SHOP Program

News & Analysis as of

Health care reform reporting requirements: Final rules

The Patient Protection and Affordable Care Act (PPACA) contains requirements for both individuals and employers related to health care coverage. In order to assure compliance with certain of these requirements, PPACA requires...more

Affordable Care Act Redux

Another delay in implementation of the Affordable Care Act (“ACA” or “Obamacare”) has prompted PK Law to update our material on the Act. Here are some points to bear in mind as March 31 approaches...more

The Affordable Care Act’s Employer Mandate: Are You In Compliance?

So, by now, most readers are aware of the postponement of the Affordable Care Act’s (“ACA”) on-line application process to small business under the SHOP (Small Business Health Options Program) marketplace until 2014 for...more

HHS and IRS Release Updates on the SHOP Marketplace, Fees, Taxes, and Payment Parameters

Before departing for the 2013 Thanksgiving holiday, the Obama administration released several new regulatory announcements and guidance relating to the implementation of the Affordable Care Act (ACA). The new guidance delays...more

Health Care Reform Provisions For 2014 And Beyond

Executive Summary: Earlier this year, the Obama Administration delayed implementation of the employer mandate, a major provision of the 2010 health care reform law (the Affordable Care Act or "ACA"). The delay of the...more

What Does “Obamacare” Mean for California Employers?

Signed into law by President Barack Obama in 2010, the Affordable Care Act (the “ACA”) is commonly referred to as “Obamacare”. It is important for California employers to note that the ACA “employer mandate” has been delayed...more

No More Pre-Tax Premiums For Individual Insurance Policies?

Over the years we have seen some employers, particularly small employers, choose to provide health coverage to their employees by paying all or part of the premium for individual insurance policies that the employees have...more

Health Insurance Exchanges: The Facts Behind the Debate

Health insurance exchanges (commonly called the MarketPlace or the Exchanges) are a complex and highly debated part of the Affordable Care Act (ACA). With the looming January 1, 2014, deadline to open the marketplace for...more

Save The Date: Oct. 1, 2013 — ACA Open Enrollment Begins

A fundamental feature of the Patient Protection and Affordable Care Act (“ACA” or “Act”) is the introduction of health care exchanges, or marketplaces, where individuals and small businesses may purchase “affordable” and...more

HHS Publishes Final Rule on Exchanges, SHOPs, and Eligibility Appeals

Final regulations required for October 1, 2013 open enrollment are largely unchanged from the proposed rule. On August 30, the Centers for Medicare & Medicaid Services (CMS) of the Department of Health and Human...more

HHS Releases Proposed Rule Aimed at Oversight of Health Insurance Exchanges

On June 14, 2013, HHS released a proposed rule containing many provisions aimed at oversight of federally-facilitated exchanges (FFEs), state health insurance exchanges (State Exchanges), qualified health plan (QHP) issuers,...more

Healthcare Reform in 2013: What Every Nonprofit Needs to Know

In this presentation: - Definition of “Small Employer” - The Five Pillars of the Small Group Market - The SHOP Exchange - The Small Employer Tax Credit - New Fees and Notice and Disclosure...more

CMS Proposes Rule for Exchanges and SHOPs Under the Affordable Care Act

New marketing integrity and oversight provisions warrant review and comment. On June 14, the Centers for Medicare and Medicaid Services (CMS) in the U.S. Department of Health and Human Services (HHS) published its...more

Healthcare Law -- May 21, 2013

Clearing up the Rumors around Health Reform Delays: What Really Happened, What Won’t and Steps Employers and Insurers Can Take Now - Rumors are flying in health policy circles that the Obama Administration might delay...more

Affordable Care Act: Health Insurance Exchanges and Other Issues for Small Employers

The Affordable Care Act (ACA) has a variety of implications for small employers and their employees. Under the Qualified Health Plan and Health Insurance Exchange provisions of the ACA, the term “small employer” is defined as...more

Health Care Reform Implementation Update - April 12, 2013

While Congress was in recess, the Centers for Medicare and Medicaid Services (CMS) surprised many when it changed course on Medicare Advantage payment rates – switching from a 2.3 percent reduction to a 3.3 percent increase,...more

Legal Alert: Full Implementation Of SHOP Health Exchanges Delayed

The Department of Health and Human Services ("HHS") recently announced that full implementation of the SHOP component of the state-based health insurance exchanges created by the Affordable Care Act (the "ACA") run in full or...more

HHS Revisions to SHOP Rule

On March 11, 2013, the Department of Health and Human Services (HHS) published a proposed rule that would amend an earlier final rule related to health insurance exchanges and, more specifically, the Small Business Health...more

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....more

ACA Affordable Insurance Exchanges and Qualified Health Plans

In This Issue: Exchanges and Types of Plans To Be Offered Through Exchanges; Essential Health Benefits; Premiums; Cost Sharing Reductions; and Other Issues. Excerpt from Exchanges and Types of Plans To Be...more

CMS Releases Rules on Notice of Benefits and Payment Parameters Implementing Risk Adjustment, Reinsurance and Risk Corridor...

On March 1, 2013, CMS released a proposed rule, an interim final rule and a final rule—set for publication in the Federal Register on March 11, 2013—that implement the risk adjustment, reinsurance and risk corridor programs...more

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