The Affordable Care Act

Coverage Options for Small Businesses

Courtesy of Enroll Virginia via Gary LaPorta

The Small Business Health Options Program (SHOP) is a new program that simplifies theprocess of buying health insurance for your small business.

For 2014, the SHOP Marketplace is open to employers with 50 or fewer full-time-equivalent employees (FTEs). The advantages of using SHOP include:

  • You control the coverage you offer and how much you pay toward employee premiums.
  • You can compare health plans online on an apples-to-apples basis, which helps you make a decision that's right for your business.
  • You may qualify for asmall business health care tax creditworth up to 50% of your premium costs. You can still deduct from your taxes the rest of your premium costs not covered by the tax credit.Beginning 2014 the tax credit is available only for plans purchased through SHOP.

Compare plans and apply online

The Small Business Health Options Program (SHOP) is designed for small employers with 50 or fewer full-time equivalent employees. With one online application, on your own or with the help of an ENROLL Virginia Navigator or other assister; you can compare price, coverage, and quality of plans in a way that's easy to understand.

You can enroll starting October 1, 2013 for coverage starting as soon as January 1, 2014. You can also enroll and begin coverage any time after January 1, 2014.

How to know if you qualify for the SHOP Marketplace

  • In 2014, SHOP is open to employers with 50 or fewer full-time equivalent (FTE) employees. Beginning in 2016, all SHOPs will be open to employers with up to 100 FTEs: If you're self-employed with no employees, you can get coverage through the individual market Health Insurance Marketplace, but not through SHOP.
  • If you plan to use SHOP, you must offer coverage to all of your full-time employees - generally those working 30 or more hours per week on average.
  • At least 70% of your full-time employees must enroll in your SHOP plan.

Steps your employees take to get SHOP health insurance

Once you choose SHOP health insurance coverage that works for your business, your employees can sign up for it online through the Marketplace.

After you choose your health insurance plan, you or the Marketplace will notify your employees and tell them how to sign up. There are tools to help you create an employee roster, set up an employee email distribution list, or download the offer of coverage and distribute it to your employees manually.

Once your employees get the offer, they follow a few steps:

  • Verify their information to confirm that the name, date of birth, and Social Security information you provided are correct
  • Provide additional information like address, contact preferences, tobacco use, and whether they have dependents that need coverage. This information will give them a better idea of what their costs will be.
  • Review the plan to see if it meets their needs. Your employees can see how much they will pay each month as a premium, what their deductible will be, and how much their total out-of-pocket costs could be. All of these steps can be done directly through the Marketplace.
  • Next, employees decide whether they want to accept or decline coverage for themselves and their dependents. If they accept the plan, they can view, download, and print a summary of the plan coverage.

Coverage won't take effect until you approve the plan. Once the employee enrollment period is over, you can see who accepted coverage (including dependents if you're offering dependent coverage). You can calculate the total costs to your business and decide if the plan you've chosen works for you. At this point, you can decide to approve the plan or explore other SHOP options.

The website for SHOP is: