Small Business Health Options Program (SHOP) FAQ
Guidance for FAQ regarding Reporting Requirements and IRS Reporting
Program Area: Small Business Health Options Program (SHOP)
Question: The HHS Final Exchange Establishment Rule, 45 CFR 155.720(i), requires the SHOP to report to the IRS employer participation, employer contribution, and employee enrollment information in a time and format to be determined by HHS. What information will issuers be required to report for purposes of employer contributions to the FF-SHOP and how will this information be collected?
Answer: 45 CFR 155.720(i) of the HHS Final Exchange Establishment Rule (http://www.gpo.gov/fdsys/pkg/FR-2012-03-27/pdf/2012-6125.pdf) describes a reporting standard for SHOPs. This standard is limited to employers and does not include QHP issuers. All individuals providing health insurance, however, are subject to the standards for "Reporting Health Insurance Coverage" under 26 U.S.C. 6055 (http://www.gpo.gov/fdsys/pkg/USCODE-2011-title26/pdf/USCODE-2011-title26-subtitleF-chap61-subchapA-partIII-subpartD-sec6055.pdf). The IRS will provide information regarding the implementation of these standards.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: August 28, 2013
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