HHS Issues Final Rule on SHOP Exchange Program

This content was originally published on the IFEBP.org website.

The Department of Health and Human Services (HHS) released a final rule implementing Affordable Care Act provisions relating to the Small Business Health Options Program (SHOP). This rule finalizes the amendments in the proposed rule of March 11, 2013, regarding triggering events and special enrollment periods. It implements a transitional policy regarding employees' choice of qualified health plans (QHPs) in the SHOP.

  • The final rule changes the special enrollment period from 60 days to 30 days in most instances.
  • If an employee or dependent becomes eligible for premium assistance under CHIP or loses eligibility for Medicaid or CHIP, the employee or dependent would have a 60-day special enrollment period to select a Qualified Health Plan.
  • There is a transitional rule regarding what QHPs an employer may choose to offer.

The regulations are effective July 1, 2013.

HHS also published a