Health Care Law Offers New Insurance Options for Small Employers

Trying to find health insurance for your employees?

Check out the Small Business Health Options Program—SHOP—part of the new Health Insurance Marketplace. The SHOP Marketplace gives you a choice of quality, private health insurance plans, information, and tools to make comparisons and choose the one that works best for your company and employees.

In many states, you can enroll in SHOP coverage directly through an agent, broker or a health insurance company that offers a SHOP Qualified Health Plan.

When you buy coverage through the SHOP Marketplace, you may also qualify for a tax credit worth up to 50 percent of your contributions to employee premium costs (up to 35 percent for tax-exempt employers.) Small employers have already received more than $1 billion in tax credits since this tax credit was created in 2010.

Detailed information on the SHOP Marketplace is available at HealthCare.gov.

The Quick Facts: New Health Law and Small Employers

• You’re not required to offer health insurance under the health care law if you have fewer than 50 employees, nor is there any penalty if you don’t.

• You can buy insurance through the SHOP Marketplace if you have 50 or fewer full-time employees, and you offer insurance to all full-time employees (generally those working 30 or more hours a week.)

• Every plan in the SHOP Marketplace covers a comprehensive set of benefits, including doctor visits, hospital stays, preventive care, and prescriptions.

• New rules require these plans to treat you fairly, meaning:

  • insurance companies can’t raise premiums for the group just because of an employee’s preexisting health condition or because an employee gets sick or injured; and

  • there are new limits on charging small groups higher premiums for older employees.

3 Steps for Employers to Apply for Coverage in the SHOP Marketplace

1 – Contact

Contact an agent, broker, or insurance company to help you apply for SHOP eligibility and find and compare available SHOP plans. You can also use our premium estimation tool on HealthCare.gov to browse and compare plans and pricing information.

Work with your agent, broker, or insurance company to pick a plan that is right for your company. Health Care.gov can direct you to the correct website for your state.

2 – Enroll

Your agent, broker, or insurance company will help enroll you and your employees. You don’t need to wait for SHOP eligibility confirmation to enroll.

After you pick your plan, the insurance company will provide the premium costs for you and your employees, and each of you will be able to enroll directly with the insurance company.

After you’ve offered your employees coverage, make sure those who accept the offer submit their enrollment forms to the agent, broker, or insurance company. Upon enrollment, you’ll pay your first month’s premium directly to the insurance company.

3 – Claim

If you plan to claim the Small Business Health Care Tax Credit, you’ll need to get an official eligibility determination from the SHOP Marketplace. If you’re eligible, you’ll claim the tax credit when you submit your federal income tax returns for 2014. You’ll need to have your SHOP eligibility notice from the SHOP Marketplace in order to claim the credit.

If you’re not eligible to participate in the SHOP Marketplace, you and your employees can keep your coverage, but you won’t be eligible for the Small Business Health Care Tax Credit.

If you have questions about what the SHOP Marketplace offers or how to apply, visit HealthCare.gov or call the SHOP Employer Call Center toll-free at 1-800-706-7893. TTY users should call 711 to access the SHOP Employer Call Center. Tell the customer service representative if you need help in a language other than English.