Regulators Propose Rules on Small Biz Health Exchange Participation

August 12, 2011 ( - The Departments of Health and Human Services and Treasury have proposed standards and processes for employers enrolling in qualified health plans and insurance affordability programs through the Small Business Health Options Program (SHOP) to be established under the new health reform law.

The regulators said small employers participating in SHOP will be able to offer their employees choice in health plans and cut their costs with new tax credits. The eligibility process will minimize burden on states and individuals by relying on electronic data sources to verify applicant information wherever possible. In most cases, this will allow for a near real-time eligibility process so that individuals can receive an eligibility determination and enroll in a plan in a single session.  Like the banking and travel industries, Exchanges will use standards for information technology to make the system easy for consumers while encouraging innovation and competition.  

By using the same simplified eligibility rules for premium tax credits, Medicaid, and CHIP, individuals can enroll in the program that best fits their needs without unnecessary steps or redundant paperwork. The proposed rule also simplifies the redetermination process to help enrollees maintain coverage year after year without unnecessary disruptions.  

This proposed rule, as well as other proposed rules on the individual health care exchanges, can be found at