Small Business Health Options Program (SHOP) FAQ
Guidance for FAQ regarding 834 Transaction and Cancellation Transaction
Program Area: Small Business Health Options Program (SHOP)
Question: Under what circumstances could an issuer initiate a cancellation for a Federally-facilitated Small Business Health Options Program (FF-SHOP) employer group and associated employees and dependents?
Answer: Per Section 156.285 (c) (7)(iii), issuers participating in FF-SHOP Marketplaces are required to effectuate SHOP coverage unless the issuer receives an 834 cancellation transaction from the FF-SHOP prior to the coverage effective date. Cancellation transactions will be sent to issuers if the FF-SHOP does not receive the initial binder payment by a specified date prior to the coverage effective date. Issuers will never generate cancellation or termination transactions for plans in the FF-SHOP Marketplaces.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: August 01, 2014
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