The Small Business Health Options Program (SHOP) is likely to undergo some changes soon, according to a May 2017 announcement by the Centers for Medicare & Medicaid Services (CMS).

Specifically, CMS has proposed a rule that would affect employer enrollment in SHOP coverage. Currently, employers enroll online on the federal SHOP marketplace (FF-SHOP).

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 enrollment has been underwhelming—from a participation standpoint, as well as broker and carrier involvement.

According to CMS, approximately 27,000 employers have active coverage through SHOP Marketplaces as of January 2017, covering nearly 230,000 individuals. This is a very small number in comparison to the number of small business employees nationwide—a number estimated to be 60 million. The Congressional Budget Office (CBO) at one point estimated that 4 million would enroll in coverage through the SHOP Marketplaces by 2017.

Under the proposed rule, which would take effect on January 1, 2018, small business employers would either enroll directly with insurance companies that offer SHOP plans, or through a broker.

What is the potential impact to dental plans?

According to the National Association of Dental Plans (NADP), it is uncertain how the proposed rule change to SHOP enrollment in federally facilitated marketplaces might impact dental plans.

If an employer collaborates with a broker registered with the FF-SHOP, he or she can present available dental plans to the group. However, it is uncertain how much exposure SHOP dental plans will get if employers choose direct enrollment.

What can you, as a broker, do now? If you’re interested in the SHOP market, stay tuned for more updates from CMS. SHOP can help expand coverage options for small businesses and small groups. As some small business employers might not have time to identify appropriate plan options, it’s a great opportunity to position yourself as an expert to guide them through the process—especially as existing rules might change.

Any questions about your current Solstice products? Login to your portal on https://www.solsticemarketplace.com/ 

Want to start selling Solstice? Give us a call at 877-760-2247 or email us at sales@solsticebenefits.com