HealthCare.gov Hasn't Updated SHOP Marketplace Rules for 2016

The federal heath insurance exchange website has not updated information about its Small Business Health Options Program (SHOP) for 2016, potentaially confusing small business owners about their eligibility.

The federal health insurance exchange website has not updated information about its Small Business Health Options Program (SHOP) for 2016, potentially confusing small business owners about their eligibility.

While visiting HealthCare.gov, ValuePenguin noticed a discrepancy between the information on the website and changes to the program that went into effect this year. To qualify for the SHOP Marketplace, commonly called an exchange, small businesses must meet a number of requirements and at least one full-time employee must enroll in a group plan offered. In 2015, that full-time employee could not be a spouse or family member, automatically making some family businesses ineligible to participate in the health insurance program. That rule has since been altered, but not according to the HealthCare.gov website.

More answers: The SHOP Marketplace

A screenshot of a HealthCare.gov SHOP Marketplace webpage taken Jan. 8, 2016. The rules regarding family member enrollment in the program have since changed.

Beginning Jan. 1, a family member of a business owner could enroll in a firm's SHOP exchange plan and, assuming they are the only enrollee, qualify the business for the program. The only stipulation is the family member cannot be a spouse or be claimed as a dependent. A child that is younger than 19 years old, a student younger than 24 years old or permanently and totally disabled at any age, qualifies as a dependent, according to the Internal Revenue Service. Many small businesses are owned and run by families and it's very possible that a parent would hire a child to work for the business and find themself in this circumstance.

ValuePenguin spoke to a HealthCare.gov who confirmed the changes to the rule and acknowlended that the website had not be updated. She said federal SHOP Marketplace employees were aware of the information and that they were working to correct it on the website.

SHOP Marketplace explanation continued

Another screenshot of a HealthCare.gov SHOP Marketplace webpage taken Jan. 13, 2016. Again, the rules regarding family member enrollment in the program have not been updated.

Webpages lacking updates might misguide users but they are far from the issues HealthCare.gov experienced when it launched in 2013. The federal healthcare exchange website was filled with glitches at its onset and failed to allow users to sign up for plans for nearly the entire first month of first open enrollment period. Nearly $300 million was spent between 2011 and 2014 to correct the website's functionality and a months-long investigation by the Government Accountability Office took place following the fiasco, according to The Associated Press.

Sterling Price

Sterling Price is a junior research analyst at ValuePenguin specializing in health and life insurance. He graduated from Syracuse University with a bachelors degree in Finance and Accounting and has previous experience as a licensed life insurance representative.

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