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11/10/2020 » 11/13/2020
UDS Training 2020

SHOP

What is SHOP? 

Small business employers with 50 or fewer full-time equivalent employees (FTEs) can apply for health coverage anytime during the year by using the Small Business Health Options Program (SHOP) on HealthCare.gov. Only employers who use SHOP are eligible for the Small Business Healthcare Tax Credit.

What is the Employer Mandate?

Starting in 2015, employers with over 50 full-time equivalent employees or a combination of full-time and part-time equivalent employees will be subject to the employer shared responsibility provision, or employer mandate. These employers will be subject to a fine collected by the IRS for each month they have one or more full-time employees receiving a Premium Tax Credit (PTC)

  • Employees can only get PTC if employer-sponsored coverage is not offered or it is considered unaffordable (greater than 9.5% of the employees’ household income)
  • Employers will not be subject to the shared-responsibility payment if employees that work on average less than 30 hours a week receive a PTC.
 

Who Can Use SHOP? 

To participate in the Small Business Health Options Program (SHOP) Marketplace, an employer must: 

  • Have a principal business address within the state where they're buying coverage, or have an eligible employee with a primary worksite within the state where they're buying coverage.
  • Have at least one common-law employee on payroll (not including a business owner or sole proprietor, or their spouses on the payroll). 
  • Offer coverage to all full-time employees — those working an average of 30 or more hours per week.
  • Employ 50 or fewer full-time equivalent employees (FTEs), including part-time employees. For example, 2 half-time employees generally equal 1 full-time equivalent employee. Beginning no later than January 1, 2016, SHOP will be available for employers with 100 or fewer FTEs. Visit the SHOP Full-time Equivalent Employee Calculator for a quick way to calculate how many full-time equivalent employees you have.

 

Helpful Resources

CMS Technical Assistance Resources on SHOP

FTE Calculator

HealthCare.gov Information for Employers and Consumers

SHOP Overview (IPHCA)

SHOP Small Employer Call Center at 1-800-706-7893 (TTY: 711). Monday through Friday, 9 a.m. to 7 p.m.; Saturday and Sunday, 9 a.m. to 5 p.m. ET.