Small Business Health Options Program (SHOP) FAQ
Guidance for FAQ regarding Premium Calculations and Tobacco Surcharge
Program Area: Small Business Health Options Program (SHOP)
Question: Will the 834 reflect that a tobacco user participating in a tobacco cessation program is a tobacco user? Will the premium in this instance be a non-tobacco rate?
Answer: The rate on the 834 will be the premium an issuer should expect to receive from the FF-SHOP based on the allowable rating factors for that enrollee. Thus, an employee who is a regular tobacco user and participates in a smoking cessation program will have the non-tobacco rate on the 834. We are also planning to have a flag for tobacco use and an enrollee's expected participation in a wellness program.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: March 05, 2014
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