Small employers can appeal a Small Business Health Options Program (SHOP) eligibility decision.
Employers can appeal two kinds of SHOP actions:
If you're determined ineligible to participate in SHOP, you'll get a notice with details specific to your situation. You have 90 days from the date of this notice to request an appeal.
If your state is running its own SHOP, the appeals process may be different. Refer to your state's SHOP for more details.
Your SHOP eligibility determination notice will explain how to file an appeal for your specific situation.
You can appeal by filling out the form below:
Then, mail your completed appeal form to: Health Insurance Marketplace 465 Industrial Boulevard London, KY 40750-0061
An authorized representative, like an agent or broker, can file an appeal for you. You may also get help in a language other than English.
Note: Keep a copy of your appeals form for your records.
You'll get a letter or phone call saying that your appeal was received. It will provide a description of the appeals process and instructions for submitting additional materials if needed.