Enrolling in the Marketplace

  1. Small employer goes directly to an insurance company, agent or broker certified by the Marketplace to get and submit an application. They can also view basic plan and pricing information on Healthcare.gov to help them choose a plan.
  2. The agent, broker or issuer will help the small employer complete enrollment process and provide employer with exact premium quote.
  3. Employer provides information to employees for enrollment, pays issuer first month’s premiums upon achieving applicable minimum participation rate.
  4. At any point in this process the employer, on their own or with the help of a certified agent or broker, will go to HealthCare.gov and download a fillable PDF SHOP application and mail the application to the marketplace.
    1. An employer does not need to create an account on HealthCare.gov to access this form.
    2. The application will assess company size, location, intent to insure all full time employees, and other basic requirements for SHOP participation.
  1. Employers can enroll in a SHOP Qualified Health Plan through the issuer prior to receiving notice of eligibility from the marketplace.

Once the SHOP makes an eligibility determination, they will pass along that information to the IRS to ensure businesses are able to receive the expanded tax credit available to them in 2014.

Employers will still have the option to work directly with the SHOP marketplace with paper applications, rather than going direct to issuer if they so choose.