Small Business Health Options Program (SHOP) FAQ
Guidance for FAQ regarding Issuer Participation Requirements and Plan Coverage
Program Area: Small Business Health Options Program (SHOP)
Question: For Federally-faciliated Small Business Health Options Program (FF-SHOP) plans, will the deductible and maximum out-of-pocket amount reset each January or when a plan renews?
Answer: Issuers may establish Small Business Health Options Program (SHOP) plan benefit years according to applicable state law, either a calendar year or a 12-month contract year. So the answer to this question depends on whether the plan benefit period is filed and approved based on a calendar year or a contract year. Either way, the rates for all SHOP plans must be locked in for 12 months based on when a group initially enrolls.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: June 26, 2014
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