About the

SHOP Marketplace 8 things you can do to get ready now

1. Make sure you understand how insurance works. For 

example, you’ll want to understand the difference between 

premiums and out-of-pocket costs, like deductibles and 

copayments. You’ll want to compare these details to 

help determine which plans are right for you and your 

employees. Visit HealthCare.gov to learn more about how 

insurance works.

2. Learn about different types of health insurance. Through 

SHOP, you’ll be able to choose a level of coverage that 

gives you and your employees the right balance of cost 

and benefits.

3. Learn about SHOP. You’ll want to understand how SHOP 

works, which businesses qualify, and how using SHOP can 

benefit you and your employees.

4. Start thinking about when to begin coverage. You’ll need 

to choose a month to start coverage. Consider what timing 

would work best for you and your employees.

5. Set your budget. Think about how much money you’re 

able to spend for group coverage. You’ll also need to 

consider how much your employees can spend for their 

coverage.

6. Get organized. You’ll want to have basic information 

about your business organized and available, like a list of 

employees you plan to cover and your tax ID number.

7. Make a list of questions you have before it’s time to 

choose which health plans you’ll offer. Consider what’s 

most important for your budget and your employees. 

8. Look for help. Licensed agents and brokers may be able to 

help you with your SHOP options at no additional cost to 

you and your employees. You also may continue using your 

current licensed agent or broker to buy health insurance 

through SHOP.

CMS Product No. 11630

June 2013
A new way to buy health insurance for your 

small business

Today, small employers like you have a tough time finding and 

affording coverage that meets the needs of your employees. 

Starting in 2014, you’ll have more choice and control over your 

health insurance spending through the Small Business Health 

Options Program (SHOP), a new program that simplifies the 

process of buying health coverage for your small business. 

You control the coverage you offer

You control the coverage you offer, and how much you pay 

toward employees’ premiums.

Access to tax benefits

In 2014, you can get the Small Business Healthcare Tax Credit 

only when you buy coverage through SHOP. To qualify, you 

must have fewer than 25 FTEs making an average of about 

$50,000 a year or less. You must also pay at least 50% of your 

full-time employees’ premium costs The tax savings is worth 

up to 50% of your contribution toward employees’ premium 

costs (up to 35% for tax-exempt employers). 

SHOP makes it easy for you to take advantage of other cost 

savings, like the chance for you and your employees to use 

pre-tax dollars to make your premium payments.

New consumer protections

You and your employees will also benefit from new 

protections that help you get real value for your premium 

dollars. There are new limits on the higher premiums insurance 

companies can charge businesses with older employees, and 

an employee with high health care costs no longer increases 

your group’s premium. There are also new limits on the share 

of premiums going to insurance companies’ profits and 

administrative costs.

Insurance plans run by private companies

Health plans available through SHOP will be run by private 

health insurance companies, the same way small group plans 

are run now. All plans will offer the same set of essential health 

benefits, like doctor visits, preventive care, hospitalization, and 

prescriptions.

Starting October 1, 2013, plans will present their cost and 

coverage information in a standard format, using simple 

language that’s clear and easy for you to understand. You 

will be able to easily compare plans based on price, benefits, 

quality, and other features that are important to you and your 

employees. You can complete a single application and choose 

the coverage that works for your business. You and your 

employees will be able to enroll through your broker or online 

through the Marketplace.

Visit HealthCare.gov now for more information

Get answers to your questions and sign up for e-mail or 

text updates. You can also call the Health Insurance 

Marketplace Call Center at 1-800-318-2596. TTY users 

should call 1-855-889-4325.