Proposed Rule for Health Insurance Exchanges

Issued July 29, 2011

On July 11, 2011 the Department of Health and Human Services (HHS) released a proposed rule related to the establishment of Health Insurance Exchanges (HIX) under the Patient Protection and Affordable Care Act.

Small Business Health Options Program (SHOP)

As part of the proposed rule, guidelines were set for employers to participate in SHOP—the small group provision of HIX.

  • The goal of SHOP is to allow small businesses (up to 100 employees, as the state may direct) to purchase coverage at rates similar to that of a large group.
  • One uniform application for SHOP for employees.
  • Large groups (100+ employees) may purchase coverage from insurers within the SHOP beginning in 2017.

For specifics on the proposed rule and how it affects states, carriers, agents and brokers, and employers, please visit the Department of Health and Human Services.

HHS is accepting public comments on this proposed rule within 75 days of its release. All Exchange regulations are expected to be finalized by mid-2012.