The Small Business Health Options Program (SHOP) will remain open for small businesses with 1-50 employees in 2018, and will boast new features that’ll impact how small employers and their employees enroll in and manage their coverage for SHOP plans starting on or after January 1, 2018.

CMS effectively discontinues FF-SHOP  

On May 15th, 2017, CMS announced that it would effectively discontinue the SHOP Marketplace within the 33 states that participate on the federally-facilitated SHOP (FF-SHOP) Exchange on Healthcare.gov. In 2017, 232,698 employees 94.25% less than the than the 4 million originally predicted by the Congressional Budget Office (CBO) – enrolled in SHOP coverage; these consumers represent the 27,000 employers that participated in the federal program. 

Small businesses in these states will no longer be able to enroll in SHOP plans online beginning January 1, 2018. Rather than utilizing Healthcare.gov to choose a plan and enroll, employees will work with an insurance company or with a SHOP-registered agent or broker to enroll in coverage and to pay their premiums; premiums will no longer be paid through Healthcare.gov.  

These states have two options: 

  • transition to CMS’ new approach, in which employers would enroll in SHOP directly through an insurance company, or 
  • establish their own state-based SHOP (SB-SHOP) exchange. 

To ease the transition, CMS has published fact sheets, calculators, and other tools for employers.  

SB-SHOP v FF-SHOP 

The tables below compare the enrollments of the 33 FF-SHOPs and 17 state based SHOPs (SB-SHOP), as of January 2017; this data includes the number of business enrolled, and number of employees covered by these businesses.  

Despite the disparity in number, state-run SHOPs have more than two and half times the number of businesses enrolled in SHOP as compared to the FF-SHOPs and more than five times the number of employees covered through SHOP.  

What's new for SHOP in 2018

Data: CMS, SHOP Marketplace Enrollments from January 2017 *Hawaii formerly operated an SB-SHOP, but received approval through a 1332 waiver to replace it with a substitute program.

What does the future of SHOP look like?  

While SHOP did not become the widespread success as intended, it did include many provisions used by employers to gain unprecedented access to insurance. Despite CMS’ decision to end the FF-SHOP, states with their own SB-SHOPs will remain unaffected and will create an opportunity for states to fill the vacated space and strengthen the environment in which small businesses are able to offer coverage to their employees.  

In May, Softheon announced that its proven Software as a Service (SaaS) and Business Process as a Service (BPaaS) solutions can assist states looking to preserve their ability to offer affordable insurance options to small businesses. By migrating their FF-SHOP Exchanges to the Softheon Cloud, states seeking reprieve from the imminent closing can retain their ability to serve their small business population. Softheon’s FF-SHOP contingency option offers a minimal risk, 90-day implementation plan with full regulatory compliance.   

Since this announcement, Softheon has partnered with Access Health Connecticut (AHCT) to facilitate its SHOP Exchange. This collaboration has created the ultimate consumer experience for Connecticut’s small businesses looking for insurance options.   

To learn more about how you can start the transition to a strong state-based SHOP platform, please email info@softheon.com 

Sources:  

  1. https://www.healthcare.gov/small-businesses/provide-shop-coverage/shop-marketplace-overview/  
  2. https://www.kff.org/health-reform/state-indicator/state-health-insurance-marketplace-types/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D   
  3. https://healthpayerintelligence.com/news/cms-to-shutter-small-business-health-options-program-website  
  4. https://aishealth.com/archive/nhpw052217-03   
  5. https://ct.wolterskluwer.com/resource-center/articles/small-employers-can-shop-health-insurance  
  6. http://healthaffairs.org/2017/05/15/cms-announces-plans-to-effectively-end-the-shop-exchange/   

The views and opinions expressed by the authors on this blog website and those providing comments are theirs alone, and do not reflect the opinions of Softheon, Inc. Please direct any questions or comments to research@softheon.com 

Yvonne Villante
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Yvonne Villante

Director of Marketing at Softheon
Yvonne Villante is the Director of Marketing at Softheon. Before this, Yvonne held several roles within the organization including Senior Research Manager, Corporate Research Manager, and Marketing Research Analyst. She holds a MBA in healthcare administration from Ohio University and a BS in business management from SUNY Stony Brook. During her undergraduate studies, she graduated within the top 10% of her class.
Yvonne Villante
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