On July 5, 2013, HHS released technical guidance, in the form of questions and answers, applicable to the Federally-Facilitated Small Business Health Options Program (FF-SHOP). The guidance gives a clearer picture of how FF-SHOPs will operate and helps eligible employers to begin planning for the first FF-SHOP open enrollment period (November 15, 2013 through December 15, 2013).

Employers with an average of 50 or fewer employees may participate in the SHOP system. Some states have elected to implement their own SHOP system, while the federal government will establish the FF-SHOP system in others. For example, the FF-SHOP system will operate in Wisconsin, Illinois, Indiana and Michigan while Minnesota will operate its own SHOP. This guidance applies only to the FF-SHOP.
Among other things, the guidance clarifies that:
  • Premium rate factors will be determined by the employer's principal business address, not the employee's home address;
  • Employers will not be allowed to offer varying coverage for different classes of employees;
  • Employers may cover retirees through the FF-SHOP, but retirees must pay the same contribution rate as active employees;
  • COBRA enrollees are eligible for FF-SHOP coverage and may be included in minimum participation counts;
  • Insurers will be required to add domestic partners as dependents to the employee's coverage, if the employer provides for such coverage; and
  • Employers will be notified 90 days before FF-SHOP coverage ends, allowing them to make decisions regarding continuing coverage. If an employer elects to remain with the same plan as the previous year, renewal will happen automatically