Small Business Health Options Program (SHOP)
The Small Business Health Options Program (SHOP) helps businesses provide health coverage to their employees.
SHOP insurance is generally available to employers with 1-50 full-time equivalent employees (FTEs). If you have fewer than 25 employees, you may qualify for the Small Business Health Care Tax Credit, if you buy SHOP insurance. Learn more about SHOP eligibility rules and the Small Business Health Care Tax Credit.
If you're a sole proprietor or self-employed with no employees, you can get individual coverage through the Health Insurance Marketplace.
Enrolling in SHOP insurance
For SHOP insurance that starts on or after January 1, 2018, employers have two options for enrolling:
- Through an insurance company
- With the assistance of a SHOP-registered agent or broker
To learn more about SHOP visit HealthCare.gov
Benefits of the SHOP Insurance
- You control the coverage you offer and how much you pay toward employee premiums.
- You can choose from high-quality private health insurance plans that meet the needs of your business and employees.
- You can choose to offer health only, dental only, or both health and dental coverage. If offering dependent coverage and an employee enrolls, the employee’s dependents can enroll in health only, dental only, or both health and dental coverage.
- You can start coverage any time of the year.
- If you have fewer than 25 employees, you may qualify for a Small Business Health Care Tax Credit worth up to 50% of your premium costs (up to 35% for tax exempt/non-profit employers). You can still deduct from your taxes the rest of your premium costs not covered by the tax credit. The tax credit is generally available only when an employer offers SHOP plans. Use the Small Business Health Care Tax Credit Estimator to find out if you may qualify and how much you may save.
How to know if you qualify for the SHOP Marketplace
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SHOP insurance is available to employers with 1-50 full-time equivalent (FTE) employees in most states (in some states, employers with 1-100 employees qualify). Use our FTE Employee Calculator to find out if you qualify to use SHOP.
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You must offer SHOP coverage to all of your full-time employees – generally those working 30 or more hours per week on average.
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In many states, at least 70% of employees offered coverage must accept the offer, or be covered by another form of coverage, for the employer to participate. (Employers who apply for or renew SHOP coverage between November 15 and December 15 each year can enroll without meeting this requirement.) For help calculating the SHOP minimum participation rate in your state, visit the MPR Calculator.
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You must have an office or employee work site within the state whose Small Business Health Options Program you want to use.
Get more details on SHOP eligibility rules.
Preview plans and prices now
Browse health and dental plan information right now. See the available plans and sample prices based on the number and ages of employees and their dependents.
SHOP Resources
Model SHOP employer eligibility application - Opens in a new window
SHOP tools:
- Full-time Equivalent (FTE) Employee Calculator
- Small Business Health Care Tax Credit Estimator
- Minimum Participation Rate (MPR) Calculator
- See Plans and Prices
- SHOP Eligibility Determination Tool
SHOP regulations and guidance:
For additional resources, please visit marketplace.cms.gov
Questions?
Contact the SHOP Call Center at 1-800-706-7893 (TTY: 1-888-201-6445)
Resources for Agents and Brokers
- Resources for Agents and Brokers in the Health Insurance Marketplaces
- General Resources
- Plan Year 2022 Open Enrollment
- Plan Year 2022 Registration and Training
- SHOP
- Web-brokers in the Health Insurance Marketplace
- Help On Demand
- Video Learning Center
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QUICK LINKS:
- Issuer and DE Partner Directory
- Agent/Broker FAQs
- Agent/Broker Newsletters
- Agent/Broker Help Desks
- Registration Completion List
- Agent/Broker Marketplace Registration Tracker
- Registration Termination List
- Find Local Help
Updates
- March 5, 2020 Information Related to COVID–19 Individual and Small Group Market Insurance Coverage
- March 12, 2020 FAQs on Essential Health Benefits Coverage and the Coronavirus (COVID-19)
- March 18, 2020 FAQs on Catastrophic Plan Coverage and the Coronavirus Disease 2019 (COVID-19)
- March 24, 2020 FAQs on Availability and Usage of Telehealth Services through Private Health Insurance Coverage in Response to Coronavirus Disease 2019 (COVID-19)
- March 24, 2020 Payment and Grace Period Flexibilities Associated with the COVID-19 National Emergency
- March 24, 2020 FAQs on Prescription Drugs and the Coronavirus Disease 2019 (COVID-19) for Issuers Offering Health Insurance Coverage in the Individual and Small Group Markets
- April 11, 2020 FAQs about Families First Coronavirus Response Act and the Coronavirus Aid, Relief, and Economic Security Act Implementation
*This document was updated on April 15, 2020, to correct an error in footnote 10 regarding the current end date of the public health emergency related to COVID 19. - April 13, 2020 Postponement of 2019 Benefit Year HHS-operated Risk Adjustment Data Validation (HHS-RADV)