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SHOP Exchanges: The Basics. Timothy Stoltzfus Jost Washington and Lee University College of Law. SHOP Exchanges. Exchanges to make coverage more accessible and affordable to small businesses

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shop exchanges the basics

SHOP Exchanges: The Basics

Timothy Stoltzfus Jost

Washington and Lee University College of Law

shop exchanges
SHOP Exchanges
  • Exchanges to make coverage more accessible and affordable to small businesses
  • Should increase the market power of small businesses and choice for small businesses and their employees
  • Proposed regulations take a practical approach to implementation and offer flexibility to employers
shop exchanges1
SHOP Exchanges
  • Must exist in each state (either as state or federal exchanges)
  • May be separate or combined with individual exchange
  • Individual and small group risk pools may be combined or kept separate
which employers may participate
Which Employers May Participate?
  • Serves small employers (1-100, or, at state option, 1-50 until 2016)
  • States may expand to larger employers beginning in 2017
  • Proposed regulations would not cover businesses without employees
shop exchanges proposed regulation options
SHOP Exchanges: Proposed Regulation Options
  • Required: employer choice of actuarial value tier, employee choice of qualified health plan (QHP)
  • States can offer employers options:
    • (1) employees can choose any QHP offered in the SHOP in any tier;
    • (2) employers select specific tiers from which an employee may choose a QHP;
    • (3) employers select specific QHPs from different tiers of coverage from which an employee may choose a QHP; or
    • (4) employers to select a single QHP to offer employees.
shop exchanges proposed regulations
SHOP Exchanges: Proposed Regulations
  • Rolling enrollment for employers, but upon enrollment locked into one year periods (and premiums locked in)
  • Must offer exchange coverage to all employees
  • Exchange must provide aggregate bill
  • Employers must notify exchange about employee change of status
  • Employers with multiple worksites can offer access to single exchange or to exchanges where employees located