After multiple delays, early access to the federally-facilitated Small Business Health Options Program launched Monday in five states.

The Centers for Medicare and Medicaid Services said on Sept. 10 that this access was coming to benefit advisers and small employers in Delaware, Illinois, New Jersey, Ohio and Missouri  in late October.

Although enrollment in the states will still not start until the official Nov. 15 enrollment kick-off, small employers will be able to use to do such things as establish a profile, assign an agent or broker to their account, complete an employer eligibility application, and browse plans and pricing when they become available.

While it is “wonderful” that CMS has launched this site, David Oscar, a broker/consultant at Altigro Financial Group in Fairfield, N.J., says agents and brokers do not know much about it, since carriers haven’t launched their rates yet, and the early access is just a gathering tool.

“So until we as a community of brokers gets training or products, we are not going to be able to decide to steer clear or have people engage,” Oscar, communications chair for the New Jersey Association of Health Underwriters, says.

Other brokers for the most part plan to steer clear of SHOP. Anne Petry, a broker with Jaggi Insurance and Investment Services in Forsyth, Ill., says that in her state small groups were able to take advantage of transitional relief and keep their pre-Affordable Care Act plan for one more year. On average, the rates for the old plans have been much lower than the new metallic plans, she explains.

“We have spoken to some of our small groups about the SHOP, but after looking further at the qualifications for the tax credit, none of our groups have qualified. Financially it doesn't make sense to move there,” she adds.  “From speaking with other local brokers, this seems to be the consensus as a whole.”

Petry says that when the transitional relief is over, she expects small groups to look “a little more at the SHOP and the options available.”

Even so, in a CMS blog post, Rhett Buttle, director of private sector engagement, said that with Monday’s launch of early access for small businesses, health insurance agents and brokers and trained assisters CMS will be able to test the “new online features, which will give the SHOP Marketplace important information about the user experience to begin the continuous quality improvement process before the site goes live in mid-November.”

Those new features allow small businesses to establish a marketplace SHOP account, assign a SHOP agent/broker to their account, complete an employer SHOP eligibility application, obtain an eligibility determination, and upload an employee roster.

Employers will also be able to browse 2015 SHOP plans and pricing when the exchanges are launched in November, allowing them to decide which plans to offer their employees for this round of open enrollment. CMS says it has provided hands-on training in those five states to those interested in using early access.


In April 2013, Bloomberg reported that SHOP was delayed due to concerns by insurers. At the time announcing the delay, Kathleen Sebelius, then secretary of the Department of Health and Human Services, said that “to try to get the aggregated premiums, all the choice plans up and running in year one was probably going to lead to some major glitches.” The decision to delay was made after feedback from insurers, whom she didn’t name, and other parties.

Then in June 2014, more than a dozen states said they would delay offering employee choice in 2015. CMS said on June 10 it granted requests for lenience from 18 states in their effort to enact  employee choice, which provides employers the opportunity to allow employees to choose any health plan at the actuarial value, or metal level, selected by the employer.

The states that will not offer employee choice in 2015 are Alabama, Alaska, Arizona, Delaware, Illinois, Kansas, Louisiana, Maine, Michigan, Montana, New Hampshire, New Jersey, North Carolina, Oklahoma, Pennsylvania, South Carolina, South Dakota and West Virginia.

Additional reporting by Senior Editor Melissa Winn.

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