Reform Alert - News from the Blues' Office of National Health Reform

SHOP employee choice

June 26, 2014

On June 10, the Centers for Medicare and Medicaid Services (CMS) announced that the Small Business Health Options Program (SHOP) employee choice feature will not be implemented in Michigan and 17 additional states during the 2015 plan year. Employee choice is when the employer offers multiple plans to employees selecting coverage through the FF-SHOP. The employer can either offer all plans on the FF-SHOP to their employees or they can offer all plans within a metal level. Without employee choice in Michigan, the employer can only choose one plan with one issuer (at any metal level, but only one plan).

CMS did not implement employee choice in any federally facilitated SHOPs (FF-SHOP) in 2014 as a result of technical issues. CMS permitted states to request an additional one-year delay in employee choice, postponing its implementation in those states until at least 2016. Michigan submitted a request on June 3 for delay and was approved. Other states approved include: Alabama, Alaska, Arizona, Delaware, Illinois, Kansas, Louisiana, Maine, Montana, New Hampshire, New Jersey, North Carolina, Oklahoma, Pennsylvania, South Carolina, South Dakota and West Virginia.

The remaining 14 states with an FF-SHOP will have employee choice available to small businesses in 2015.

Where can I find more information?
More information is available here.

The information in this document is based on preliminary review of the national health care reform legislation and is not intended to impart legal advice. The federal government continues to issue guidance on how the provisions of national health reform should be interpreted and applied. The impact of these reforms on individual situations may vary. This overview is intended as an educational tool only and does not replace a more rigorous review of the law’s applicability to individual circumstances and attendant legal counsel and should not be relied upon as legal or compliance advice. As required by US Treasury Regulations, we also inform you that any tax information contained in this communication is not intended to be used and cannot be used by any taxpayer to avoid penalties under the Internal Revenue Code.