Small Business Health Options Program (SHOP) FAQ
Guidance for FAQ regarding Employer/Employee Interaction and Application
Program Area: Small Business Health Options Program (SHOP)
Question: How will the FF-SHOP prevent a new group from enrolling into an HMO plan when out-of-state?
Answer: There will not be a mechanism in place in 2014 or 2015 to prevent an employer from enrolling in a plan without network access. There will be a comparison tool on HealthCare.gov providing plan-specific information to enrollees. Employers and employees will be able to navigate to Issuers' websites for provider network information. CMS will work with Issuers to ensure educational information is provided to employers about the consequences of selecting a QHP for their employees that does not provide network access for an out-of-state employee's primary worksite.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: July 05, 2013
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