Get More Benefits &
Save More! Call For
More Info Today

What Is the Small Business Health Options Program?

A Small Business Health Options Program health plan can offer employers with a substantial benefits package, but other plans may be less costly.

Health plans provided through the Small Business Health Options Program (SHOP) exchanges allow payers to provide the nation’s smallest businesses with affordable plan options that provide critical health benefits.

SHOP health insurance operates under separate exchanges from the individual health plan marketplace.

The SHOP market has experienced some significant administrative changes in recent months. Federal agencies have redesigned how small businesses can buy and enroll in SHOP plans.

Small businesses that can find the correct SHOP plan can receive a wide-ranging health benefits package with cost alleviation options like state and federal subsidies.

With 27.7 million small businesses operating in the United States, players that can connect small business owners with SHOP coverage may have a chance to capture a lucrative segment of the employer-sponsored insurance market.

What Is a Shop Plan and How Small Businesses Enroll?

A SHOP health plan as a plan that provides businesses with 1 to 50 workers with health or dental benefits. SHOP plans use a metal-tier structure just like individual health plans to determine benefits and cost sharing charges.

There are three major categories for businesses to enroll in a SHOP plan.

Small businesses are required to offer coverage to at least one full-time employee (working 30 or more hours a week) who is not an owner, spouse, or business partner.

Individual state rules for SHOP participation rates necessitate SHOP businesses to cover between 0 percent and 75 percent of their full-time employees to qualify for enrollment.

Small businesses are also not required to offer SHOP benefits to part-time employees, according to federal law.

An employer searching for SHOP coverage needs to find a primary SHOP insurer in their state. Small businesses with out-of-state, full-time workers must consult with a SHOP broker to provide compliant coverage at both the state and federal level.

SHOP health plans are provided by private payers and are available for purchase through SHOP-specific insurance brokers or through the payer itself.

Employers can use a full-time employment calculator to establish whether their business qualifies for SHOP. Small businesses can also access a quick premium checker to see the lowest available premiums for their health insurance plan.

Small Business Benefits of SHOP Enrolment

Most smaller businesses can qualify for. SHOP Tax Credits and Premium Assistance Programs to offset the costs of ensuring employees.

Small businesses buying SHOP plans can qualify for the tax credit if they have fewer than 25 full-time employees, have an average employee salary of $50,000 or less per year, pay for at least 50 percent of their employees’ premiums, and currently offer SHOP benefits to workers.

SHOP businesses in the states of Alabama, Arizona, Georgia, Indiana, Kansas, and Oklahoma can receive generous premium aid packages from their states. For instance, in Oklahoma, a small business could receive the help that covers up to 60 percent of premium costs, if the business meets specific employer and employee needs.

Small businesses can also enroll in SHOP coverage at any time during the year, making them a flexible insurance choice for health insurance companies.

SHOP insurance offers employees with essential health benefits like preventive care, outpatient services, prescription drug treatments, and emergency care.

These health insurance plans can also be used as a medical-only, dental-only, or combination health plan. For instance, an employer could purchase a SHOP dental plan if they already have an ACA-compliant medical plan to enhance their benefits package.

Resources and References:

• Full-time Equivalent Employee Calculator
• Metal Tier Structure Categories