Small Business Health Options Program (SHOP) FAQ
Guidance for FAQ regarding Premium Calculations and Tobacco Surcharge
Program Area: Small Business Health Options Program (SHOP)
Question: If an employee or an employee's dependent obtaining coverage through the FF-SHOPs uses tobacco (as defined in 45 CFR 147.102(a)(1)(iv)), how can the employee or dependent avoid the tobacco premium rating surcharge?
Answer: The FF-SHOPs will not impose the tobacco premium rating surcharge at the time of initial enrollment (or re-enrollment) if the employee or dependent, as applicable, agrees at the time of enrollment (or renewal or re-enrollment) to participate in a wellness program meeting the standards of section 2705 of the Public Health Service Act, such as a tobacco cessation program.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: September 13, 2013
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