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Employees with a Small Business Health Options Program (SHOP) insurance offer in 2017 can login to HealthCare.gov to accept or decline their offer

Find the right SHOP health insurance plan for your employees

We're testing the use of star ratings for SHOP plans this year in several states and will use this test to improve the program.

These resources and tools make it easier for you to help clients in the Small Business Health Options Program (SHOP). For more resources, visit the employer’s resource page.

Advise & enroll small businesses for SHOP plans

• Custom premium estimates: Answer a few questions about your client's business to get a custom premium estimate
• The SHOP Full-Time Equivalent (FTE) Calculator: See if your clients may be eligible to participate
• The Small Business Health Care Tax Credit Estimator: See if your clients may qualify for a tax credit and how much it may be worth
• Minimum Participation Rate Calculator: Find out if your clients meet the participation requirement

Fast answers for agents & brokers

• Get fast answers to your most pressing questions.
• Check out frequently asked SHOP questions

Questions?

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

States using HealthCare.gov for SHOP no longer process employee enrollments, determine employee eligibility, or accept employee appeal requests related to enrollment eligibility. If you:

• Applied for your employer’s SHOP Marketplace coverage and were denied coverage: Contact your employer or insurance company for more information about employee enrollment and eligibility.
• Are eligible for your employer’s SHOP Marketplace coverage, due to a qualifying life event, but couldn’t enroll during a Special Enrollment Period because the insurance company denied you coverage: You can file a SHOP employee complaint. Note: Employee dependents aren't eligible for a Special Enrollment Period if your employer doesn’t offer coverage to dependents.

Ways to report that you could not enroll in SHOP coverage

You can report this information to SHOP by:

• Calling the SHOP Call Center at 1-800-706-7893 (TTY: 1-888-201-6445).
• Sending an email to shop@cms.hhs.gov documenting the concern and providing supporting evidence. Note: Don’t include Personally Identifiable Information (PII) — like your Social Security Number — in your email. Call the SHOP Call Center at the number above if any PII needs to be provided as a part of your SHOP employee complaint submission.

You have 90 days from the date of your Special Enrollment Period ineligibility notice to submit this information to SHOP.

Note: Keep a copy of your complaint for your records.

After you've contacted SHOP

You'll get a response saying that your complaint was received. It will provide a description of the process and instructions for submitting additional materials, if needed.

Questions?

• An employee should contact their employer or insurance company with questions regarding their SHOP health and/or dental coverage — including plan year start and end dates, payment-related inquiries, life changes, and/or claims-related questions.
• For all other questions related to the SHOP employee complaint process, contact the SHOP Call Center at 1-800-706-7893 (TTY: 1-888-201-6445).

Offering health coverage is a major decision for your business. When looking for a plan that fits the needs of your business and employees, you should carefully consider things like the cost to you and your employees, and the health services covered.

For a basic guide on some health insurance products and services that may be available to small businesses, check out these resources. You can also contact a licensed agent or broker for more help.

Note: Business owners with no employees can use the Marketplace for individuals and families to enroll in a health plan that best fits their needs. Learn more about coverage options for self-employed individuals here.

Group health insurance coverage

A group health insurance plan, like a plan purchased through the Small Business Health Options Program (SHOP) or otherwise from a private insurance company, provides coverage to eligible employees. Business owners can offer their employees one plan or a selection of plans to choose from.

Small employers (generally those with 1-50 employees) may be eligible to purchase coverage through SHOP.

Enrolling in a SHOP plan is generally the only way for an eligible small employer, including non-profits, to claim the Small Business Health Care Tax Credit.

• Learn more about purchasing insurance through SHOP
• See SHOP plans and prices
• How the Affordable Care Act (ACA) affects small businesses

If there are no SHOP plans available in your area, or your business is a large employer, you can work with an insurance company or licensed agent or broker to find out what group plans may be available to you, or learn more using the resources below.

Health reimbursement arrangements

Health reimbursement arrangements (HRAs) are a type of group health plan. HRAs allow employers to help their employees pay for medical expenses, including premiums for individual coverage in some cases.

Health Savings Accounts and other tax-favored health plans

There are various health plans that are designed to give individuals tax advantages to offset health care costs. These include: Health Savings Accounts (HSAs), Health Flexible Spending Arrangements (FSAs), and Health Reimbursement Arrangements (HRAs).

For more details on tax-favored health plans, refer to IRS Publication 969.

The Affordable Care Act (sometimes called the health care law, or ACA) established the Small Business Health Options Program (SHOP) for small employers (generally those with 1–50 full-time and full-time equivalent employees (FTEs)) who want to provide health and dental coverage to their employees.

Certain employers can enroll in SHOP through private insurance companies, or with the help of a SHOP-registered agent or broker. SHOP plans are generally the only way to qualify for the Small Business Health Care Tax Credit to lower premium costs.

But other parts of the health care law may also affect employers.

Required reporting about the Marketplace to your employees

Certain employers are required to provide certain information about the Marketplace to their employees, whether they offer health insurance or not.

90-day maximum waiting period

If you offer health insurance to your employees, you must offer it to all eligible employees when they become eligible for health coverage. Learn about the 90-day waiting period from the IRS (PDF, 40.4 KB).

Summary of Benefits and Coverage (SBC) disclosure rules

Employers must provide employees with a standard "Summary of Benefits and Coverage" (SBC) form explaining what their health plan covers and what it costs. The purpose of the SBC is to help employees understand their health insurance options. You could face a penalty for non-compliance. Get details about SBCs and see a sample completed form.

Flexible Spending Accounts (FSAs)

Employees can't contribute more than the annual dollar limit set by the IRS to their Flexible Spending Accounts. That limit doesn't apply to employer contributions to the employees' FSAs. Employers have 2 options to let employees carry over unspent FSA funds into the following plan year. Get more information from the IRS (PDF, 1.2 MB).

Workplace wellness programs

The Affordable Care Act creates incentives to promote employer wellness programs and other activities that support healthier workplaces. The maximum reward to employers using a wellness program that's contingent on employee health has increased from 20% to 30% of the cost of health coverage. The maximum reward for programs designed to prevent or reduce tobacco use is 50%. Learn more about wellness incentives from the Department of Labor.

Employer Shared Responsibility Payment

Certain businesses with 50 or more full-time and full-time equivalent employees that don't offer insurance that meets certain minimum standards may be subject to the payment. Get details about the Employer Shared Responsibility Payment from the IRS.

Reporting information on health coverage by employers and insurance companies

The health care law requires the following organizations and some other parties to report that they provide health coverage to their employees:

• Certain employers, generally those with 50 or more full-time and full-time equivalent employees
• Health insurance companies
• Self-insuring employers of any size

Learn more about these reporting requirements from the IRS.

Medical Loss Ratio rebates

Insurance companies must generally spend at least 80% of premium dollars on medical care. Insurance companies that don't meet this requirement must provide rebates to policyholders — usually an employer who provides a group health plan. Employers who get these premium rebates must allocate the rebate properly. Get more details about federal tax treatment of Medical Loss Ratio rebates from the IRS.

If you already offer health insurance to your employees

If you offer health insurance to your employees that is not through SHOP, you can keep the coverage you have. In general, offering a SHOP plan is the only way to qualify for the Small Business Health Care Tax Credit.

IRS resources for small businesses

The IRS offers several resources to help employers:

• "Affordable Care Act: What employers need to know (PDF)"
• Guide to tax provisions of the Affordable Care Act for employers
• Health care questions and answers for employers

More resources for small businesses

There are many health insurance products and services that are available for small businesses and their employees. Learn more about other health insurance products and services that may be available.