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

Issue Date: September 17, 2014

Program Area: Small Business Health Options Program (SHOP)

Question: If an issuer has a negative payment balance because the issuer's last group terminated from the Federally-facilitated Small Business Health Options Program (FF-SHOP), will the FF-SHOP invoice the issuer in this situation?

Answer: If an issuer has a negative balance after the last group terminated from FF-SHOP, the Centers for Medicare & Medicaid Services (CMS) will send the issuer a Demand Letter for the balance due back to FF-SHOP to clear the negative balance.

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