Small Business Health Options Program (SHOP) FAQ
Guidance for FAQ regarding Employer/Employee Interaction and Medicare
Program Area: Small Business Health Options Program (SHOP)
Question: If an employer with less than 20 employees signs up through the SHOP, would an employee who is also on Medicare pay the same rate on the SHOP?
Answer: The SHOP follows the same Medicare Secondary Payer rules as the outside market. All else equal, a small group rate does not differ based on Medicare eligibility. Please see 45 CFR 147.102.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: April 11, 2013
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