Small Business Health Options Program (SHOP) FAQ
Guidance for FAQ regarding Employer/Employee Interaction and Minimum Participation Rate
Program Area: Small Business Health Options Program (SHOP)
Question: Previously, it was mentioned that state minimum participation rates would be adhered to if a state's rate was higher than the FF-SHOP's default 70% rate. Is that still accurate or will all states participating in the FF-SHOP be required to adhere to the 70% participation rate?
Answer: Pursuant to 45 C.F.R. 155.705(b)(10), states participating in the FF-SHOP must follow the 70% minimum participation rate rule. However, if a State can provide evidence to CMS that either State law or wide-spread issuer practice dictates a rate higher or lower than the FF-SHOP's default rate, that State rate may be used in place of the 70% participation rate requirement. Based on information received to date from States, FF-SHOPs will use different minimum participation rates in the following States for 2014 and 2015: State FF-SHOP Minimum Participation Rate Arkansas 75% Iowa 75% Nevada 75% New Hampshire 75% New Jersey 75% South Dakota 75% Tennessee 50% Texas 75%
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: July 30, 2013
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