To sell SHOP plans, you must have an active state insurance license and a National Producer Number (NPN), and sign a privacy and security agreement with SHOP each year. Learn more about the process, including optional training available.
First, you’ll need to have a CMS Enterprise Portal user ID. If you don’t already have one, register 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 in 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.
For plans starting on or after January 1, 2018, 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.
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.
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, but not through SHOP – which is generally only available to small businesses with 1 - 50 employees.
Individuals can get insurance through the Health Insurance Marketplace.
If you have at least one full-time employee (and 50 or fewer FTEs other than yourself, a spouse, a family member, or another owner), you can enroll in a SHOP plan.
If you're self-employed with no employees, you can enroll in insurance through the Health Insurance Marketplace, but not a SHOP plan.
Check with your employer. Employers can 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 current employees of businesses that are offering SHOP plans can enroll.
If you’re unemployed, you can enroll in a plan through the Health Insurance 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 (based on a 40-hour work week), an average salary of $50,000 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 agent or broker who signed a SHOP privacy and security agreement. Ask any agent or broker you want to work with if they’ve signed it.
You can find a list of SHOP-registered agents and brokers using our Find Local Help tool.
What if I operate my business in more than one state?
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 for 2018 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 through 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.
Log in to your HealthCare.gov account. Your insurance won’t be affected by the changes to SHOP until it’s time for you to renew your insurance for 2018.
Contact your insurance company with questions about SHOP plans, like applications, enrollment, renewal, and changing or updating coverage.
For questions about SHOP eligibility determination or the SHOP appeals process you can contact the SHOP Call Center at 1-800-706-7893 (TTY: 1-888-201-6445) or refer to the available information on HealthCare.gov:
If you have between 1-50 employees, you're not required to offer insurance, and you won't face a penalty if you don't. But you can choose to offer insurance through SHOP or any other source.
If you have 50 or more employees, you may have to offer health insurance that meets certain standards. If you don't, you may be liable for a payment. Learn about the Employer Shared Responsibility Payment.
For 2018 SHOP plans (coverage starting on or after January 1, 2018), employers won't use HealthCare.gov to 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 or had a gap in coverage.
Even though you won't use HealthCare.gov to enroll, it has a variety of resources available to you. You can quickly check premiums in your area, 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.
No. To continue or change the insurance you offer your employees, you must renew each year. You may get a notice from your insurance company or SHOP when your business is approaching its renewal date.
If you have at least one full-time employee (other than yourself, a spouse, a family member, or another owner), you can enroll in a SHOP plan.
For plans that begin on or after January 1, 2018, you'll make your SHOP premium payments to your insurance company, not HealthCare.gov.
Enter 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.