A traditionally-funded, fully-insured arrangement with the added advantage of an Employer Tax Return.

Compliance/ Tax Credit Information-

SHOP coverage is the same as being fully-insured and compliance also follows the same guidelines. However, by participating in SHOP coverage, you could be eligible for a premium tax return if the following rules are met:

• Tax-Exempt Employers- pay up to 35% of employer premium share

• Non-Tax-Exempt Employers- pay up to 50% of employer premium share

• To receive full-tax credit:

1) Have less than 10 full-time equivalent employees

2) Have average wages equal $25,000 or less

• Otherwise

Deduct 1/15 of tax credit amount for every full-time equivalent employee up to 25 full-time equivalent employees AND/OR deduct 1/25 of tax credit amount for every $1,000 of average wages above $25,000 up to $50,000.

• If full-time equivalent employees are above 25 AND/OR average wages are above $50,000, employer is not eligible for tax credit. 

Participation- 75% of employees including valid waivers.

Note: Within the Open Enrollment Period from November 15th to December 15th, participation Requirement is waived.