In order to offer health insurance to your employees through the Small Business Health Options Program (SHOP) Marketplace, your business or non-profit organization must:
Have 50 or fewer full-time equivalent employees (FTEs)
- Use the FTE Calculator to see if you qualify based on how SHOP counts FTEs. (See below for possible changes in employee count in some states.)
- Note: To qualify for SHOP you must have at least 1 FTE employee other than owners, spouses and other family members of owners, and partners.
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 — generally those averaging less than 30 hours per week or seasonal workers. (You can offer coverage to part-timers if you want to.)
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 and December 15 any year. During this time the participation requirement isn't enforced.
Have an office or employee work site within the state whose SHOP Marketplace you want to use
More answers: Eligibility to use the SHOP Marketplace
- Do some states allow business with more than 50 employees to participate in SHOP?
Some states may make the SHOP Marketplace available to businesses with up to 100 employees. If you have more than 50 employees and don’t know if you can use the SHOP Marketplace, contact your state Department of Insurance or the SHOP Call Center using the number above.
- What if I currently offer SHOP insurance and my business grows to more than 50 employees?
Once enrolled in the SHOP Marketplace, 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%
- Nevada: 75%
- New Hampshire: 75%
- New Jersey: 75%
- South Dakota: 75%
- Tennessee: 50%
- Texas: 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.