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A service of Maryland Health Benefit Exchange
The Small Business Health Options Program—SHOP
SHOP = the Small Business Health Options Program
The SHOP helps small business owners enroll for group health insurance
The SHOP allows eligible small business owners access to thesmall business health care tax credit.
The SHOP provides small businesses access to group health insurance rates and benefits.
What is the SHOP?
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The SHOP is open to..
Employers with Maryland-based businesses or non-profit organizations with a principle business address within Maryland.
Employers with 50 or fewer full-time equivalent employees, including part-time employees. In 2016, this will increase to 100 or fewer full-time employees.
Employers must have at least one common-law employee that is not the business owner or their spouse.
Employers must offer coverage to all full-time employees.
SHOP- Eligibility
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SHOP Eligibility Process:
A SHOP Administrator will review the employer’s application to confirm that each of the eligibility requirements is met.
A SHOPAdministrator will notify the employer of their eligibility determination.
Eligibility for the Small Business Health Care Tax Credit is determined by the IRS.
SHOP- Eligibility
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Employee ChoiceThe employer selects a metal level, and the employees may choose any plan offered by any insurance company within that metal level.
BenefitsEmployees are free to choose between a broader selection of plans to meet their individual needs.Allows employers to recruit and retain in a competitive environment.
Enrollment Options
Emplo
yerC
hoice
Carrier
A B C D E F
Platinum
Gold
Silver Employee Choice
Bronze
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Enrollment Options
Employer Choice
The employer selects a menu of qualified health plans across metal levels from a single insurance company. Employees may choose from one of those plans.
BenefitsEmployees can choose from a variety of coverage levels that best meet their needs.Allows employers to recruit and retain in a competitive environment.
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Enrollment Options
Metal Levels
SHOP offers varying levels of insurance plans, known as metal levels.Each metal level covers a different percentage of the total plan's essential health-benefit expenses.Metal levels offered are platinum, gold, silver and bronze.
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Benefit 1: Tax credits to help pay the employer’s share of employee premium costs if qualified
Benefit 2: Flexibility in contributing to employee premiums
Benefit 3: Simplicity in paying for employee premiums
Benefit 4: More coverage optionsfor businesses and their employees
Benefit 5: Excellent customer service for questions about plans
SHOP Benefits for Small Businesses
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Tax CreditsThe small business health care tax is available for plans purchased through the Maryland Health Connection SHOP Marketplace.
It may be claimed for any two consecutive years beginning in 2014.
Small businesses will still be able to deduct any premium costs not covered by the tax credit.
For qualifying small businesses, up to 50 percent of your contribution toemployee premiums may be covered by the tax credit (or 35 percent fortax-exempt small employers).
SHOP Benefits for Small Businesses
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Flexibility
Flexibility for employers to contribute to employee premiums
Fixed Percent contribution:o The employer pays a set percentage of an employee’s health
insurance premiums, which can be different for employees and dependents.
SHOP Benefits for Small Businesses
Fixed Dollar contribution:o An employer will set a fixed dollar amount for how much the employer
and employee will contribute towards an employee’s health insurancepremiums.
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Simplicity
Simple administration of the health plans offered to employeesEmployers can easily…
o Set when and how long their employees’open enrollment period is — any month,any time of year
o Set the waiting period before new employees can enroll
o Use online tools to add and drop employees and dependents
o Receive a single monthly bill for allemployee premiums, regardless of how many insurance companies employeeschoose
SHOP Benefits for Small Businesses
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SHOP Benefits for Small Businesses
Plan Quality
All plans are certified by the Maryland Health Benefit Exchange. Both health and dental coverage are available.
All plans include the essential health benefits & preventive services such as:
Doctor Visits Hospital StaysEmergency Care PrescriptionsMaternity Care Pediatric CareMental Health Care Substance Abuse TreatmentCancer Screenings Routine VaccinationsBirth Control Flu & Pneumonia Shots
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SHOP Benefits for Small Businesses
Coverage Options
Maryland small business owners now have the ability to see all of the health insurance options available to them in one location.
https://www.marylandhealthconnection.gov/shop-certified-insurance-plans-2015/
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SHOP Benefits for Small Businesses
Medical CarriersAetna CareFirst CoventryEvergreen Health Kaiser PermanenteUnited Healthcare
2015 SHOP-Authorized Insurance Carriers
Dental CarriersCareFirst
DentaQuest
Dominion Dental
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Enrolling in SHOP is easier than ever!Steps to Enroll:
Step 1 Select a SHOP-authorized broker
Step 2 Complete a SHOP Eligibility Application
Step 3 Select a metal level or plan(s)
Employer Enrollment in SHOP
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SHOP Brokers
What is a SHOP-Authorized Broker?
SHOP-authorized brokers are insurance brokers who can provide free help enrolling small businesses and their employees in a health plan.
Producer Referral Program: Employers can get assistance finding a SHOP-authorized broker by calling:
877-304-9934410-268-6877
Click here to see a list of SHOP-authorized brokers:https://www.marylandhealthconnection.gov/assets/SHOP-Directory-2015.pdf
Employers can also contact a SHOPAdministrator for assistance with finding a SHOP-authorized broker. 15
SHOP Administrators
What is a SHOP Administrator?
SHOPAdministrators provide Maryland Health Connection’s small business marketplace services.
Three SHOPAdministrators offer:
More than 30 years of experience of excellent service and timely, courteous professionalism with small business employersAccess to the SHOP Marketplace through their web portals
Free services for Maryland's small business community
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SHOP Administrators
What does a SHOP Administrator do?
SHOPAdministrators:Assist businesses with selecting a SHOP-authorized broker.
Process SHOP eligibility applications.
Provide businesses easy administration of their SHOP health insurance and benefits program and multiple ways to pay a single monthly bill.
Manage the initial SHOP implementation and set-up as well asthe ongoing new hires, eligibility changes and open enrollmentprocess.
Provide daily customer service support services.
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SHOP Administrators
Who are the SHOP Administrators?
BenefitMall– 1-800-452-4559
Group Benefit Services– 1-800-638-6085
Kelly Exchange Services– 1-800-815-7360
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Inform the Small Business Community About the SHOP
How Can You Help?Add SHOP information to your organization’s website with a link to the SHOP informational page: https://www.marylandhealthconnection.gov/business-owners/
Offer SHOP brochures in your lobby, waiting rooms or directly to your clients.
Add SHOP information to your resource guides for small business owners.
Help Spread the Word
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Inform the Small Business Community About the SHOPHow Can You Help?
Request a SHOP speaker for your next meeting or workshop.
Talk to your clients about SHOP. We can provide your team members with SHOP talking points.Distribute SHOP print materials at community events.
Contact us to discuss how your organization can partner with Maryland Health Benefit Exchange to spread the word about the SHOP.
Jenny Garrison, Outreach [email protected]
443-890-5522
Help Spread the Word
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Questions?
For additional information regarding SHOP, please send all inquiries to:[email protected]
or call Betty Vassilaros, SHOP Manager at 410-547-1837.
Thank You!
