Horizon BCBSNJ Brief Notes V. 22, No. 904: How small employer health care exchanges impact you

Horizon BCBSNJ Brief Notes V. 22, No. 904: How small employer health care exchanges impact you and the insurance industry
Applies to: Small employer market (two to 50 employees)

How small employer health care exchanges impact you and the insurance industry

Two issues to consider and a call to action

The Affordable Care Act (ACA) requires that Small Business Health Options Programs (SHOPs), commonly called exchanges, be established in all states starting in 2014. Also, the ACA requires insurers that offer small group coverage in the state market outside the exchange to participate in that state’s federal SHOPs exchange in 2014 and beyond.

Horizon Blue Cross Blue Shield of New Jersey supports expanding access to health care coverage, but believes that SHOPs should be phased in after 2014.

Please consider these two issues:

1. Getting SHOPs up and running is highly complex. Under SHOPs, health plans will need to make major operational changes in basic billing and enrollment. This will divert resources from what should be a top priority ensuring individual exchanges work effectively, especially with Open Enrollment less than nine months away.

2. Many key operational details to support enrollment, plan management and financial services are still missing. Horizon BCBSNJ believes it will take more than a year after the release of specifications for health plans and states to make all the major changes needed for SHOPs to work.

A call to action:

We ask that you contact the Obama Administration and your Congress person and urge them to phase in SHOPs after 2014. Contacts in the Obama Administration are:

  • Marilyn Tavenner, CMS Acting Administrator.
  • Jeanne Lambrew, White House Deputy Assistant to the President for Health Policy.

You may find your representative in the House of Representatives here.

If you have questions, please contact your Horizon BCBSNJ sales executive or account manager

Also see:
BB2013SHOPS (Size: 979 Kb )