To sell SHOP plans, you must have an active state insurance license and a National Producer Number (NPN), have completed Marketplace registration, and sign the SHOP privacy and security agreement each year.
First, you’ll need to have a CMS Enterprise Portal user ID. If you don’t already have one, you can register for one at the CMS Enterprise Portal. Then, you’ll need to sign the yearly SHOP Privacy and Security Agreement in the Marketplace Learning Management System (MLMS).
You'll also be asked if you want your contact information to be displayed for SHOP. Select "Yes," so small employers can find you through the Find Local Help tool.
This may vary based on insurance company. Check with the insurance companies you plan to work with.
You can check with the insurance company for most questions about SHOP plans, such as applications, enrollment, renewal, and changing or updating coverage.
For questions relating to the eligibility determination, appeals process, or agent/broker registration, please contact the Marketplace agent/broker email help desk at FFMProducer-AssisterHelpDesk@cms.hhs.gov.
Contact your employer or insurance company for questions about your SHOP coverage.
Employees don't need to create an account on HealthCare.gov. You'll get your SHOP insurance offer from your employer or from an insurance company.
No. You can decline your employer's SHOP coverage and get insurance through another source. But you may not be eligible for a tax credit or savings through the Marketplace if you decline employer-sponsored coverage.
Contact your employer or the insurance company to see your employer's coverage offer. You may be offered one plan or a choice of plans.
Generally, no. When it's time to renew, talk to your employer or insurance company. You'll have an opportunity to view, accept or decline your employer's coverage offer for the next year's coverage.
Yes, most people are eligible to enroll in health coverage through the Marketplace. You’ll use the Marketplace for individuals and families to buy health insurance instead of SHOP — which is generally only available to small businesses (generally those with 1-50 employees).
Generally, no. You probably won’t qualify for group coverage if you run your own business and have no employees, or are self-employed. But you can purchase qualified health coverage through the Marketplace for individuals and families. To qualify for SHOP, you generally must have between 1-50 employees with at least one employee other than the owners or their spouses.
Check with your employer. Employers may decide whether to offer SHOP insurance to part-time employees.
If you previously had health coverage through SHOP, you may be able to maintain coverage, but you'll likely have to pay for the entire premium yourself. Check with your employer about signing up for COBRA coverage. Otherwise, only members of the group health plans of businesses that are offering SHOP plans can enroll.
If you’re unemployed, you may be eligible to enroll in a plan through the Marketplace.
Learn about your coverage options if you’re unemployed.
The prices shown are estimates based only on some basic information. When you apply, you’ll provide more details and see the exact amount you’d pay for each plan.
You can decide how much of your employees' premiums you want to pay. There's no minimum or maximum percentage or dollar amount.
Yes, offering SHOP coverage is generally the only way to qualify for the Small Business Health Care Tax Credit. To be eligible, your business must have fewer than 25 employees (or the full-time equivalent of 25, based on a 40-hour work week), an average salary of about $54,000 or less, and meet some other requirements.
Use our SHOP FTE Calculator to count your total FTEs based on each worker’s full- and part-time hours.
Yes. You can work with any Marketplace-registered agent or broker who signed a SHOP privacy and security agreement for the applicable plan year. Ask any agent or broker you want to work with if they’ve signed it for the current plan year.
You can find a list of SHOP-registered agents and brokers using our Find Local Help tool.
You have several choices about how you offer SHOP insurance. Learn about your options if your business operates in more than one state.
You may still be able to get SHOP insurance through a different insurance company or plan.
If SHOP plans aren't available in your area, you may still be able to enroll in non-SHOP small group coverage.
There are several other options for offering insurance to your employees if there are no SHOP plans available in your area. You may still be able to enroll in a small group health plan by working with a health insurance agent or broker, or by purchasing it directly from an insurance company.
In areas with no available SHOP plans, some small businesses that offer non-SHOP small group coverage may still be able to claim the Small Business Health Care Tax Credit. See the updated guidance from the IRS.
If you decide to terminate your business’ employer-sponsored coverage, your employees may be eligible to apply for coverage through the Health Insurance Marketplace for Individuals and Families.
Find out more about other products and services that may be available to small businesses.
Contact your insurance company or a SHOP-registered agent or broker with questions about SHOP plans, enrollment, renewal, and changing or updating coverage.
For questions about SHOP eligibility determinations or HealthCare.gov, you can contact the SHOP Call Center at 1-800-706-7893 (TTY: 1-888-201-6445).
If you qualify as a large employer (generally one with at least 50 full-time and full-time equivalent employees):
If you don’t qualify as a large employer:
For SHOP plans in states with a Federal SHOP, employers won’t use HealthCare.gov to enroll employees in or renew coverage. Instead, they’ll work with their insurance company or SHOP-registered agent or broker. (Employees will get their coverage offers from the insurance company or employer.)
But, some employers may still need to use HealthCare.gov to verify that they're eligible if they're enrolling in SHOP for the first time, had a gap in coverage, or have made a change that could end their eligibility.
Even though you won't use HealthCare.gov to enroll, it has a variety of resources available to you. You can get a custom quote and estimate your savings through the Small Business Health Care Tax Credit.
It's a 12-month period of benefits under your health plan. For SHOP coverage, this period may not be the same as the calendar year. To find out your plan year, ask your insurance company or employer.
Generally, no. To continue or change the insurance you offer your employees, you typically must renew each year. You may get a notice from your insurance company when your business is approaching its renewal date, but this may vary by insurance company.
If you have at least one full-time employee (other than yourself, a spouse, a family member, or another owner), you may be able to enroll in a SHOP plan.
You'll make your SHOP premium payments to your insurance company or companies, not HealthCare.gov.
Use the Find Local Help tool by entering your ZIP code and check the box saying you're looking for coverage for your small business. You'll see a list of nearby agents and brokers who sell SHOP plans to small businesses.
There's no limited enrollment period for the Small Business Health Options Program (SHOP).
Whether you apply online or use an agent or broker, you can apply, pick a plan, and enroll employees any time of year. Coverage can start at any time you choose.