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BenefitsLink Health & Welfare Plans Newsletter

Supplement to
November 27, 2013
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Supplement to November 27, 2013

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[Official Guidance]

Text of HHS FAQs on New Enrollment Process for the Federally Facilitated SHOP Marketplace (PDF)
Questions and answers include: "How can I get coverage for my employees through the SHOP Marketplace? ... Why is CMS making this change? ... Will I be able to offer my employees coverage that takes effect January 1? Has CMS contacted agents and brokers to ensure that employers can get through the process by the December enrollment deadline? ... When will my employees and I be able to apply and enroll in the SHOP online? ... How exactly does 'direct enrollment' work for the Federally Facilitated SHOP Marketplace? ... Does this mean that I don't need to go to HealthCare.gov at all? ... What are the benefits of getting coverage through the Federally Facilitated SHOP Marketplace? ... If I submit a paper application, by myself or through an agent, broker or insurance company, how will I hear back and when will I know about my eligibility to participate in the SHOP? ... What happens if I, as an employer, have eligibility issues? ... How can I find an agent or broker to help me with my SHOP application? ... What happens if there isn't an agent or broker available to help me? ... When will I be able to see plan data for the Federally Facilitated SHOP so I can make specific plan choices for my employees? ... Earlier, employers were told they needed to create an online account before applying for SHOP eligibility. If I already created an online account what happens to that account? ... Where can I get more information or help filling out the Federally Facilitated SHOP application?" (Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services)  

[Official Guidance]

HHS Delays Online Access to SHOP Marketplace until November 2014, Provides for Interim Direct Enrollment for SHOP Marketplace Coverage
Excerpt: "For small businesses in states with a SHOP Marketplace that's run by the federal government, we are making changes to make sure that you can take advantage of SHOP coverage and the tax credit as soon as possible. Specifically, for 2014, small employers will enroll their employees in coverage through an agent, broker, or insurer that offers a certified SHOP plan and has agreed to conduct enrollment according to HHS standards. This process, called 'direct enrollment,' is similar to how most small employers get insurance today. You don't need to apply for SHOP eligibility before enrolling, or to use HealthCare.gov, unless you'd like to see information on your plan options, including which insurance companies offer SHOP Qualified Health Plans in your area.... If you want your employees' coverage to begin on January 1, the current enrollment deadline is December 15. In the Federally-facilitated SHOP, we intend to extend this deadline to December 23.... [W]e anticipate that small employers throughout the country will have online access to an online SHOP Marketplace by November 2014. Also, for the first time ever, small employers in all 50 States and the District of Columbia will be able to offer their employees a choice of plans from multiple issuers while making a single monthly payment, for coverage taking effect on or after January 1, 2015." (U.S. Department of Health and Human Services)  

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