTEs are eligible for SHOP.
  • Have this information ready when using the calculator:
    • A list of all your employees, both full-time (those working 30 or more hours per week) and part-time (working fewer than 30 hours per week)
    • The number of hours worked per week by each part-time employee

GO TO THE SHOP FTE CALCULATOR

The Small Business Health Care Tax Credit Estimator

See if you qualify for the Small Business Health Care Tax Credit, and if so, approximately how much it would be worth.

  • Have this information for the applicable tax year ready when using the estimator:
    • Number of employees who work at least 40 hours per week
    • Number of hours worked by all part-time workers who work at least 120 days per year
    • Total wages paid (the amount subject to Social Security and Medicare tax)
    • Total amount of health insurance premiums you pay for your employees

GO TO THE TAX CREDIT ESTIMATOR

Learn more about the Small Business Health Care Tax Credit.

Minimum Participation Rate (MPR) Calculator

  • Helps predict if you’ll meet the MPR required to enroll in the SHOP coverage (in most states, at least 70% of employees must accept their insurance offer before the group can enroll)

  • Have this information ready when using the calculator:

    • State where your main business office is located
    • Number of employees accepting coverage
    • Number of employees not accepting your SHOP coverage offer who don’t have other kinds of health coverage
    • Number of employees not accepting your SHOP coverage offer who are covered by other insurance (like another job plan, a spouse’s or another person’s coverage, COBRA, the individual and family Health Insurance Marketplace®, Medicare, Medicaid, veterans coverage, Indian Health Service coverage, or TRICARE).

GO TO THE MINIMUM PARTICIPATION RATE CALCULATOR

Learn more about minimum participation rates (PDF, 211 KB).

Find Local Help

  • Find an agent or broker in your area who’s licensed and registered to sell SHOP insurance
  • They can advise you on your coverage options, help you enroll and answer your coverage questions

GO TO THE FIND LOCAL HELP TOOL

Learn more about working with an insurance agent.

See plans and prices

  • Use the link below and enter information about your business for a custom cost estimate.
  • This tool lists all available SHOP plans in your area. If there are no SHOP plans in your area, you may also be able to get qualified small group health coverage outside of SHOP through an insurance company or an agent or broker. Visit find.healthcare.gov to see what private health plans outside of the SHOP may be available to you.

SEE PLANS AND PRICES IN YOUR AREA

Questions?

  • Contact the SHOP Call Center at 1-800-706-7893 (TTY: 1-888-201-6445).
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Protect yourself from Marketplace fraud & scams

Get tips to help protect you from fraud, while getting you the coverage you need. Official government site.

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The Small Business Health Care Tax Credit

You may qualify for the Small Business Health Care Tax Credit that could be worth up to 50% of the costs you pay for your employees' premiums (35% for non-profit employers).

See if you qualify for savings

Enrolling in a Small Business Health Options Program (SHOP) plan is generally the only way for a small business or non-profit to claim the Small Business Health Care Tax Credit. To qualify for the tax credit, all of the following must apply:

  • You have fewer than 25 full-time equivalent (FTE) employees
  • Your average employee salary is about $56,000 per year or less
  • You pay at least 50% of your full-time employees' premium costs
  • You offer SHOP coverage to all of your full-time employees. (You don't have to offer it to dependents or employees working fewer than 30 hours per week to qualify for the tax credit.)



Higher benefits for smaller businesses

The tax credit is highest for companies with fewer than 10 employees who are paid an average of $27,000 or less. The smaller the business, the bigger the credit.

Questions?

More answers: The Small Business Health Care Tax Credit

What’s an example of how the tax credit works?

Here's one scenario:

Number of employees: 10
Wages: $250,000 total, or $25,000 per employee
Employer contribution to employee premiums: $70,000
Tax credit amount: $35,000 (50% of employer's contribution)
Do I have to buy SHOP insurance to claim the tax credit?

Generally, yes. Buying SHOP insurance is generally the only way to qualify for the Small Business Health Care Tax Credit.

What if I have seasonal workers?

Generally, seasonal workers aren't included in the full-time employee and wage calculation unless they work for you more than 120 days during the tax year. Learn more about seasonal workers from the IRS.

Where can I learn more about the Small Business Health Care Tax Credit?

The Internal Revenue Service has more information about the Small Business Health Care Tax Credit.

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Find out if your small business qualifies for SHOP

To offer Small Business Health Options Program (SHOP) health and/or dental insurance to your employees, your business or non-profit organization must meet 4 requirements:

1. Have 1-50 full-time equivalent employees (FTEs)

  • Use the FTE Calculator to find out if you qualify.
  • To qualify for SHOP, you must have at least 1 FTE employee other than owners, spouses, and family members of owners, and partners.

2. Offer coverage to all full-time employees

  • Full-time employees generally work 30 or more hours per week.
  • You don’t have to offer coverage to part-time employees — those averaging less than 30 hours per week — or seasonal workers. (But, you can offer coverage to part-time employees if you choose.)

3. Enroll at least 70% of the employees you offer insurance to

4. Have an office or employee work site within the state whose SHOP you want to use

Questions?

More answers: SHOP Eligibility

Do some states let businesses with more than 50 employees to participate in SHOP?

Some states may make the Small Business Health Options Program (SHOP) available to businesses with up to 100 employees. If you have more than 50 employees, and don’t know if you’re eligible for SHOP, contact your state Department of Insurance, or call the SHOP Call Center at 1-800-706-7893 (TTY: 1-888-201-6445).

What if I currently offer SHOP insurance and my business grows to more than 50 employees?

Once enrolled in SHOP insurance, businesses can renew their coverage even if a group increases to more than 50 employees.

How do I know my state’s minimum participation rate?

In most states, at least 70% of the employees you offer coverage to must enroll in it or have coverage from another source — like a family member’s job, Medicare, Medicaid, the military (TRICARE), veterans’ programs, or individual health insurance.

Some states have different minimum participation rates:

  • Iowa: 75%
  • Louisiana: 75%
  • Mississippi: 0%
  • New Hampshire: 75%
  • South Dakota: 75%
  • Tennessee: 50%
  • Texas: 75%
  • Utah: 75%

The SHOP Minimum Participation Rate Calculator takes your state’s rules into account and tells you how many employees must accept your offer. Before using this tool, you may want to find out if your employees are interested in insurance you may offer, and if they already have coverage from another source.

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How to work with a SHOP-registered insurance agent or broker

You can work with a Small Business Health Options Program (SHOP)-registered agent or broker to enroll in SHOP insurance.

Need a SHOP-registered agent or broker?

Enter your ZIP code to find one in your area.

Getting help from an agent or broker

SHOP-registered agents and brokers can provide help with SHOP insurance — from comparing plans to helping you enroll. Specifically, they can help you:

In general, you won't pay more if you use an agent or broker.

Note: If you're not using an agent or broker, you can enroll through your insurance company.

Choosing an agent or broker

  • Work with your current agent or broker: You can continue working with your agent or broker as long as they're registered with SHOP.
  • Find a new agent or broker: Enter your ZIP code and check the box for small businesses, and you’ll get a list of SHOP-registered agents and brokers in your area. You can also enter your contact information on the Help On Demand tool and an agent or broker will reach out to you.

Questions?

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How to offer SHOP health insurance to your employees

Health insurance plans offered through the Small Business Health Options Program (SHOP) are quality, affordable health and dental insurance coverage for small businesses and their employees. SHOP plans are offered by private insurance companies, cover essential health benefits, and may not exclude coverage for treatments for pre-existing conditions.

Making a SHOP health insurance decision

You can generally enroll in SHOP coverage year-round. To find the best plan for your business and employees, think about price, benefits, and features. You may also want to consider:

  • Whether to offer your employees one plan or a choice of plans
  • Whether to offer medical coverage, dental coverage, or both
  • How much of your employees' premiums you’ll pay
  • Whether to offer coverage to dependents and part-time employees
  • When coverage starts
  • How long new employees must wait before they get a coverage offer

You should also check SHOP availability in your state. Some states may use their own websites for enrolling and managing SHOP coverage.

Employees may still be eligible for premium tax credits if the plan you offer isn’t considered “affordable”. Affordability is based on how much the employee pays for coverage for themselves and their dependents. If the plan isn’t affordable, the employee may enroll in a Marketplace plan instead.

Understanding SHOP insurance categories

There are 4 categories of SHOP plans to choose from. The categories have nothing to do with the quality of care. They're based on the way the cost of care will be shared between your employees and the insurance company.

Choosing a stand-alone dental plan

You can add dental coverage to your SHOP insurance offer or offer dental insurance by itself without a SHOP health plan. Some SHOP health insurance plans also include dental benefits.

As with health plans, you can choose how much of an employee’s dental premium you pay.

Talk to your insurance company or agent or broker to find out more about SHOP dental plans.

How to enroll through SHOP

You have 2 options for enrolling:

  • Work with a SHOP-registered agent or broker. You can use your current agent or broker or find a new one, as long as the agent or broker is registered with the applicable Marketplace to sell SHOP insurance. Find an agent or broker today.
  • Contact your insurance company and sign up with them. Find SHOP plans in your area. You may want to write down some important information such as the plan name, metal level, plan type, and plan ID to have handy when you contact the insurance company.

Remember, the specific enrollment steps may vary by insurance company. Talk with your insurance company or SHOP-registered agent or broker to make sure you're aware of any monthly deadlines for completing your enrollment.

Your agent, broker, or insurance company will be able to provide you with the information you and your employees will need.

Paying premiums & managing coverage

You'll pay your premiums to your insurance company, not HealthCare.gov. If you need to make changes or updates to your SHOP coverage during the year, contact your agent, broker, or insurance company.

Verifying your eligibility for SHOP

You must meet certain requirements to purchase insurance through SHOP. To verify that you can enroll in SHOP coverage, use the SHOP Eligibility Determination Form.

The SHOP Eligibility Determination Form only takes a few minutes to fill out, and you’ll find out instantly if you’re eligible for SHOP insurance. Just enter some basic information about your business, certify that you meet the eligibility requirements, review your form, and submit.

Save your completed form and eligibility results for your records. Proof of SHOP eligibility may be required to enroll in SHOP coverage through an insurance company or to claim the Small Business Health Care Tax Credit.

Note: Once you complete the SHOP Eligibility Determination Form, you should get an email that includes your SHOP eligibility results. Your eligibility results are also shown on the final page of the form.

How to renew your SHOP plan

About 45–60 days before your current SHOP coverage ends, contact your insurance company, agent, or broker to find out what plans and prices are available to you. Insurance companies may have different timelines for renewing coverage, so be sure to ask:

  • When you need to submit your enrollment for a coverage renewal
  • How long your employees will have to accept your renewal
  • When you should pay your first premium

Questions?

More Answers: How to offer SHOP health insurance to employees

I am unable to enroll in SHOP insurance by logging into my HealthCare.gov account. What do I do?

For SHOP plans that start on or after January 1, 2018, you don't pick a plan, apply, or enroll through HealthCare.gov. Instead, you enroll either through the insurance company or with the assistance of a Marketplace-registered agent or broker.

As a small business employer, do I have to offer insurance to my employees' dependents?

Generally no, but some states do require it. Check with your state's Department of Insurance.

If you do offer insurance to employee’ dependents, they can accept or reject your offer. If they decline it, they can enroll in a plan for individuals and families through the Marketplace, but they may not be eligible for savings through premium tax credits or cost-sharing reductions. If they’re not eligible for such savings, they'd have to pay full price.

If I don't offer insurance to dependents, can they get insurance through the Marketplace?

Yes. Dependents can get insurance for individuals and families through the Marketplace, if they are otherwise eligible. Depending on the entire household's income, if dependents aren’t eligible for other health coverage, they may qualify for savings through premium tax credits and cost-sharing reductions.

What if there are no SHOP plans available in my area?

You may still be able to enroll in a small group health plan through an agent or broker or directly with a health insurance company. However, it may not be considered SHOP coverage, and you generally will not be able to claim the Small Business Health Care Tax Credit. See what non-SHOP plans may be available to you at finder.healthcare.gov, or search for an agent or broker in your area.

You may also have other options for providing benefits to your employees besides traditional group coverage, such as with a Health Reimbursement Arrangement (HRA). Learn more about what other products and services may be available to you.

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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.

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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?

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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).
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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:

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