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Options for business-provided insurance

Cottonwood Journal Extra of Cottonwood, Arizona

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Guest Perspective

New resources are available to Arizona small business owners seeking to provide health insurance options to their employees under the Affordable Care Act.

The Small Business Health Options Program, or SHOP, is part of the new Health Insurance Marketplace. SHOP gives small business owners access to available choices for private health insurance plans. The Marketplace website,, provides information and tools to allow you to compare plans and choose coverage that works best for your company and employees.

Here are a few important points about the Affordable Care Act that small business owners should keep in mind:

You're not required to offer health insurance under the health care law if you have fewer than 50 employees, nor will you face any penalty if you don't.

You can buy insurance through the SHOP Marketplace if you have 50 or fewer full-time employees, and you offer insurance to all full-time employees.

Every plan in the SHOP Marketplace covers a comprehensive set of benefits, including doctor visits, hospital stays, preventive care and prescription drugs.

New rules require these plans to treat you fairly; insurance companies can't raise premiums for the group just because of an employee's preexisting health condition or because an employee gets sick or injured, and there are new limits on charging small groups higher premiums for older employees.

In Arizona, small business owners can enroll in SHOP coverage directly through an agent, broker or a health insurance company that offers a qualified SHOP health plan. An agent, broker, or insurer can help you find and compare SHOP plans, give wou exact prices and help your employees enroll. They can also help small business owners fill out and send in a paper application to determine their eligibility for the SHOP Marketplace.

Additionally, you can find plan information, a premium estimation tool and a downloadable application for SHOP eligibility on Healthcare, gov.

You don't need to wait to hear back from the SHOP Marketplace about your eligibility before enrolling. But if you want to apply for the Small Business Health Care Tax Credit, you'll need to get a notice of your SHOP eligibility before you file your returns for tax year 2014. Small businesses that buy coverage through the SHOP Marketplace also may qualify for a tax credit worth up to 50 percent of their contributions to employee premium costs; up to 35 percent for tax-exempt employers. Small businesses have already received more than $1 billion in tax credits since this credit was created in 2010.

If your business has 50 or more employees, you're considered a "large business" under the health insurance law. Several important parts of the law apply to you.

If you have more than 50 full-time equivalent employees, you generally won't be able to use the SHOP Marketplace to offer health insurance to them. However, starting in 2016, SHOP will be open to employers with up to 100 FTEs.

You can view a detailed frequently asked questions document on SHOP at

If you have questions about what the SHOP Marketplace offers or how to apply, visit or call the SHOP Employer Call Center toll-free at (800) 706-7893

David Sayen is Medicare's regional administrator for Arizona, California, Hawaii, Nevada, and the Pacific Territories. You can always get answers to your Medicare questions by calling 1-800-MEDICARE [1-800-633-4227].

Copyright 2014 Cottonwood Journal Extra, Cottonwood, Arizona. All Rights Reserved. This content, including derivations, may not be stored or distributed in any manner, disseminated, published, broadcast, rewritten or reproduced without express, written consent from SmallTownPapers, Inc.

Original Publication Date: April 23, 2014

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