By Brooke Ellis on Sep 26, 2016 2:39:56 PM
Looking for new windows of opportunity to sell health or dental insurance? You might want to go SHOP-ping. It appears that the Small Business Health Options Program (SHOP) has remained largely a secret. An estimated 120,000 to 170,000 individuals have coverage through the SHOP Marketplace, which is a very small number in comparison to the number of small business employees nationwide—a number estimated to be 60 million.
As a broker, you can promote SHOP to help expand insurance options for small businesses and small groups.
SHOP in a nutshell
Healthcare.gov, the federal Affordable Care Act (ACA) Marketplace, describes SHOP as the resource for small business or nonprofit employers who want to provide health and dental coverage to members or employees “affordably, flexibly and conveniently.”
SHOP exchanges are “tailored for each state” and can be accessed at Healthcare.gov or state-run exchanges, like the New York State of Health (NYSOH) SHOP with groups or businesses with 50 or fewer full-time or equivalent employees being eligible.
While SHOP might suffer from lack of awareness, winds of change are on the horizon for the savvy broker.
Winds of change in the Exchanges
SHRM notes that many small business employers have encouraged staff to obtain health insurance on an individual basis—but that soon may change, according to Michael Stahl, senior vice president of a Texas-based brokerage.
Stahl cites three events that may encourage small business employers to turn to the SHOP marketplace:
- Significant premium increases in individual policies;
- Insurance carriers exiting the ACA exchanges; and
- Fewer insurer provider networks that will continue to offer coverage within exchanges.
Savvy brokers can cite these winds of change to help educate small business owners and encourage small groups and businesses to pivot to SHOP.
Why sell SHOP?
Healthcare.gov points out five reasons for brokers to sell insurance through the SHOP Marketplace.
- Commission. Insurers must pay the same commission for sales through the SHOP Marketplace as for other small group sales.
- Visibility. Create a broker profile, and potential new clients seeking coverage will be able to find you.
- Help your clients. Certain small business can qualify for tax credits if they purchase coverage.
- Convenience. Applications, proposals, enrollments—you name it, it’s all available online through the SHOP broker portal.
- Maintain relationships. You can continue to serve existing clients seeking SHOP coverage.
Talk SHOP to your clients
Unveiling this option to clients might just make you a hero! SHOP gives small business employers and small groups access to high-quality plans from private insurers. And some small business clients might qualify for tax credits when they enroll.
Employers retain “choice and flexibility” with SHOP. Your clients can choose whether to offer employees one plan or a variety of plans, as well as to offer health coverage alone, health and dental coverage or dental coverage alone. Employers can decide how much to pay toward employees’ premiums and whether to cover dependents. There is also control over the length of employees’ initial enrollment period and at what point new employees are eligible to participate.
Carriers have no minimum participation requirements on the SHOP; therefore, members of the same small group can have plans from a variety of insurers. Employees can select which plans work best for themselves and their families.
To support your client pitch:
- Be prepared with the latest information on eligibility and minimum participation rates.
- Testimonials from other small businesses are a great way to drive your pitch home.
Small business owners don’t always have the time or expertise to research and identify coverage options. That’s where you come in. Help your clients gain awareness of the benefits to participating in ACA’s SHOP marketplace.