Healthcare Update: CMS Releases SHOP Program Rule; White House Memorandum Updates Exchange Progress


    CMS Releases SHOP Program Rule

    On May 31, the Centers for Medicare & Medicaid Services (CMS) released a final rule on the Small Business Health Options Program, part of the Affordable Care Act (ACA), as well as simplified application forms for the program. The final rule was published in the Federal Register on June 4.

    Under the SHOP program, beginning October 1, small employers in each state will be able to choose from a range of health insurance options for their employees for coverage beginning January 1, 2014. The start of the SHOP program is intended to be synchronized with that of the state healthcare insurance exchanges, or marketplaces, that are also being created under the ACA. Enrollment periods and other aspects of SHOPs are also aligned with special enrollment periods for group insurance under the Health Insurance Portability and Accountability Act of 1996.

    For plan years beginning on or after January 1, 2014 and before January 1, 2015, SHOPs in 16 states plus the District of Columbia may choose to offer their employees either one selected qualified health plan (QHP), or a choice of QHPs. In the 33 states in which the federal government will operate Federally-facilitated SHOPs (FF-SHOPs), however, employers will be required to choose a single QHP for their employees from the choices available. This transitional policy will be replaced by an employee choice model beginning in 2015.

    CMS also released the final SHOP applications for employers and employees on its website. CMS pointed out that at only three and two pages long, respectively, the online applications are shorter and simpler than most insurance applications.

    Click here for a complete copy of the Update.

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