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

Issue Date: September 17, 2014

Program Area: Small Business Health Options Program (SHOP)

Question: Does a Federally-facilitated Small Business Health Options Program (FF-SHOP) payment amount represent the premium due for the month?

Answer: An 820 file contains a DTM segment for each payment. Even though a payment period is often a month, it is not accurate to say the payment received represents the month's premium. Issuers should use the value listed in the DTM segment to determine the coverage start and end dates.

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.