Health Care Reform Blog: SHOP Exchange Delay?


Last month HHS proposed regulations that would delay implementation of the employee choice requirement in SHOP Exchanges until 2015. We’ve received a number of calls asking what the delay means.

The SHOP Exchange is the exchange where small employers can purchase insurance for their employees starting in 2014. The rule proposes to delay only one piece of the SHOP Exchange - the employee choice provisions. Under the employee choice provisions, a small employer selects a level of coverage for its employees. The employees can then choose any plan offered within that level of coverage and they are not limited to a particular carrier.

For example, if an employer chooses silver level coverage, each employee could choose any plan within the silver level, meaning some employees may choose a Wellmark product and others may choose a Coventry product. HHS has proposed delaying this employee choice provision until 2015. If this delay is finalized, small employers could still purchase insurance through the SHOP Exchange beginning in 2014; however, they would have to choose a specific plan to offer all employees and employees would not have the ability to choose between plans.

It is uncertain whether HHS will finalize the proposed delay. Comments on the proposed rule were due April 1, 2013. It is also uncertain what impact the delay will have on SHOP Exchange participation in 2014.

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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