Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: September 02, 2014

Program Area: Small Business Health Options Program (SHOP)

Question: If an employer changes the business address during the plan year, are the employer group's rates impacted or are rates locked in for the plan year?

Answer: Pursuant to 45 C.F.R. 155.705(b)(6)(ii) and 156.285(a)(3), issuers may not vary rates for a qualified employer during the employer's plan year. Therefore, the Federally-facilitated Small Business Health Options Program (FF-SHOP) may apply a new geographic rating factor only upon renewal. If an employer group moves the employer's principal business address to a different geographic rating area in the same state, the FF-SHOP will re-run the eligibility determination process to verify the employer is still located in the same state. If the employer moves to a different state, and continues to opt to offer coverage to all full-time employees through the SHOP in which the employer has principal business address, the group will lose its eligibility for enrollment in the SHOP in its former state, and would have to re-apply to participate in the SHOP in the new state.

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