Do I have to provide insurance to my employees?
If you have 1 to 50 full-time equivalent (FTE) employees, you’re not required to provide insurance to your employees. You can choose to offer insurance through SHOP or any other source. But you don’t have to, and there’s no penalty if you don’t.
Certain businesses with 50 or more full-time and full-time equivalent employees that don’t offer insurance that meets certain minimum standards may be subject to the payment.
Can I enroll in the same SHOP coverage that I offer my employees?
Yes, as long as at least one of your employees (who isn’t a business owner, partner or family member) also enrolls in your coverage.
If my only employee is my spouse or a family member, can I use SHOP to cover us both?
Generally, no. Spouses and family members don’t count when determining if your business is eligible to use SHOP. To be eligible, you must have 1 to 50 full-time equivalent (FTE) employees who aren’t business owners, partners, or family members.
Can my employees enroll in SHOP coverage after the initial enrollment period?
Yes, but only if they qualify for a
Special Enrollment Period due to a life change, like having a baby, adopting a child, or getting married.
For new employees hired after your initial SHOP enrollment period, you can decide on a waiting period before coverage can become effective. Waiting periods can’t exceed 90 days.
You may be able to get the Small Business Health Care Tax Credit.
Enrolling in SHOP insurance is generally the only way for eligible small employers to take advantage of the Small Business Health Care Tax Credit. You may qualify if you have fewer than 25 full-time equivalent (FTE) employees making an average of about $56,000 or less.
Eligible small employers who offer and enroll in SHOP plans may be eligible to receive the Small Business Health Care Tax Credit, which may be worth up to 50% of the employer’s contribution toward premium costs (up to 35% for tax-exempt employers). Eligible small employers should apply for the Small Business Health Care Tax Credit through the Internal Revenue Service (IRS) when they file their tax returns.