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Small Business Health Options Program (SHOP) FAQ

Guidance for FAQ regarding Employer/Employee Interaction and Minimum Participation Rate

Program Area: Small Business Health Options Program (SHOP)

Question: Outside of the 11/15-12/15 window, how will minimum participation rates be tracked? Will the issuer or FFM be responsible for calculating participation rates?

Answer: Minimum participation rates in FF-SHOPs are only calculated at the time of initial enrollment (and upon renewal outside of 11/15-12/15). The FFM is responsible for calculating participation rates for plan years beginning on and after January 1, 2015.

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

Issue Date: March 05, 2014

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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.