November 15th Marks a Big Day for the Affordable Care Act

November 3, 2014

The Health Insurance Marketplaces (also known as the State Health Exchanges) will be opening on November 15 for individuals to enroll in non-employer sponsored plans for 2015. While employers are generally not greatly impacted by open enrollment for individual plans, there are a few reasons why employers may want to mark November 15 down on their calendars:
Window to enroll in a SHOP plan with less than 70% participation. Unlike individuals (who generally must sign up for a health plan during the 3 month open enrollment window), small businesses that wish to purchase insurance through the Small Business Health Plan Options Program (SHOP) exchange can usually enroll in any month. In order to be eligible to sign up for a SHOP plan year round, however, at least 70% of the employer’s full time employees must enroll in that SHOP plan. For small businesses that are not able to satisfy that requirement, November 15 marks the start of a one month window during which they can enroll in a SHOP plan with less than 70% participation of full time employees. We recommend that businesses considering a group health plan investigate their options now so they can take advantage of this window if there is any chance that they may be close to or under that 70% participation line.
Expected launch of online SHOP enrollment. While SHOP has been open since late 2013, the online option was delayed and is still not operational in most states. For the almost 3 dozen states using the federal government’s small business exchange, November 15 is the expected release date of the online portion of the program. As of that date, employers should be able to purchase group coverage on the computer rather than having to rely on paper forms. Many of the states running their own small business exchanges are also launching or improving their online systems, so we encourage you to learn about the options available in your state.