The Federally-facilitated SHOP Marketplace Health Insurance Options for Small Businesses March 2015

What Small Employers Use to Face Many obstacles to offering health insurance to employees Difficulty comparison shopping between plans Unpredictable premium increases Higher rates for groups with: o Women o Older workers o Workers who have chronic conditions or high-cost illnesses Waiting periods for coverage of pre-existing conditions

What SHOP Offers Small Employers SHOP Health Plans: Can’t deny coverage to small employers (guaranteed availability / renewability) Can’t limit benefits or sell coverage with higher rates: o For those with pre-existing health conditions o For women o Based on employees’ health status Must disclose and justify proposed premium hikes of 10% or more, which the state or the U.S. Department of Health and Human Services review (pools risks across the small group market, not by employer – inside and outside the SHOP Marketplace – stabilizing premiums) Limit on the portion of premium dollars used for administrative and overhead costs (80% MLR)

Healthcare.gov Small employers HealthCare.gov to: o Browse, select and offer employees health plans o Employees enroll themselves online o Find and authorize a SHOP-registered broker to help with online enrollment SHOP-registered brokers can access new online features and manage accounts when authorized by clients SHOP Call Center will assist employees, as well as employers, agents and brokers 5

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Need Assistance? SHOP offers many ways to get help: From the Toll Free SHOP Call Center: (TTY: 711 ) Available M-F 9:00am-7:00pm ET Assists employers, agents and brokers, and employees From a SHOP-registered agent or broker Once an account is created, employers can: o Search online to find one locally o Authorize that agent or broker to manage the employer’s SHOP account online From a Navigator or other assister “Find Local Help” on HealthCare.gov lets employers locate one in their area – no SHOP Marketplace account needed 10