What is the SHOP Marketplace?
The Small Business Health Options Program (SHOP) Marketplace helps businesses provide health coverage to their employees.
For 2014, the SHOP Marketplace is open to employers with 50 or fewer full-time-equivalent employees (FTEs). If you have fewer than 25 employees, you may qualify for tax credits if you buy insurance through SHOP.
Benefits of the SHOP Marketplace
- You control the coverage you offer and how much you pay toward employee premiums.
- You can choose from 4 levels of coverage to find a plan that meets the needs of your business and employees.
- You can start coverage any time. Enroll by the 15th of the month and coverage can begin on the 1st of the following month.
- If you buy SHOP coverage and have fewer than 25 employees, you may qualify for a small business health care tax credit worth up to 50% of your premium costs. You can still deduct from your taxes the rest of your premium costs not covered by the tax credit. Beginning in 2014 the tax credit is available only for plans purchased through SHOP.
How to know if you qualify for the SHOP Marketplace
- In 2014, SHOP is open to employers with 50 or fewer full-time equivalent (FTE) employees.
- In order to use SHOP, you must offer coverage to all of your full-time employees – generally those working 30 or more hours per week on average.
- In many states, at least 70% of your full-time employees must enroll in your SHOP plan. (Employers who apply for SHOP coverage between November 15 and December 15 each year can enroll without meeting this requirement.)
- There is a SHOP Marketplace in each state. You must have an office or employee work site within the SHOP's service area to use that particular SHOP.
Get more details on SHOP eligibility rules (see question 2).
Preview plans and prices now
You can browse health and dental plan information right now. You’ll see available plans and sample prices based on the number and ages of your employees.
Apply for SHOP coverage
To enroll in a SHOP plan, you’ll use an agent, broker, or insurance company. You’ll also fill out a SHOP eligibility application.
Choose your state and we’ll help you get started.
View detailed questions and answers on SHOP procedures, including eligibility, application, enrollment, employee communications, and more.
Have questions about the SHOP Marketplace for businesses with 50 or fewer employees? Call 1-800-706-7893 (TTY: 1-800-706-7915). Hours: Monday through Friday, 9 a.m. to 7 p.m. EST. Agents and brokers may also use this number.
How do I get the Small Business Healthcare Tax Credit?
In 2014, you can get the Small Business Healthcare Tax Credit only when you buy coverage through the SHOP. It applies to businesses with fewer than 25 FTEs with average salaries of about $50,000 or less.
How do I count employees for SHOP?
The limit on employer size applies to full-time equivalent (FTE) employees, which can include part-time employees. For example, 2 half-time employees equal 1 full-time equivalent employee.
For details on how to count FTEs, see question 2 on this SHOP information document.
While part-time employees are considered when determining your eligibility for SHOP, you don’t have to offer coverage to part-time employees. That’s for you to decide.
In 2014 and 2015, insurance companies in states that run their own Marketplace can use the state's method of counting full-time employees to determine who's eligible for SHOP. If your state runs its own Marketplace, the application will provide details on how to count employees.
Learn if your state is running its Marketplace by choosing your state here. If the federal government runs the Marketplace in your state, you’ll be taken to a page that explains how to apply for SHOP.
Can I cover myself through a SHOP plan I offer my employees?
How will I know if I can reach the required enrollment level?
When you apply for SHOP, you'll need to fill out information about your employees in order to get a good cost estimate.
- To make it easier, you may want to find out from your employees ahead of time if they're interested in health coverage you may offer or whether they already have coverage.
- This will also give you an idea of how many employees may enroll.
- You won't know exactly how many employees will enroll until you choose your coverage and contribution amount and offer it to your employees.
Get details on SHOP coverage, including information on eligibility, required enrollment level, and application procedures.
How many of my employees must enroll in SHOP?
In many states, at least 70% of employees offered coverage must enroll in order for you to buy insurance through the SHOP Marketplace. This percentage may be different in your state.
For details, see questions 6 and 7 on this SHOP information document.
Employees with coverage through another employer plan, Medicare, Medicaid, the military, or veterans' programs are not included in the calculation.
Employees with individual private coverage (the kind they buy themselves, not through an employer) are included in the calculation.
Example (assuming a 70% participation rate is required):
You offer coverage to 14 full-time employees
- 2 have coverage through a spouse's employer
- 1 is covered by Medicare
- 1 is covered by TRICARE
14 employees total, minus 4 who aren’t included in the calculation = 10 employees who count toward the 70% requirement
70% of 10 employees = 7. At least 7 employees must enroll for you to qualify for a SHOP plan.
- If you’re not able to meet the minimum participation rate you can apply for coverage during an annual enrollment period from November 15 through December 15. This period is designed to allow employers that don't meet the participation rate to offer a SHOP plan.
Can I offer multiple plans to my employees?
As an employer, you can choose from a number of plans from multiple insurance companies in the SHOP. But once you have selected a plan, in most states your employees will have only that one plan as an option. In some states in 2014, you can offer multiple plans. When you fill out your SHOP application you'll learn if you can offer one or more plans. In 2015, you will be able to offer multiple plans from all state SHOPs.