In addition, Catherine can offer your full-time, part-time, and seasonal employees and independent workers Supplemental *Short-Term Disability (* per Industry, Business, and Employee eligibility guidelines and carrier), *Accident, *Life, *Hospital, *Cancer, *Critical Care, *Dental, and *Vision insurance at no direct cost to you or your business, as your employees and independent workers fund their Supplemental insurance through payroll deduction or through eligible employee-direct-bill. Please contact Catherine to schedule a free consultation by either by submitting your information in the field to the right or by contacting her at 940-597-4757 or [email protected].
Summary Information Concerning On the Marketplace SHOP Plan
Have a primary business address in the state where you're buying coverage.
Have at least one employee enrolling in coverage who isn't the owner, business partner, or spouse of the owner or business partner.
Have from 1 to 50 full-time equivalent (FTE) employees.
Offer SHOP coverage to all full-time W-2 employees.
Benefits of SHOP Marketplace Plans
All plans offered through the SHOP must provide a set of Essential Health Benefits. They all cover Pre-existing Conditions and Free Preventive Services. Enrollment will be conducted on the insurance carrier's platform, not on the SHOP website.
You control the coverage you offer and how much you pay toward employee premiums.
You can choose from 4 levels of coverage to find a plan that meets the needs of your business and employees.
You can start coverage any time. Enroll by the 15th of the month and coverage can begin on the 1st of the following month.
In Order to Use SHOP Marketplace
In order to use SHOP, you must offer coverage to all of your full-time W-2 employees – those working 30 or more hours per week on average.
In many states, at least 75% of your full-time employees must enroll in your SHOP plan.
SHOP Small Business Tax Credit
Enrolling in a Small Business Health Options Program (SHOP) plan is generally the only way for a small business or non-profit to claim the Small Business Health Care Tax Credit. To qualify for the tax credit, all of the following must apply:
You have fewer than 25 full-time equivalent (FTE) employees
Your average employee salary is about $50,000 per year or less
You pay at least 50% of your full-time W-2 employees' premium costs
You offer SHOP coverage to all of your full-time W-2 employees. (You don't have to offer it to dependents or employees working fewer than 30 hours per week to qualify for the tax credit.)
Higher benefits for smaller businesses
The tax credit is highest for companies with fewer than 10 W-2 employees who are paid an average of $25,000 or less. The smaller the business, the bigger the credit.
You can find out if you qualify for the small business health care tax credit by visiting www.irs.gov. You can also consult with your tax advisor or accountant to learn if you qualify, and if so, how much your credit will be.
Employer Shared Responsibility Fee
If you have fewer than 50 full-time employees, you’re not subject to the Employer Shared Responsibility parts of the law any year. You may use the SHOP Marketplace to offer coverage for your employees.
Some employers with 50 or more FTE employees who don’t offer insurance, or whose offer of coverage is not affordable or doesn’t meet certain minimum standards, are subject to Employer Shared Responsibility provisions. They may owe a payment if at least one of their full-time employees enrolls in a plan through the Health Insurance Marketplace and receives a premium tax credit.
Comparing SHOP Health Plans
Your SHOP premium estimates are based upon the zip code of your business domicile, or legal address, the number of full-time W-2 employees working 30 or more hours per week, and their age.
There are 4 categories of plans in the SHOP Marketplace. They offer similar benefits, but differ based on how enrollees and the plan share the costs of care. SHOP plans are by metallic names: Bronze, Silver, Gold, Platinum.
As with all health plans, you and your employees pay a monthly premium. You can decide up front exactly how much to contribute towards your employees’ premium costs, so you have control over your company's health coverage spending. You are not responsible for any spouse or dependent premium costs.
When comparing plans, just as important as the premium cost is how much your employees have to pay out-of-pocket for covered services. The plan with the lowest premium may not provide you or your employees with the best overall value.
Premiums are usually lower for plans that pay a smaller share of medical costs when your employees get care. For example, with a Bronze plan, your employees will probably pay a lower monthly premium than they would for a Gold plan. But they'll probably pay more when they go to the doctor. For example, Platinum plans generally have the highest monthly premiums and lowest out-of-pocket costs for services. They will likely provide better financial protection if your employees use a lot of services or have a major health crisis.
When comparing plans, just as important as the premium cost is how much your employees have to pay out-of-pocket for covered services. The plan with the lowest premium may not provide you or your employees with the best overall value. In general, when choosing health coverage for your business, keep this in mind: The lower the premium, the higher the out-of-pocket costs. The higher the premium, the lower the out-of-pocket costs.
Summary Information Concerning Group Plans off the Marketplace
Group Health insurance plans off the Marketplace are not eligible for Small Business Tax Credits, but may be if no SHOP plans are offered in your area and if your business meets certain guidelines. The IRS can give more guidance on tax credits at www.irs.gov.
Plans still offer Essential Health Benefits, cover Pre-existing Conditions, and Free Preventive Services. Many Group Health plans may also offer Group Dental, Life, and Disability, based on industry and employee eligibility guidelines and carrier. For a free consultation with recommendations and quotes, please contact Catherine.
Summary Information Concerning Supplemental Insurance off the Marketplace
In addition, Catherine can offer your full-time, part-time, and seasonal employees and independent workers Supplemental *Short-Term Disability (*per Industry, Business, and Employee eligibility guidelines and carrier eligibility guidelines), *Accident, *Life, *Hospital, *Cancer, *Critical Care, *Dental, and *Vision insurance at no direct cost to you or your business, as your employees and independent workers fund their Supplemental insurance through payroll deduction or through eligible employee-direct-bill. Please contact Catherine to schedule a free consultation for more information.