Smart Benefits: November 15 Key for Individual – and Employer – Health Exchange Enrollment

Smart Benefits: November 15 Key for Individual – and Employer – Health Exchange Enrollment

The Health Insurance Marketplaces (also known as the State Health Exchanges) will open on November 15 for individuals to enroll in non-employer sponsored plans for 2015. While employers are generally not greatly impacted by open enrollment for individual plans, employers should still want to mark November 15 on their calendars for two key reasons:

-Window for SHOP enrollment with less than 70% participation. Unlike individuals (who generally must sign up for a health plan during the three-month open enrollment window), small businesses that want to purchase insurance through the Small Business Health Plan Options Program (SHOP) exchange can usually enroll in any month. But to be eligible to sign up for a SHOP plan year round, at least 70% of the employer’s full-time employees must enroll in that SHOP plan. If small businesses can’t satisfy that requirement, November 15 marks the start of a one-month window when they can enroll in a SHOP plan with less than 70% participation of full-time employees.

-Expected launch of online SHOP enrollment. While SHOP has been open since late 2013, the online option was delayed and is still not operational in most states. For the almost three dozen states using the federal government’s small business exchange, November 15 is the expected release date of the online portion of the program. At that time, employers should be able to purchase group coverage via computer rather than using paper forms. Many states running their own small business exchanges are also launching or improving their online systems.

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Amy Gallagher has over 21 years of healthcare industry experience guiding employers and employees. As Vice President at Cornerstone Group, she advises large employers on all aspects of healthcare reform, benefit solutions, cost-containment strategies and results-driven wellness programs. Amy speaks regularly on a variety of healthcare-related topics, and is often quoted by national publications on the subject matter. Locally, Amy is a member of SHRM-RI, the Rhode Island Business Group on Health, and the Rhode Island Business Healthcare Advisory Council.