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

Issue Date: September 11, 2014

Program Area: Small Business Health Options Program (SHOP)

Question: In the case that an issuer's products offered on the Individual and the Small Business Health Options Program (SHOP) Marketplaces are associated with the same Issuer Tax ID, how can issuers have separate 820 Payment transactions sent to clearinghouses for the Individual and SHOP Marketplaces, respectively?

Answer: CMS will not send 820 files to two different locations for the FF-SHOP and Federally-facilitated Marketplace (FFM). Although there are two separate 820 files generated, both Marketplace files will be sent to the same pick-up location.

HHS is committed to making its websites and documents accessible to the widest possible audience, including individuals with disabilities. We are in the process of retroactively making some documents accessible. If you need assistance accessing an accessible version of this document, please reach out to the guidance@hhs.gov.

DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.