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CMS: 18 federally-facilitated SHOPs to delay employee choice until 2016

June 11, 2014

The Centers for Medicare & Medicaid Services will allow 18 states with a federally-facilitated Small Business Health Options Program (SHOP) to delay implementing employee choice in the SHOP until 2016, the agency announced yesterday. “The other 14 states with federally-facilitated SHOPs will join most state-based SHOPs and have employee choice available to small businesses in 2015, doubling the number of states offering this option,” CMS said. “In 2015, nearly two-thirds of Americans will live in states where small business workers can choose a health plan rather than have their employer do it for them.” The SHOP employee-choice model allows employees to choose any health plan at the actuarial value, or “metal,” level selected by the employer. Under a final rule issued last month updating requirements for health insurance marketplaces beginning in 2015, state insurance commissioners could recommend delaying SHOP employee choice if they thought the provision would cause insurers to price products and plans higher in 2015. The SHOP Marketplace helps small businesses provide health coverage to their employees.