Final rule on small business health exchanges released

The U.S. Department of Health and Human Services this week released a final rule explaining the operation of Small Business Health Options Program (SHOP) exchanges, the online health insurance marketplaces established by the 2010 health care law as a new option for small businesses to compare and purchase health plans for their employees.

The exchanges will sell small group market plans that are generally open to businesses with between 2 and 50 employees in 2014 and 2015 and up to 100 employees in 2016. States have the option to expand eligibility to businesses with 100 or more employees in 2017.

HHS also released forms for employers and employees to apply for coverage through the SHOP exchanges starting Oct. 1.

The federal government will run SHOP exchanges in 33 states, and already has scaled back a key feature: the ability for a small business to offer employees a range of SHOP plan choices. Federally run SHOP exchanges will restrict small businesses to a single plan in 2014, rather than letting small companies give their employees a range of plans to choose from. State-run SHOP exchanges have the same option, according to the final rule.

Additionally, the Treasury, HHS and Labor Departments on June 3 published a final rule governing employer wellness programs. The rule explains the discount (generally, 30 percent, but as high as 50 percent, in the case of certain smoking-cessation incentives) that group health plans can offer to employees as incentives to participate in wellness activities. The June 3 wellness-program rules complement an IRS regulation published May 3 that tells employers how to calculate the value of wellness programs in determining whether health plans meet "minimum value" and “affordability” standards under the 2010 health care law.