Affordable Care Act, The SHOP

This is the third segment of my intent to educate my readers on the intricacies of ACA (The Affordable Care Act).

In this blog we are going to continue speaking to the Marketplace which will be available online as of October 1st, 2013.  The subject of todays information is on what is called the SHOP.  The SHOP is the Marketplace being set up for companies with less than 50 employees.

Prior to going into details, let’s refresh your memory.  A Marketplace is an internet portal established by the Federal or State Governments which will offer the consumer the ability to establish eligibility for premium discounts, tax incentives and search for the best available health insurance program in your State.  Not every States will offer a Marketplace for their residents; if your state has  decided not to pursue this avenue, the Federal Marketplace will be available to everyone.  Every insurance carrier licensed in your state to sell health insurance will appear in the Marketplace.

There are two types of Marketplaces, for individuals and their families and for companies with less than 50 employees.  Today we will speaking about the latter.

A company with less than 50 employees is not required to offer their employees health insurance.  However, if the employer decide that they do want to offer this benefit, the employer has the right to choose the company, the program and how much of the premium the employee will out-of-pocket.

Remember that in the previous blog I explained that there are four programs to choose from, Bronze, Silver, Gold and Platinum.  Bronze being the most basic of the four and Platinum being the most complete.  All four programs are required to meet the most basic criteria as established by ACA.

Although most small businesses will, most probably, opt out of offering any sort of health plans for their employees, it is always good to know what is available to the employer as well as the employee.

If the employer chooses to offer any one of the plans previously listed, the employer may be eligible for tax incentives, especially if they are providing coverage for employees earning less than the poverty level.

The employee may benefit from coverage obtained through a SHOP, only because the rates may be better than going through the individual Marketplace.  On the other hand, the employee may be eligible for premium discounts through the individual Marketplace which will not be available if he/she chooses to join the employer’s plan.  The only way to know if the employee will benefit from one program or the other is by researching each Marketplace according to their specific needs.  This is an instance where the Health Insurance Professional (HIP) comes in very handy.

The HIP has learned to navigate through the Marketplaces being able to readily offer advice and guidance to both the employer and the employee.

Even if you do not plan to offer your employees a Health Insurance Plan, you might want to afford them the ability to ask questions and gain knowledge so that they may have a better understanding of what they and their family can expect from ACA.

If you would like to have us come in and speak to your employees, please contact us at info@soraglobal.com and we will be happy to set up an appointment to come in after October 1st.

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