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Search on: Keyword/Phrase: SHOP, Dates: 05/01/2014 through 05/14/2014
 
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View 1552 When can issuers expect the CMS 820 Companion Guide to be published? CMS intends to release the SHOP Chapter of the CMS HIX 820 Companion Guide soon and it will be posted to REGTAP at that time with ... more 05/08/2014
View 1553 Will only full payments be sent to Issuers or will partial payments be sent? Is there a payment threshold less than 100%? Only full payments will be sent to Issuers. Partial payments can be collected by the FF-SHOP until 100% payment is received from t ... more 05/08/2014
View 1554 How will the FF-SHOP handle paper checks and ensure initial payments are received prior to the coverage effective date? The FF-SHOP must receive the initial binder check by the 26th of the month. If a payment is not received by this date, a cancellat ... more 05/08/2014
View 1556 Can a group receive a tax credit off of the SHOP in 2014 or is a group required to fill out the SHOP paper application and be cons ... more In order to claim the expanded small business healthcare tax credit in 2014, eligible small groups must submit a paper application ... more 05/08/2014
View 1557 If an Issuer contacts the SHOP at the end of a group's grace period, will the SHOP be able to tell the Issuer whether the gro ... more As of November 2014, Issuers may contact the SHOP Call Center to receive the current payment status of FF-SHOP groups. 05/08/2014
View 1558 What are the employer reporting requirements for terminations? If someone leaves employment on the 30th of the month, how long doe ... more Terminations may be reported to the FF-SHOP on any day of the month, and the termination effective date will be the last day of th ... more 05/08/2014
View 1560 Issuers understand that the FF-SHOP will not accept credit card payments. Will the FF-SHOP accept prepaid debit cards? Debit cards will not be accepted. Only ACH direct debit transfers will be accepted. 05/08/2014
View 1561 For special enrollment periods in SHOP, does plan selection have to occur within 30 days of the triggering event? In most instances, yes, plan selection must occur within 30 days of the triggering event. The only exception is loss of Medicaid/C ... more 05/08/2014
View 1562 Is CMS allowing groups to make retroactive changes? With few exceptions, e.g., birth/adoption/death, effective dates in FF-SHOPs are always the first of the month, and termination ef ... more 05/08/2014
View 1563 If an employer is billed 4/10 and the employer notifies the FF-SHOP of an employee termination of 3/11 on 4/11, what is the employ ... more The termination effective date in this example will be 4/30. 05/08/2014
View 1566 How will the FF-SHOP's minimum participation rate work in 2015? Will employers have to meet the default 70% minimum participa ... more CMS regulations require the FF-SHOP to calculate minimum participation rates at the level of the SHOP--not at the level of an Issu ... more 05/08/2014
View 1568 Will the 820 218 be sent from CMS to Issuers or be sent directly to the bank? The FF-SHOP will send the 820 218 directly to the bank. The 820 306 will be sent to Issuers. 05/08/2014
View 1569 How can Issuers contact the SHOP Call Center to receive payment status for a group enrolled in FF-SHOP beginning in 2015? Will CMS ... more Issuers may contact the SHOP Call Center today with questions involving the 2014 Direct Enrollment Process. The number is 1-800-70 ... more 05/08/2014
View 1570 Will the 820 have the exchange assigned group ID? The FF-SHOP does not assign Group IDs. Only Issuers generate Group IDs in FF-SHOPs. Issuer assigned Group ID is an optional elemen ... more 05/08/2014
View 1572 Will effectuation guidelines for SHOP be updated in terms of what data is required on the 834 effectuation transaction? Yes, CMS will cover Group XML and 834 enrollment transactions and required data elements on future REGTAP calls. 05/08/2014
View 1573 Are Issuers required to validate that brokers have signed the FFM privacy and security agreement in order to sell in FF-SHOP, for ... more Issuers are expected to validate that brokers in FF-SHOPs have a valid state license and have completed the FFM privacy and securi ... more 05/08/2014
View 1574 Will the FF-SHOP 820 be pushed to a different location than the Individual 820? The payee group set-up determines the file routing. If the Issuer ID for both SHOP and the Individual Market is the same, 820 HIX ... more 05/08/2014
View 1575 The requirement for a group to start with a zero balance does not make sense for a January enrollment for an existing SHOP group. ... more This is correct. CMS expects there to be a zero balance as of the 2015 plan year. Issuers will collect any past-due balances from ... more 05/08/2014
View 1576 Our state requires that issuers process claims during the grace period. How will plans bill for coverage during the FF-SHOP grace ... more FF-SHOP QHP and SADP Issuers will not be invoicing any groups with 2015 coverage effective dates. The FF-SHOP will continue to inv ... more 05/08/2014

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