Small Business Health Options Program (SHOP) delayed until January 1, 2015

On March 11, 2013 The U.S. Department of Health and Human Services (HHS) published a proposal for delaying the Small Business Health Options Program (SHOP) for small businesses until January 1, 2015.  This proposal is expected to be approved.

SHOP is an insurance exchange for businesses that is part of the Affordable Health Care Act (ACA), the new federal health care law.

This delay in SHOP would affect the 33 states where the health insurance exchange will be run on a federal level.  HHS reports that administrative delays and operational challenges have prevented them from securing the variety of affordable care options for small businesses to offer to their employees beginning January 1, 2014.  The agency has advised the 17 States that have opted to manage their own exchange programs that they may either move forward with the full version of SHOP for January 1, 2014, or delay their programs until January 1, 2015.

Under the new proposed timeline, SHOP will be available to small businesses and their employees for open enrollment beginning October 1, 2014 for a January 1, 2015 effective date.  HHS has announced that one plan option will be made available to small employers for the original January 1, 2014 effective date, but it is still unknown which health carriers will be involved, what the plan design will look like and what the monthly premium cost will be.

The SHOP weighed heavily during initial debates to the Affordable Care Act, with supporters citing that the SHOP option would offer small businesses opportunities historically afforded to large businesses.  States will decide whether “small businesses” will be classified as fewer than 100 employees, or fewer than 50 employees.

SHOP will allow small business employees to choose from a variety of health plans through multiple carriers that will best suit their family’s needs and budget.  The SHOP will simplify administration on the employer’s end by uniting all plan premiums into one billing statement for the employer to pay on a monthly basis.

SHOP is designed to simplify decision-making for employees by offering side-by-side comparisons for the multiple options available to them.  Online access, and customer support, will provide employees with the tools they will need to make an informed decision about the quality and cost of individual or the family’s health plan choice.

Within the SHOP program, insurers will no longer be able to deny enrollment to employees with unfavorable health histories or deny treatment for pre-existing conditions.  Premiums will no longer be based on employees’ health histories or the industry for which their company does business.  Premiums can, however, be based on ages and smoking histories of employees that are subscribing to the SHOP plans.

Many view this as a very disappointing set-back to the implementation of ACA and the promise of “affordable care” and multiple options and choices.  With the individual mandate still set for January 1, 2014, it will be interesting to see if further proposed delays are announced.  Those individual plan options are scheduled to be available for open enrollment October 1, 2013.

Yet, only months away, there has still been little guidance as to how those individual options will be structured, what carriers will offer them, how many options there will be or premium rates, among other concerns.

The wait has been stressful for all business owners while they try to anticipate their insurance options and costs for 2014.  BCN  Services will continue to evaluate options and proactively communicate them to its clients.

Follow the HR HeaRtbeat.com blog for updates on this topic and others relating to the Affordable Care Act.  Contact BCN Services for further discussion and guidance as this new law is implemented.  Contact us at 800-891-9911 or visit www.www.bcnservices.com.

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Frank Lewandowski, Partnership Manager

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