Healthcare Insurance and SHOP
You can enroll your business to provide coverage for your employees at any time.
The New Health Care Law
- What is SHOP?
- An online Health Insurance Marketplace for Delaware small businesses and their employees.
- Who is eligible for SHOP?
- Small businesses with 50 or fewer Full-Time Equivalent (FTE) employees.
- Who is eligible for the Small Business Health Care Tax Credit?
- A qualified employer must have fewer than 25 FTE employees. The average employee salary must be about $50,000 per year or less. The employer must pay at least half of the health insurance premiums. Insurance coverage must be purchased through the SHOP Marketplace.
- How do businesses enroll?
- Through SHOP’s online enrollment portal on healthcare.gov .
- Are business owners required to offer health coverage to employees this year?
- In 2015, businesses with 100 or more FTE employees are required to provide health insurance coverage. In 2016, businesses with 50 or more FTE employees are required to provide health insurance coverage. Businesses with fewer than 50 full-time employees are not required to provide health care coverage in any year.
- When can businesses purchase health coverage?
- Small-business employers and their employees can enroll in a SHOP-qualified health plan (QHP) anytime throughout the year. Employers who enroll by the 15th of any month will have coverage beginning on the 1st of the following month.
If you prefer to work with an agent or broker, you may do so.
Be sure to ask if the agent is certified to discuss Marketplace programs or review this list of Delaware-certified agents and brokers.
Tax Credit Eligibility
A qualified employer must have fewer than 25 FTE employees.
The employer must pay at least half of the insurance premiums.
Insurance coverage must be purchased through the SHOP Marketplace.
If your business meets these requirements, then you are eligible for a tax credit that may equal 50% of your share of the premium. The tax credit is available for two years, and the businesses that will receive the highest credits are those with fewer than 10 FTE employees and average wages less than $25,000.
5 Reasons to Participate in the SHOP Marketplace
- You’ll retain employees.
- When you give employees the benefits they deserve, they’ll be more satisfied, less likely to quit, and have higher commitment to meeting your company’s goals.
- You’ll save on taxes.
- Many small-business owners believe they cannot afford to offer insurance. But with tax credits available to small businesses through the SHOP Marketplace, this may no longer be the case.
- You can choose.
- At the SHOP Marketplace, you can compare health insurance plans and choose one that’s right for your employees, your budget, and your business needs.
- You’ll boost morale.
- Offering health insurance can enhance your employees’ feeling of belonging, providing them with a greater sense of value. Plus it shows your loyalty to them.
- Time lost is money lost.
- The SHOP Marketplace plans offer preventive care that can keep employees healthy and working. If employees don’t get preventive care and yearly physicals, you could see an increase in your healthcare costs.
How the SHOP Marketplace Works
The SHOP Marketplace basics
- For Delaware in 2017, the SHOP Marketplace will serve businesses with 2–50 FTE employees.
- If you already provide coverage to your employees, you can keep it.
- Employers can continue to use their brokers to buy insurance through the SHOP Marketplace. Businesses with 100 or more employees will have to offer health care coverage in 2017 or make an employer shared responsibility payment .
- Businesses with 51–99 FTE employees will not have to worry about offering coverage or facing a potential penalty until 2017.
- Employees can choose not to accept employer-sponsored coverage and shop for coverage in the individual Health Insurance Marketplace . As long as your coverage includes certain requirements, employers will not be subject to a shared responsibility payment. Important: If the SHOP plan an employer offers meets certain standards of affordability and coverage, an employee won’t qualify for premium tax credits or other savings based on income if the employee buys a plan through the individual Health Insurance Marketplace instead.
Are Your Employees Eligible for SHOP?
Employees must live in the United States.
Employees must be U.S. citizens or nationals (or be lawfully present).
Employees can’t be currently incarcerated.
How do employees sign up for SHOP?
Employees in Delaware will use a portal on the website healthcare.gov to apply for coverage, compare plans and enroll. The Health Insurance Marketplace is open through January 31, 2017.
As an employer, you will find tools on the website to help you:
Create an employee roster
Set up an employee email distribution list
Download the offer of coverage and distribute it to your employees manually