Small Business Exchange “SHOP”

Small Business employers who have 49 or fewer employees will have three choices in regards to Health Insurance benefits for their employees in 2014:

  1. Offer a fully insured plan through either:
    Private Market
    “Current System
    Small Business
    Exchange “SHOP”
  2. Offer a Self-Funded / ASO plan (Administrative Services Only), if allowed by state law, where essential health benefits and metal level requirements don’t exist
     
  3. Do not offer coverage and let employees buy through the Individual market. However, other options may exist, such as defined contribution, adjusting contribution levels by employee, etc.

Large Employers with 50 or more employees will have will have three choices in regards to Health Insurance benefits for their employees in 2014:

  1. Offer health insurance – either fully insured or Self-Funded / ASO – that meets the minimum coverage definition (no essential health benefit or metal level requirements) and is affordable.
     
  2. Offer some level of coverage that does not meet minimum requirements and pay the employer penalty
     
  3. Do not offer coverage and let employees buy through the Individual market and pay the employer penalty.


Health Reform FAQs:

What is the Employer Mandate?
Does the Employer Mandate apply to groups with 49 or fewer employees?
How are FTE (Full-time equivalents) calculated?
How do Employers with nearly 50 employees determine if they meet the large employer threshold?
What if our current Group Insurance does not renew until late 2014?
What is the Affordability plan requirement?
What are the penalties for not adhering to the Employer Mandate?
Do employers have to contribute to the employee’s premium?
How will the new plans be structured in the exchange?
Are Employers required to offer Dependent coverage?

Please contact me if you would like to more information Health Care Reform and how it will affect your business.

Eilene Rothman
Phone: (800) 300-0205
Email: Eilene@InsuranceRus.com