Small Business Health Options Program (SHOP) FAQ
Guidance for FAQ regarding 834 Transaction and Effectuation Transaction
Program Area: Small Business Health Options Program (SHOP)
Question: Are issuers required to effectuate initial enrollment transactions even if the transaction only adds a spouse or dependent to the policy?
Answer: Dependents may never enroll in a Federally-facilitated Small Business Health Options Program (FF-SHOP) Qualified Health Plan (QHP) or Stand-alone Dental Plan (SADP) without the employee also enrolling. Per QHP agreements, issuers must effectuate all enrollment transactions submitted to issuers from the FF-SHOP and maintain that coverage (assuming premium payments are up to date).
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: July 16, 2014
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