To offer Small Business Health Options Program (SHOP) health 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 see if you qualify.
- Note: 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 — generally workers averaging 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. (However, you can offer coverage to part-time employees if you choose.)
3. Enroll at least 70% of the employees you offer insurance to
- Employees with other health coverage aren't counted as rejecting your offer.
- Use the SHOP Minimum Participation Rate Calculator to see how many of your employees must accept.
- Some states have different minimum participation requirements. See if this affects you.
- If you don’t meet your minimum participation requirement, you can enroll between November 15 - December 15 any year. During this time, the participation requirement isn't enforced.
4. Have an office or employee work site within the state whose SHOP you want to use
More answers: SHOP Eligibility
- Do some states allow 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.
States with different minimum participation rates:
- Iowa: 75%
- Kentucky: 75%
- Mississippi: 0%
- Nevada: 75%
- New Hampshire: 75%
- New Jersey: 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.