On October 2, 2013, the Centers for Medicare and Medicaid Services (CMS) issued FAQ #6 for the Federally-facilitated Marketplace for small businesses, also known as the SHOP Exchange (FF-SHOPs).
The selected questions and responses include information about the following issues:
- How premiums will be calculated in the FF-SHOPs;
- How premium rates for small employers with employees in multiple states will be calculated;
- Whether a small employer’s premium rate may be changed during the employer’s plan year (for example, if the employer moves its headquarters to another state during the plan year);
- Whether composite (or average) premiums may be used in the FF-SHOPs;
- How employers may contribute to employee and dependent premiums in an FF-SHOP;
- Whether employers purchasing coverage through the FF-SHOP may vary premium contribution amounts to different employee classifications (i.e. part-time vs. full time, hourly vs. salary);
- How employees will be allowed to contribute to their premiums in an FF-SHOP;
- What happens if an employer’s estimate of the number of employees who will participate (elect coverage) is different from actual participation, and the associated impact on premiums; and
- Examples of contribution calculations.
Small employers with 50 or fewer employees are currently eligible to purchase group health insurance coverage through a SHOP Exchange. However, online enrollment for the FF-SHOPs will not be available until November 1, 2013.
For more information, see our prior post on the delay of online enrollment or contact one of the Experts at Hill, Chesson & Woody
