overview of 2015 small business health options program (shop) … · 2020-01-09 · hip link helps...

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Marketplace Eligibility Enrollment Period HIP Link Program Individuals may enroll during special enrollment period after becoming eligible for HIP Link as this is considered a qualifying event; Employer annual open enrollment period SHOP Marketplace Individuals may enroll during a special enrollment period for qualifying events; Employer annual open enrollment period; Employer may enroll during SHOP special enrollment period if participation requirements are not met Employers from any market segment may enroll in the program (small, large, self- funded or union/PEO) Individuals must be eligible for HIP and have access to HIP Link qualified employer sponsored insurance Insurance Agent or Broker Employers with 50 or fewer full-time equivalent (FTE) employees, including non- profit organizations Insurance agent can offer information for health insurance products in the commercial market Insurance agent can offer information for health insurance products in the commercial market; Insurance agent may be able to assist the SHOP employer through the healthcare.gov agent portal Essential Health Benefits Employer plans comply with the state’s essential health benefit requirements; Additional benefits may be offered Employer plans comply with the state’s essential health benefit requirements Small Business Healthcare Tax Credit HIP Link does not offer employers a tax credit, but becoming eligible for HIP Link does not prevent them from accessing the small business tax credit. Employers with < 25 employees enrolled in the SHOP may be eligible for a small business tax credit Annual Renewal; Redetermination Employer may renew coverage and offer benefits for the next benefit period; HIP Link employees must meet the annual redetermination requirements to stay enrolled in the program Employer may renew coverage and offer benefits for the next benefit period ENROLLMENT Overview of 2015 Small Business Health Options Program (SHOP) Marketplace and HIP Link HIP Link helps employees to afford their employer’s health coverage. HIP Link is available to HIP-eligible employees and dependents who have access to HIP Link-approved employer-sponsored insurance plans. HIP Link provides a $4,000 account that reimburses employees for premiums, less a monthly contribution equal to 2 percent of income. This account can be used to cover costs for covered health services like copayments, coinsurance and deductibles. Employer plans must meet minimum benefit standards for employees to be eligible for HIP Link. All plans sold on the SHOP are benefit eligible, and HIP Link can help low-income employees afford the costs of enrolling in employer insurance. For additional information about the SHOP Marketplace, please visit Healthcare.gov. For additional information about the HIP Link program, please visit HIP.IN.gov or email [email protected]

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Page 1: Overview of 2015 Small Business Health Options Program (SHOP) … · 2020-01-09 · HIP Link helps employees to a˜ord their employer’s health coverage. HIP Link is available to

Marketplace EligibilityEnrollment Period

HIP

Lin

k P

rogra

m Individuals may enroll during special enrollment

period after becoming eligible for HIP Link as this is considered a qualifying event; Employer annual open enrollment period

SH

OP

Mar

ket

pla

ce Individuals may enroll during a special enrollment period for qualifying events;

Employer annual open enrollment period;

Employer may enroll during SHOP special enrollment period if

participation requirements are not met

Employers from any market segment may enroll in the program (small, large, self-

funded or union/PEO)

Individuals must be eligible for HIP and have access to

HIP Link qualified employer sponsored insurance

Insurance Agent or Broker

Employers with 50 or fewer full-time equivalent (FTE) employees, including non-

profit organizations

Insurance agent can offer information for health

insurance products in the commercial market

Insurance agent can offer information for health

insurance products in the commercial market;

Insurance agent may be able to assist the SHOP employer through the

healthcare.gov agent portal

Essential Health Bene�ts

Employer plans comply with the state’s essential

health benefit requirements; Additional benefits may be offered

Employer plans comply with the state’s essential

health benefit requirements

Small Business Healthcare Tax Credit

HIP Link does not offer employers a tax credit, but

becoming eligible for HIP Link does not prevent

them from accessing the small business

tax credit.

Employers with < 25 employees enrolled in the SHOP may be eligible for a

small business tax credit

Annual Renewal;Redetermination

Employer may renew coverage and offer benefits for the next benefit period; HIP Link employees must

meet the annual redetermination

requirements to stay enrolled in the program

Employer may renew coverage and offer

benefits for the next benefit period

ENROLLMENT

Overview of 2015 Small Business Health Options Program (SHOP) Marketplace and HIP Link

HIP Link helps employees to a�ord their employer’s health coverage. HIP Link is available to HIP-eligible employees and dependents who have access to HIP Link-approved employer-sponsored insurance plans. HIP Link provides a $4,000 account that reimburses

employees for premiums, less a monthly contribution equal to 2 percent of income. This account can be used to cover costs for covered health services like copayments, coinsurance and deductibles. Employer plans must meet minimum bene�t standards for employees to be eligible for HIP Link. All plans sold on the SHOP are bene�t eligible, and HIP Link can help low-income employees

a�ord the costs of enrolling in employer insurance.

For additional information about the SHOP Marketplace, please visit Healthcare.gov.

For additional information about the HIP Link program, please visit HIP.IN.gov or email [email protected]