An agent or broker may assist employers with a SHOP application and enrollment directly on the SHOP website. The employer must first log directly into his or her own SHOP account. The agent or broker may assist the employer in creating his or her account if needed, but the employer must create his or her own Marketplace username and password and should not share this information with third parties, including agents and brokers. The agent or broker will then assist with completing the application, where the employer will be prompted to enter the agent or broker’s National Producer Number (NPN) and other identifying information.
Note: There are 12 enrollment cycles per year; one per month.
Agents can help employers input basic information about their businesses.
Next, agents may help the employer input an employee roster with basic information about each employee.
After all the information is entered by the employer, SHOP will generate information about the range of premiums for all plans, and, at the employer’s request, detailed descriptions of specific plans at different price points. In 2014, employers can provide health insurance coverage to their employees by offering a single qualified health plan (QHP) option.
After the employer selects one QHP, that QHP will be the default “reference plan.”
Once the employer has selected a reference plan, they choose a defined percentage of the reference plan to contribute for each employee. The employer also decides if and at what percentage they will contribute towards dependent and dental coverage. (Employer contributions to dependent insurance coverage and dental coverage continue to be optional under the Affordable Care Act.). Employers will review average plan premiums based on the ages of employees likely to enroll in coverage; after a reference plan is chosen, the employer will decide on a percentage contribution for that reference plan.
Next, the employer decides whether all employees will contribute the same amount for coverage or will pay a premium based on age.
The employer views a summary of choices and has an opportunity to explore “what if” scenarios:
Agents can also help each eligible employee enroll in a SHOP.
The employer reviews the completed application. Agents can help the employer verify he or she has provided all the required information and met the minimum participation rate. Last, the employer establishes a waiting period policy for newly-eligible employees, and submits the first month’s premium.
During the first plan year, 2014, the QHP issuer will be responsible for all billing and the employer will pay premiums to the QHP issuer directly.
Next Topic: Employees Enrollment in a SHOP
Obamacare Agents Call 877-532-3261. Consumers Call 862-262-2273