Feds Want To Bring Brokers Back In Helping Small Businesses

By Susan Rupe

The Centers for Medicare and Medicaid Services (CMS) wants to make it easier for small employers to offer health insurance to their workers, and to promote agent and broker participation in the process.

CMS intends to propose a rule that would change how small employers and their workers in the Small Business Health Options Program (SHOP) Marketplace enroll in coverage for 2018.

SHOP Marketplaces were created as part of the Affordable Care Act to make it easier for small employers to provide health coverage to their workers. However, insurance company and agent/broker participation, as well as overall enrollment in the SHOP Marketplaces has been lower than anticipated, the CMS said.

Under the approach CMS intends to propose, instead of enrolling online at HealthCare.gov, employers would enroll directly with an insurance company offering SHOP plans, or with the assistance of an agent or broker registered with the federally-facilitated SHOP.

Employers that have enrolled in SHOP coverage for plan years that began in 2017 would be able to continue using HealthCare.gov in 2018 for enrollment and premium payment, until their current plan year ends and it’s time to renew.

Employers can sign up for SHOP coverage taking effect in 2017 on HealthCare.gov until Nov. 15, 2017. CMS anticipates that states operating their own SHOP Marketplaces would be able to provide for online enrollment, or could opt to direct small employers to insurance companies and SHOP-registered agents and brokers to enroll in SHOP plans directly.

In states where the CMS operates a federally-facilitated SHOP Marketplace, and in states with a state-based SHOP on the federal platform, 7,600 employers had active SHOP coverage, covering nearly 39,000 individuals, as of January. Nationwide (including both federally facilitated and state-based SHOP Marketplaces), as of January, approximately 27,000 employers have active coverage through SHOP Marketplaces, covering nearly 230,000 individuals.

These numbers fall significantly short of the Congressional Budget Office estimate that 4 million people nationwide would enroll in coverage through the SHOP Marketplaces by 2017.

Susan Rupe is managing editor for InsuranceNewsNet. She formerly served as communications director for an insurance agents' association and was an award-winning newspaper reporter and editor. Contact her at [email protected].