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The Federally-facilitated SHOP Marketplace Health Insurance Options for Small Businesses March 2015.

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Presentation on theme: "The Federally-facilitated SHOP Marketplace Health Insurance Options for Small Businesses March 2015."— Presentation transcript:

1 The Federally-facilitated SHOP Marketplace Health Insurance Options for Small Businesses March 2015

2 What Small Employers Use to Face Many obstacles to offering health insurance to employees Difficulty comparison shopping between plans Unpredictable premium increases Higher rates for groups with: o Women o Older workers o Workers who have chronic conditions or high-cost illnesses Waiting periods for coverage of pre-existing conditions

3 What SHOP Offers Small Employers SHOP Health Plans: Can’t deny coverage to small employers (guaranteed availability / renewability) Can’t limit benefits or sell coverage with higher rates: o For those with pre-existing health conditions o For women o Based on employees’ health status Must disclose and justify proposed premium hikes of 10% or more, which the state or the U.S. Department of Health and Human Services review (pools risks across the small group market, not by employer – inside and outside the SHOP Marketplace – stabilizing premiums) Limit on the portion of premium dollars used for administrative and overhead costs (80% MLR)

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5 Healthcare.gov Small employers HealthCare.gov to: o Browse, select and offer employees health plans o Employees enroll themselves online o Find and authorize a SHOP-registered broker to help with online enrollment SHOP-registered brokers can access new online features and manage accounts when authorized by clients SHOP Call Center will assist employees, as well as employers, agents and brokers 5

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10 Need Assistance? SHOP offers many ways to get help: From the Toll Free SHOP Call Center: 1-800-706-7893 (TTY: 711 ) Available M-F 9:00am-7:00pm ET Assists employers, agents and brokers, and employees From a SHOP-registered agent or broker Once an account is created, employers can: o Search online to find one locally o Authorize that agent or broker to manage the employer’s SHOP account online From a Navigator or other assister “Find Local Help” on HealthCare.gov lets employers locate one in their area https://localhelp.healthcare.gov – no SHOP Marketplace account needed https://localhelp.healthcare.gov 10


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