Small Business Health Options Program Shop Exchange

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Small Business Health Options Program (Shop) Exchange

Author : Congressional Research Congressional Research Service
Publisher : CreateSpace
ISBN 13 : 9781503089754
Total Pages : 24 pages
Book Rating : 4.0/5 (897 download)

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Book Synopsis Small Business Health Options Program (Shop) Exchange by : Congressional Research Congressional Research Service

Download or read book Small Business Health Options Program (Shop) Exchange written by Congressional Research Congressional Research Service and published by CreateSpace. This book was released on 2014-10-30 with total page 24 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Patient Protection and Affordable Care Act (ACA; P.L. 111-148, as amended) includes a number of provisions intended to improve access to health insurance coverage. Among these are provisions that apply to the small group market to address perceived problems in the market, including low offer rates among smaller employers and the sometimes prohibitive cost of health plans available in the small group market. The small business health option program (SHOP) exchanges are among the ACA provisions directed at the small group market. SHOP exchanges are marketplaces where private health insurance issuers sell health insurance plans to small employers. All health plans available through SHOP exchanges must meet certain federally required criteria, such as offering a standardized package of benefits. Certain small employers may be eligible to receive tax credits toward the cost of coverage if they obtain coverage through a SHOP exchange. A SHOP exchange is currently in operation in every state; some are administered by states, while others are administered in part or in entirety by the Department of Health and Human Services (HHS). ACA and its implementing regulations include some prescriptive requirements for the establishment and operation of SHOP exchanges. Although these requirements often apply uniformly to all SHOP exchanges, in some instances that may not be the case. For example, some requirements apply only to SHOP exchanges administered by HHS and not to SHOP exchanges administered by states. When ACA and regulations are not prescriptive, decisions about the establishment and operation of SHOP exchanges are left to a state or the entity administering the SHOP exchange (e.g., HHS). As a result, not all SHOP exchanges share the same features or similarly implement shared features. This report describes certain features of SHOP exchanges, such as employer eligibility, methods for selecting health plans offered through SHOP exchanges, and how health insurance agents and brokers interact with SHOP exchanges. Each description includes information about how the feature is implemented in SHOP exchanges administered by states and those administered in part or in entirety by HHS. Each description also includes information about the timing of implementation. The report concludes with a discussion about the current and future place of SHOP exchanges in the broader context of the private health insurance market.

Overview of Health Insurance Exchanges

Author : Congressional Service
Publisher : Createspace Independent Publishing Platform
ISBN 13 : 9781722362843
Total Pages : 26 pages
Book Rating : 4.3/5 (628 download)

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Book Synopsis Overview of Health Insurance Exchanges by : Congressional Service

Download or read book Overview of Health Insurance Exchanges written by Congressional Service and published by Createspace Independent Publishing Platform. This book was released on 2018-07-04 with total page 26 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Patient Protection and Affordable Care Act (ACA; P.L. 111-148, as amended) requires health insurance exchanges to be established in every state. Exchanges are marketplaces in which consumers and small businesses can shop for and purchase private health insurance coverage. In general, states must have two types of exchanges: an individual exchange and a small business health options program (SHOP) exchange. Exchanges may be established either by the state itself as a state-based exchange (SBE) or by the Secretary of Health and Human Services (HHS) as a federally facilitated exchange (FFE). Some states have SBE-FPs: they have SBEs but use the federal information technology platform, including the federal exchange website www.Healthcare.gov. In states with FFEs, the exchange may be operated by the federal government alone or in conjunction with the state. States may have different structures for their individual and SHOP exchanges. Consumers who obtain coverage through the individual exchange may be eligible for financial assistance from the federal government. Financial assistance in the individual exchanges is available in two forms: premium tax credits and cost-sharing reductions. Small businesses that use the SHOP exchange may be eligible for small business health insurance tax credits. The tax credits assist small businesses with the cost of providing health insurance coverage to employees. The ACA generally requires that health insurance plans offered through an exchange are qualified health plans (QHPs). To be a certified as a QHP, a plan must be offered by a state-licensed issuer and must meet specified requirements, including covering the essential health benefits (EHB). QHPs sold in the individual and SHOP exchanges must comply with the same state and federal requirements that apply to QHPs and other health plans offered outside of the exchanges in the individual and small-group markets, respectively. Exchanges also may offer variations of QHPs, such as child-only or catastrophic plans, and non-QHP dental-only plans. This report provides an overview of the various components of the health insurance exchanges. It begins with summary information about how exchanges are structured and then discusses both individual and SHOP exchanges in terms of eligibility and enrollment, financial assistance for certain exchange consumers and small businesses, and enrollment assistance entities. The report also describes exchanges' role in certifying plans as qualified to be sold in their marketplaces and outlines the range of plans offered through exchanges. Finally, the report briefly addresses funding for the exchanges.

Overview of Health Insurance Exchanges

Author : Namrata K. Uberoi
Publisher :
ISBN 13 :
Total Pages : 12 pages
Book Rating : 4.:/5 (962 download)

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Book Synopsis Overview of Health Insurance Exchanges by : Namrata K. Uberoi

Download or read book Overview of Health Insurance Exchanges written by Namrata K. Uberoi and published by . This book was released on 2016 with total page 12 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Patient Protection and Affordable Care Act (ACA; P.L. 111-148, as amended) requires health insurance exchanges to be established in every state. Exchanges are marketplaces where individuals and small businesses can shop for and purchase private health insurance coverage. States must have two types of exchanges: an individual exchange and a small business health options program (SHOP) exchange. Exchanges may be established either by the state itself as a state-based exchange (SBE) or by the Secretary of Health and Human Services (HHS) as a federally-facilitated exchange (FFE). In states with FFEs, the exchange may be operated solely by the federal government or in conjunction with the state. Persons who obtain coverage through the individual exchange may be eligible for financial assistance from the federal government. The financial assistance in the individual exchanges is available in two forms: premium tax credits and cost-sharing subsidies. Small businesses that use the SHOP exchange may be eligible for small business health insurance tax credits. The tax credits assist small businesses with the cost of providing health insurance coverage to employees. The ACA generally requires that health insurance plans offered through an exchange are Qualified Health Plans (QHPs). Typically in order to be a certified as a QHP, a plan must offer the essential health benefits, comply with cost-sharing limits, and meet certain market reforms. Exchanges may also offer other types of health insurance plans such as catastrophic and dental-only plans. This report provides an overview of the various components of the health insurance exchanges. The report includes summary information about how exchanges are structured, the intended consumers for health insurance exchange plans, and consumer assistance available in the exchanges, as specified in the ACA. The report also describes the availability of financial assistance for certain exchange consumers and small businesses and outlines the range of plans offered through exchanges. Moreover, the report provides a brief summary of the implementation and operation of exchanges since 2014.

Health Insurance Exchanges

Author : Christian Forrest
Publisher : Nova Science Publishers
ISBN 13 : 9781634638982
Total Pages : 0 pages
Book Rating : 4.6/5 (389 download)

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Book Synopsis Health Insurance Exchanges by : Christian Forrest

Download or read book Health Insurance Exchanges written by Christian Forrest and published by Nova Science Publishers. This book was released on 2015-02 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: PPACA required by 1 January 2014, the establishment in each state of health insurance exchanges -- marketplaces where eligible individuals and small businesses can compare and select among insurance plans. Issuer participation, including the number of plans these issuers offer, is a key factor in the extent of consumer choice offered by the exchanges. The United States Government Accountability Office (GAO) was asked to examine the number and types of issuers participating in both the individual and small-business exchanges beginning in 2014, as well as how this compared with issuer participation in the individual and small-group markets prior to the exchanges. In this book, GAO describes the extent to which issuers that previously offered health plans in the individual and small-group markets participated in the exchanges in 2014; and the issuers that participated in 2014 exchanges and the health plans they offered. This book also describes Small Business Health Options Programs (SHOPs) functionality, enrollment, plan availability, and premiums; and stakeholders' views on key factors that have affected current SHOP enrollment or may affect future enrollment growth.

Small Business Health Insurance Exchanges

Author : John E. Dicken
Publisher :
ISBN 13 : 9781457859021
Total Pages : 45 pages
Book Rating : 4.8/5 (59 download)

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Book Synopsis Small Business Health Insurance Exchanges by : John E. Dicken

Download or read book Small Business Health Insurance Exchanges written by John E. Dicken and published by . This book was released on 2014-12-13 with total page 45 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Patient Protection and Affordable Care Act required Small Business Health Options Programs (SHOPs) -- exchanges or marketplaces where small employers can shop for health coverage for their employees -- to be established in all states. States may elect to establish and operate SHOPs themselves or allow the Centers for Medicare & Medicaid Services (CMS) to do so within the state. Enrollment in SHOPs was to begin in October 2013, with coverage effective January 2014. This report examined the early implementation experiences of the SHOPs. It describes (1) SHOP functionality, enrollment, plan availability, and premiums; and (2) stakeholders' views on key factors that have affected current SHOP enrollment or may affect future enrollment growth. Figure. This is a print on demand report.

Private Health Insurance Exchanges

Author : Christine Buttorff
Publisher :
ISBN 13 : 9780833095770
Total Pages : 72 pages
Book Rating : 4.0/5 (957 download)

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Book Synopsis Private Health Insurance Exchanges by : Christine Buttorff

Download or read book Private Health Insurance Exchanges written by Christine Buttorff and published by . This book was released on 2016 with total page 72 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Patient Protection and State Efforts to Establish Health Insurance Exchanges for Small Businesses

Author : John E. Dicken
Publisher :
ISBN 13 : 9781457847011
Total Pages : 37 pages
Book Rating : 4.8/5 (47 download)

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Book Synopsis Patient Protection and State Efforts to Establish Health Insurance Exchanges for Small Businesses by : John E. Dicken

Download or read book Patient Protection and State Efforts to Establish Health Insurance Exchanges for Small Businesses written by John E. Dicken and published by . This book was released on 2013-07-19 with total page 37 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Patient Protection and Affordable Care Act (PPACA) requires Small Business Health Options Programs (SHOPs) -- exchanges or marketplaces where small employers can shop for and purchase health coverage for their employees -- to be established in all states. PPACA also requires similar exchanges to be established for individuals. The Dept. of Health and Human Services' (HHS) Centers for Medicare & Medicaid Services (CMS) oversees the establishment of the exchanges, approving states to operate one or establishing and operating one itself in states that will not do so. Enrollment in the exchanges is to begin on Oct. 1, 2013, with coverage effective on Jan. 1, 2014. This report describes (1) the roles of the federal government and states in establishing SHOPs and (2) the status of actions taken and planned by the federal government and states in preparing to establish SHOPs. Tables and figures. This is a print on demand report.

Small Business and the Affordable Care Act

Author : Shane R. Lincoln
Publisher : Nova Science Publishers
ISBN 13 : 9781631178986
Total Pages : 0 pages
Book Rating : 4.1/5 (789 download)

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Book Synopsis Small Business and the Affordable Care Act by : Shane R. Lincoln

Download or read book Small Business and the Affordable Care Act written by Shane R. Lincoln and published by Nova Science Publishers. This book was released on 2014 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Patient Protection and Affordable Care Act contains several provisions to encourage employer-sponsored health coverage, particularly among small businesses. The provisions that most directly relate to small businesses are, an employer penalty for not providing health insurance; a tax credit to increase the affordability of health care for the smallest firms; and small business health insurance exchanges designed to increase plan options and lower plan costs. First, this book explains how employer-sponsored insurance can be used to address concerns about health insurance coverage and cost. It summarises the three ACA provisions most relevant to small businesses, listed above, and analyses these provisions for their potential effects on small businesses. The book then presents several approaches that could address some concerns associated with these provisions (particularly the employer penalty).

Health Insurance Exchanges Under the Patient Protection and Affordable Care Act (ACA)

Author : Bernadette Fernandez
Publisher : Createspace Independent Pub
ISBN 13 : 9781480152809
Total Pages : 40 pages
Book Rating : 4.1/5 (528 download)

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Book Synopsis Health Insurance Exchanges Under the Patient Protection and Affordable Care Act (ACA) by : Bernadette Fernandez

Download or read book Health Insurance Exchanges Under the Patient Protection and Affordable Care Act (ACA) written by Bernadette Fernandez and published by Createspace Independent Pub. This book was released on 2012-10-20 with total page 40 pages. Available in PDF, EPUB and Kindle. Book excerpt: The fundamental purpose of a health insurance exchange is to provide a structured marketplace for the sale and purchase of health insurance. The authority and responsibilities of an exchange may vary, depending on statutory or other requirements for its establishment and structure. The Patient Protection and Affordable Care Act (ACA, P.L. 111-148, as amended) requires health insurance exchanges to be established in every state by January 1, 2014. ACA provides certain requirements for the establishment of exchanges, while leaving other choices to be made by the states. Qualified individuals and small businesses will be able to purchase private health insurance through exchanges. Issuers selling health insurance plans through an exchange will have to follow certain rules, such as meeting the private market reform requirements in ACA. While the fundamental purpose of the exchanges will be to facilitate the offer and purchase of health insurance, nothing in the law prohibits qualified individuals, qualified employers, and insurance carriers from participating in the health insurance market outside of exchanges. Moreover, ACA explicitly states that enrollment in exchanges is voluntary and no individual may be compelled to enroll in exchange coverage. Exchanges may be established either by the state itself as a “state exchange” or by the Secretary of Health and Human Services (HHS) as a “federally facilitated exchange.” All exchanges are required to carry out many of the same functions and adhere to many of the same standards, although there are important differences between the types of exchanges. States will need to declare their intentions to establish their own exchanges by no later than November 16, 2012. ACA and regulations require exchanges to carry out a number of different functions. The primary functions relate to determining eligibility and enrolling individuals in appropriate plans, plan management, consumer assistance and accountability, and financial management. ACA gives various federal agencies, primarily HHS, responsibilities relating to the general operation of exchanges. Federal agencies are generally responsible for promulgating regulations, creating criteria and systems, and awarding grants to states to help them create and implement exchanges. A state that is approved to operate its own exchange has a number of operational decisions to make, including decisions related to organizational structure (governmental agency or a nonprofit entity); types of exchanges (separate individual and Small Business Health Options Program (SHOP) exchanges, or a merged exchange); collaboration (a state may independently operate an exchange or enter into contracts with other states); service area (a state may establish one or more subsidiary exchanges in the state if each exchange serves a geographically distinct area and meets certain size requirements); contracted services (an exchange may contract with certain entities to carry out one or more responsibilities of the exchange); and governance (governing board and standards of conduct). In general, health plans offered through exchanges will provide comprehensive coverage and meet all applicable private market reforms specified in ACA. Most exchange plans will provide coverage for “essential health benefits,” at minimum; be subject to certain limits on cost-sharing, including out-of-pocket costs; and meet one of four levels of plan generosity based on actuarial value. To make exchange coverage more affordable, certain individuals will receive premium assistance in the form of federal tax credits. Moreover, some recipients of premium credits may also receive subsidies toward cost-sharing expenses.

Small Business and the Affordable Care Act

Author : Shane R. Lincoln
Publisher :
ISBN 13 : 9781631178993
Total Pages : 166 pages
Book Rating : 4.1/5 (789 download)

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Book Synopsis Small Business and the Affordable Care Act by : Shane R. Lincoln

Download or read book Small Business and the Affordable Care Act written by Shane R. Lincoln and published by . This book was released on 2014-05-21 with total page 166 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Patient Protection and Affordable Care Act contains several provisions to encourage employer-sponsored health coverage, particularly among small businesses. The provisions that most directly relate to small businesses are, an employer penalty for not providing health insurance; a tax credit to increase the affordability of health care for the smallest firms; and small business health insurance exchanges designed to increase plan options and lower plan costs. First, this book explains how employer-sponsored insurance can be used to address concerns about health insurance coverage and cost. It summarizes the three ACA provisions most relevant to small businesses, listed above, and analyzes these provisions for their potential effects on small businesses. The book then presents several approaches that could address some concerns associated with these provisions (particularly the employer penalty).

The Affordable Care Act

Author : Tamara Thompson
Publisher : Greenhaven Publishing LLC
ISBN 13 : 0737776196
Total Pages : 130 pages
Book Rating : 4.7/5 (377 download)

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Book Synopsis The Affordable Care Act by : Tamara Thompson

Download or read book The Affordable Care Act written by Tamara Thompson and published by Greenhaven Publishing LLC. This book was released on 2014-12-02 with total page 130 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Patient Protection and Affordable Care Act (ACA) was designed to increase health insurance quality and affordability, lower the uninsured rate by expanding insurance coverage, and reduce the costs of healthcare overall. Along with sweeping change came sweeping criticisms and issues. This book explores the pros and cons of the Affordable Care Act, and explains who benefits from the ACA. Readers will learn how the economy is affected by the ACA, and the impact of the ACA rollout.

Patient Protection and Affordable Care ACT - Establishment of Exchanges and Qualified Health Plans - Small Business Health Options Program (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition)

Download Patient Protection and Affordable Care ACT - Establishment of Exchanges and Qualified Health Plans - Small Business Health Options Program (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition) PDF Online Free

Author : The Law The Law Library
Publisher : Createspace Independent Publishing Platform
ISBN 13 : 9781722602291
Total Pages : 28 pages
Book Rating : 4.6/5 (22 download)

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Book Synopsis Patient Protection and Affordable Care ACT - Establishment of Exchanges and Qualified Health Plans - Small Business Health Options Program (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition) by : The Law The Law Library

Download or read book Patient Protection and Affordable Care ACT - Establishment of Exchanges and Qualified Health Plans - Small Business Health Options Program (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition) written by The Law The Law Library and published by Createspace Independent Publishing Platform. This book was released on 2018-07-05 with total page 28 pages. Available in PDF, EPUB and Kindle. Book excerpt: Patient Protection and Affordable Care Act - Establishment of Exchanges and Qualified Health Plans - Small Business Health Options Program (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) The Law Library presents the complete text of the Patient Protection and Affordable Care Act - Establishment of Exchanges and Qualified Health Plans - Small Business Health Options Program (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition). Updated as of May 29, 2018 This final rule implements provisions of the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively referred to as the Affordable Care Act) related to the Small Business Health Options Program (SHOP). Specifically, this final rule amends existing regulations regarding triggering events and special enrollment periods for qualified employees and their dependents and implements a transitional policy regarding employees' choice of qualified health plans (QHPs) in the SHOP. This book contains: - The complete text of the Patient Protection and Affordable Care Act - Establishment of Exchanges and Qualified Health Plans - Small Business Health Options Program (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) - A table of contents with the page number of each section

American Health Benefit Exchange Model Act

Author :
Publisher :
ISBN 13 :
Total Pages : 11 pages
Book Rating : 4.:/5 (76 download)

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Book Synopsis American Health Benefit Exchange Model Act by :

Download or read book American Health Benefit Exchange Model Act written by and published by . This book was released on 2010 with total page 11 pages. Available in PDF, EPUB and Kindle. Book excerpt: The purpose of this Act is to provide for the establishment of an American Health Benefit Exchange to facilitate the purchase and sale of qualified health plans in the individual market in this State and to provide for the establishment of a Small Business Health Options Program (SHOP Exchange) to assist qualified small employers in this State in facilitating the enrollment of their employees in qualified health plans offered in the small group market. The intent of the Exchange is to reduce the number of uninsured, provide a transparent marketplace and consumer education and assist individuals with access to programs, premium assistance tax credits and cost-sharing reductions.

Access to Health Insurance

Author : DIANE Publishing Company
Publisher : DIANE Publishing
ISBN 13 : 9780788122194
Total Pages : 72 pages
Book Rating : 4.1/5 (221 download)

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Book Synopsis Access to Health Insurance by : DIANE Publishing Company

Download or read book Access to Health Insurance written by DIANE Publishing Company and published by DIANE Publishing. This book was released on 1995-10 with total page 72 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Small Business Health Care Challenges and Opportunities

Author : United States. Congress. Senate. Committee on Health, Education, Labor, and Pensions. Subcommittee on Primary Health and Retirement Security
Publisher :
ISBN 13 :
Total Pages : 48 pages
Book Rating : 4.3/5 ( download)

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Book Synopsis Small Business Health Care Challenges and Opportunities by : United States. Congress. Senate. Committee on Health, Education, Labor, and Pensions. Subcommittee on Primary Health and Retirement Security

Download or read book Small Business Health Care Challenges and Opportunities written by United States. Congress. Senate. Committee on Health, Education, Labor, and Pensions. Subcommittee on Primary Health and Retirement Security and published by . This book was released on 2017 with total page 48 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Small Business Health Insurance Exchanges, Low Initial Enrollment Likely Due to Multiple Evolving Factors

Author : U.s. Government Accountability Office
Publisher : Createspace Independent Publishing Platform
ISBN 13 : 9781973969204
Total Pages : 46 pages
Book Rating : 4.9/5 (692 download)

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Book Synopsis Small Business Health Insurance Exchanges, Low Initial Enrollment Likely Due to Multiple Evolving Factors by : U.s. Government Accountability Office

Download or read book Small Business Health Insurance Exchanges, Low Initial Enrollment Likely Due to Multiple Evolving Factors written by U.s. Government Accountability Office and published by Createspace Independent Publishing Platform. This book was released on 2017-07-28 with total page 46 pages. Available in PDF, EPUB and Kindle. Book excerpt: " The Patient Protection and Affordable Care Act required SHOPs-exchanges, or marketplaces, where small employers can shop for health coverage for their employees-to be established in all states. States may elect to establish and operate SHOPs themselves or allow CMS to do so within the state. Enrollment in SHOPs was to begin in October 2013, with coverage effective as early as January 2014. GAO was asked to examine the early implementation experiences of the SHOPs. In this report GAO describes (1) SHOP functionality, enrollment, plan availability, and premiums and (2) stakeholders' views on key factors that have affected current SHOP enrollment or may affect future enrollment growth. GAO reviewed relevant information from CMS and states, including data on employer and employee enrollment, plan availability, and premiums generally through June 1, 2014. GAO also interviewed representatives of key stakeholders that operate SHOPs (CMS and states), offer coverage in SHOPs (health insurance issuers), obtain coverage through SHOPs (small employers), or assist in obtaining coverage through SHOPs (agents and brokers) on a national basis and, for certain stakeholders, in five states-California, Illinois, Kentucky, Rhode Island, and Texas. The five states were selected based on factors including varied issuer participation levels and SHOP"

Designing an Exchange

Author :
Publisher :
ISBN 13 :
Total Pages : 45 pages
Book Rating : 4.:/5 (711 download)

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Book Synopsis Designing an Exchange by :

Download or read book Designing an Exchange written by and published by . This book was released on 2011 with total page 45 pages. Available in PDF, EPUB and Kindle. Book excerpt: This National Academy of Social Insurance (NASI) legislative toolkit will assist states with the design of health insurance exchanges, an important feature of the Patient Protection and Affordable Care Act (ACA). How states design and implement health insurance exchanges will matter in achieving ACA's coverage, quality, and efficiency goals. The NASI toolkit, funded by the Robert Wood Johnson Foundation, provides technical assistance to states in a number of key areas such as governance; establishment of Small Business Health Options Program (SHOP) exchanges for small employers; eligibility determination and enrollment; certification of qualified health plans; and coordination with Medicaid and the Children's Health Insurance Program.