By MARK P. CUSSEN, an article from Investopedia

Life insurance provides financial protection for millions of people in America and around the world. Not all life policies are purchased by individuals; many companies and other institutions also use life insurance for various purposes, such as to provide liquidity. But the rules that pertain to corporate ownership of life insurance are somewhat more complex than for individual or group policies. This article examines the history, purpose and taxation of corporate-owned life insurance (COLI) in America.

SEE: How Much Life Insurance Should You Carry?

Nature and Purpose of COLIAs the name states, COLI refers to life insurance that is purchased by a corporation for its own use. The corporation is either the total or partial beneficiary on the policy, and an employee or group of employees, owner or debtor is listed as the insured(s). Fundamentally, COLI differs from group life insurance policies that are typically offered to most or all of the employees in a company, because this type of insurance is designed to protect the employees and their families and not the company itself. COLI can be structured in many different ways to accomplish many different objectives. One of the most common is to fund certain types of nonqualified plans, such as a split-dollar life insurance policy that allows the company to recoup its premium outlay into the policy by naming itself as the beneficiary for the amount of premium paid, with the remainder going to the employee who is the insured on the policy. Other forms of COLI include key person life insurance that pays the company a death benefit upon the death of a key employee, and buy-sell agreements that fund the buyout of a deceased partner or owner of a business. https://tpc.googlesyndication.com/safeframe/1-0-37/html/container.htmlIn many cases, the death benefit is used to buy some or all of the shares of company stock owned by the deceased (such as with a closely-held business). COLI is also frequently used as a means of recovering the cost of funding various types of employee benefits.

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From The Limeade Team

Employees deserve to feel like their company cares about them. It’s a concept that yesterday’s business leaders questioned — but no one’s questioning it now. More than six months into the COVID-19 pandemic, employees are struggling in unprecedented ways and are looking to their employers as a source of support.

Ironically, Limeade launched the 2020 Employee Care Report on March 5, just days before stay-at-home orders were declared in multiple states. The report found that employers were coming up short on employee care.

Fast-forward multiple months, we wanted to know — have organizations stepped up their game when employees need it most?

HOW WORKERS REALLY FEEL ABOUT EMPLOYEE EXPERIENCE DURING THE PANDEMIC

Limeade is committed to improving the employee experience, which is why we wanted to see how workers feel about work right now — and how that’s changed during the pandemic. To get answers, we surveyed 1,000 employees (500 in manager roles and 500 in non-managerial roles) at companies with 500 employees or more, on burnout, well-being and perceptions of employee care during the pandemic. Here’s what we found.

Managers are carrying the weight of COVID-19, and their teams are slipping through the cracks

Managers feel they have the necessary tools to care for those they manage. Seventy-three percent said their organizations provided them with resources to support the emotional well-being of their teams, and 85% said they felt at least “somewhat equipped” to support the emotional needs of their teams.

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From WorkersCompensation.com

Flu season is nearly upon us. This year’s flu season, which usually begins in November and lasts through April, will be hitting as the U.S. is battling the coronavirus pandemic. The Centers for Disease Control (CDC) estimates that there was between 39 to 56 million flu cases for last year’s flu season. In the same period, there have been nearly 7 million reported COVID-19 cases.

The CDC explains that the flu and COVID-19 are both contagious respiratory illnesses, but are caused by different viruses. But, because the symptoms of the flu and COVID-19 are similar, it could be hard to tell the difference between the two based on symptoms alone, and testing may be needed to confirm the correct diagnosis.

In a regular year, the flu, on its own, can have a significant impact on organizations in both direct costs and lost productivity. Add in COVID-19, and the cost can be detrimental to a small business. On top of the safety precautions to help prevent the spread of coronavirus, companies need to be prepared for the flu season and minimize the risk of employee illnesses by practicing flu prevention procedures.

Workplace Flu Shot Programs

This year, getting a flu vaccine will be even more critical than ever. It will not protect against COVID-19, but it has shown to reduce the risk of flu illness, hospitalization and death and having one will help conserve health care resources. The CDC recommends getting a flu shot in September or October, but you can still get one throughout the flu season.

Many organizations are hosting on-site flu vaccinations as part of their workplace wellness programs to encourage employees to get their shots. Plus, flu shots are covered under most company healthcare plans.

If an employee is not available for the on-site flu shot event, then it is important for employers to make it easy for them to get their vaccination out of work. Employers can aid in this by letting them know of flu shot clinics in the area and giving them time to get the vaccine during work hours.

Benefits of Having a Workplace Flu Shot Program

According to Health Advocate, the cost of lost productivity due to the flu averages to be $1,000 per employee. This number does not include doctor’s visits, medication and other costs due to illnesses. Alternatively, the flu shot costs $32 per person.

There are many employer and employee benefits to having flu vaccinations in the workplace. For the employers, a flu shot program can decrease costs by reducing absences due to illnesses, as well as improve productivity and morale.

Cold and Flu Prevention Tips for the Workplace

Employees need to be informed about the contagious nature of colds and flu in the workplace and the proper way to prevent spreading these illnesses. The Occupational Safety and Health Administration (OSHA) created basic hygiene guidelines for workers to help prevent the spread of the flu in the workplace. Getting a flu shot is the best method, but additional cold and flu prevention tips for the workplace include:

Forbes – Forbes Real Estate Council, by Joe Brady

Months into the pandemic that has forced the ultimate work-from-home experiment, companies including Google, Microsoft, Morgan Stanley, JPMorgan, Amazon and Salesforce, just to name a few, have all reportedly extended their work-from-home options. Salesforce, for example, is allowing employees in all its 160 office locations globally to work remotely for the rest of this year, long after it began reopening offices in phases at the end of May 2020.

Twitter and Facebook have taken a more radical approach and have announced that their employees can work remotely forever. A Twitter representative told TechCrunch, “We were uniquely positioned to respond quickly and allow folks to work from home given our emphasis on decentralization and supporting a distributed workforce capable of working from anywhere. The past few months have proven we can make that work.”

Since the start of the pandemic, we have spoken with over 50 heads of corporate real estate across the globe as part of our Agile CRE Think Tank (ACT). As one participant summarized, work-from-home is no longer the enemy of the C-suite. Through these conversations, we have made a conservative estimate that we will see 15%-20% of participating firms will move to a more agile strategy.

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EBN, By Sam Del Rowe

Work-related stress was a very real issue for many employees even before the outbreak of the coronavirus, but the pandemic has doubled rates of stress in the workplace. More than 60% of employees say that they are experiencing greater stress than before the pandemic started, up from 30% pre-pandemic, according to research from MetLife.

“Going into the pandemic, one in three employees was already feeling stressed and burned out. That is just going to continue to magnify,” Tracey Ferstler, assistant vice president, head of return to health at MetLife, said at DMEC’s 2020 virtual annual conference.

The workplace has changed significantly since the start of the pandemic: more than 40% of employees are currently working from home, according to research from Stanford University. Additionally, they are working 2 hours more per day on average, according to data from NordVPN, a virtual private network provider.

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Team Cuatro brings you the most up-to-date and relevant information you need to navigate the benefits landscape. Our team is comprised of medical, insurance, wellness, research and legislative insiders. We are dedicated to helping employers with 20 employees or more leverage their benefits programs, reduce costs and risk by sharing what other companies won’t tell you.

In this 4Cast, Cuatro interviews Jeremy Gabrysch of Remedy, a private medical provider who delivers in-person and tele-health services to employees.

Learn more about Remedy.

Get in touch with Cuatro Benefits, we can help you move forward with optimal benefits strategies.

BCBS – Fully Insured & Self-Funded

COVID-19 Coverage Information for Employers and Members

We are closely monitoring the 2019 Novel Coronavirus (COVID-19) outbreak. We are committed to helping our employer customers and members stay informed and educated about COVID-19 and assisting those who might be affected.  

With regard to treatment for COVID-19, our plans cover medically necessary health benefits, including physician services, hospitalization and emergency services consistent with the terms of the member’s benefit plan. Members should always call the number on their ID card for answers to their specific benefit questions.  

For diagnostic testing for COVID-19, please note the following coverage information.

The same coverage above applies to HSA qualified high-deductible health plans, pursuant to the IRS notice on COVID-19 Leaving site icon issued March 11, 2020.

Coverage for self-insured and split-funded* members: Self-insured and split-funded employers must opt in to offer their employees the testing to diagnose COVID-19 when medically necessary and consistent with CDC guidance with:

Action needed: Self-insured and split-funded groups must communicate their agreement to opt in by emailing their account executive or broker to activate this coverage. These groups must opt in by March 31, 2020.

FetchMD

Below is a compilation of the major carriers’ responses to coverage of testing for COVID-19.  Please let me know if you have any questions.  All information below is current as of  3/12/20.

Aetna – Fully Insured CVS Health announced several steps to support Aetna members in response to the COVID-19 outbreak, including coverage changes. You can access the full press release here for details.   Effective immediately, Aetna members will have access to the following resources: 

  • Aetna will waive co-pays for all diagnostic testing related to COVID-19. This policy will cover the test kit for patients who meet CDC guidelines for testing, which can be done in any approved laboratory location. Aetna will waive the member costs associated with diagnostic testing at any authorized location for all Commercial, Medicare and Medicaid lines of business. 
  • For the next 90 days, Aetna will offer zero co-pay telemedicine visits for any reason. Aetna members should use telemedicine as their first line of defense in order to limit potential exposure in physician offices. Cost sharing will be waived for all video visits through the CVS MinuteClinic app, Aetna-covered Teladoc offerings and in-network providers delivering synchronous virtual care (live videoconferencing) for all Commercial plan designs. 
  • Through Aetna’s Healing Better program, members who are diagnosed with COVID-19 will receive a care package containing CVS over-the-counter medications to help relieve symptoms. The package will also include personal and household cleaning supplies to help keep others in the home protected from potential exposure. 
  • Through existing care management programs, Aetna will proactively reach out to members most at-risk for COVID-19. Care managers will walk members through what they can do to protect themselves, where to get information on the virus, and where to go to get tested. 
  • Aetna is extending its Medicare Advantage virtual evaluation and monitoring visit benefit to all Aetna Commercial members as a fully-covered benefit. This offering will empower members with other conditions that need follow-up care to engage with providers without the concern of sitting in a physician’s office and risking potential exposure to COVID-19. CVS Health is taking additional steps across the company to address the COVID-19 outbreak and protect patient access to medication. More information about the latest enhancements is available here:    
  • Beginning immediately, CVS Pharmacy will waive charges for home delivery of prescription medications. With the Centers for Disease Control and Prevention encouraging people at higher risk for COVID-19 complications to stay at home as much as possible, this is a convenient option to avoid coming to the pharmacy for refills or new prescriptions. 
  • Aetna will now offer 90-day maintenance medication prescriptions for Commercial and Medicare members and is working with state governments to make the same option available to Medicaid members where allowable. 
  • In addition, Aetna will waive early refill limits on 30-day prescription maintenance medications for all members with pharmacy benefits administered through CVS Caremark.

Please contact your Aetna representative with any questions.

CVS Health Press Releases: https://cvshealth.com/newsroom/press-releases/cvs-health-announces-covid-19-resources-aetna-members

https://cvshealth.com/newsroom/press-releases/cvs-health-announces-additional-covid-19-resources-focused-patient-access

FetchMD

  • Current service area of Austin & San Antonio
  • On-demand “house call” services that include care for ear, nose & throat, common sickness, minor injuries, skin issues, stomach problems and well checks
  • Costs:
    • Urgent Care Copay on Copay Plans
    • $145 Contracted Rate on HDHP
    • $49 Televisit Follow Up Appointments
  • Mobile Platform (App Based) and Bilingual
  • More info: https://www.fetchmd.com/
  • Hours of operation:
    • M-F: 8-8
    • Sat: 9-6
    • Sun: 10-4

BCBS – Fully Insured & Self-Funded

COVID-19 Coverage Information for Employers and Members

We are closely monitoring the 2019 Novel Coronavirus (COVID-19) outbreak. We are committed to helping our employer customers and members stay informed and educated about COVID-19 and assisting those who might be affected.  

With regard to treatment for COVID-19, our plans cover medically necessary health benefits, including physician services, hospitalization and emergency services consistent with the terms of the member’s benefit plan. Members should always call the number on their ID card for answers to their specific benefit questions.  

For diagnostic testing for COVID-19, please note the following coverage information.

  • Coverage for fully insured members: Effective immediately for all fully insured members, for testing to diagnose COVID-19 when medically necessary and consistent with Centers for Disease Control and Prevention (CDC) guidance:
  • No prior authorization needed
  • No member copays or deductibles

The same coverage above applies to HSA qualified high-deductible health plans, pursuant to the IRS notice on COVID-19 Leaving site icon issued March 11, 2020.

Coverage for self-insured and split-funded* members: Self-insured and split-funded employers must opt in to offer their employees the testing to diagnose COVID-19 when medically necessary and consistent with CDC guidance with:

  • No prior authorization needed
  • No member copays or deductibles

Action needed: Self-insured and split-funded groups must communicate their agreement to opt in by emailing their account executive or broker to activate this coverage. These groups must opt in by March 31, 2020.

 

Member communications: We have developed a member flier PDF about COVID-19 to share with your customers.

For employers: The CDC has an entire section on its website Leaving site icon focused on how coronavirus can impact employers.

Key sections of the site include:

Recommended strategies for employers to use now

What employers should do if an employee reports exposure to someone with COVID-19 (including the steps they should follow to conduct a risk assessment of their potential exposure)

Recommendations for an infectious disease outbreak response plan 

 UHC – Fully Insured

https://www.unitedhealthgroup.com/newsroom/2020/2020-03-09-covid-19-support-resources.html

UnitedHealth Group Reinforces Actions Taken to Provide Members and Patients with COVID-19 Support and Resources

  • UnitedHealthcare has waived all diagnostic test cost-sharing for insured members
  • OptumCare clinicians are trained, well-prepared and addressing patients’ needs
  • Optum’s Emotional-Support Help Line is free of charge to help anyone dealing with stress and anxiety

UnitedHealthcare and Optum are taking action to ensure health plan members and patients affected by COVID-19 have the support and resources they need. “Our top priority is the health and well-being of our members and patients – and the safety of those who deliver care,” said Dr. Richard Migliori, chief medical officer, UnitedHealth Group. “While the situation is dynamic, we are committed to adapting and supporting those we serve.” 

Actions to Support Members, Patients and the Community

Individuals who feel like they may have been exposed to COVID-19 should immediately contact their primary care provider for guidance. Advance telephone calls are highly recommended to ensure safe and proper patient handling.

UnitedHealthcare has waived all member cost sharing, including copays, coinsurance and deductibles, for COVID-19 diagnostic testing provided at approved locations in accordance with CDC guidelines for all commercial insured, Medicaid and Medicare members. UnitedHealthcare is also supporting self-insured customers choosing to implement similar actions.

Optum’s Emotional-Support Help Line is available to support anyone who may be experiencing anxiety or stress following the recent developments around COVID-19. The free service can be reached at (866) 342-6892, 24 hours a day, seven days a week and is open to all.  In addition, emotional-support resources and information are available online at www.liveandworkwell.com.

OptumCare clinicians across the country are well-prepared and providing compassionate care to COVID-19 patients of the more than 18 million people we serve through our primary care practices, urgent care centers, and in-patient homes and nursing homes.

To limit the spread of COVID-19, OptumCare clinicians have been trained on the CDC safety and clinical care protocols enabling patients to get the appropriate care, ensure the safety and well-being of the team, and protect others from exposure.  

Eligible UnitedHealthcare and OptumRx members needing help obtaining an early prescription refill can call the customer care number located on the back of their medical ID card for assistance or contact OptumRx customer service (800) 788-4863.

Health plan members are encouraged to use UnitedHealthcare’s Virtual Visit* capability, available through the UnitedHealthcare app, to help answer any general questions or concerns they might have.

UnitedHealth Group is utilizing its advanced analytics capabilities to enhance situational awareness and continuously adapt and evolve support services for members, patients and employees. 

For the Latest Information

Because this situation continues to evolve, we encourage people to stay informed by visiting the CDC website.

If individuals have travel plans, be sure to check out the CDC’s travel advisories, including the recently released CDC travel guidance for older Americans, people with underlying health concerns and all travelers planning cruise ship travel.   

UHC – All Savers

All Savers is following the above stated UHC guidance. They are also allowing early Rx refills through the end of March.

Humana – Fully Insured

Please see the attached agent email from Humana.

Humana – Self Funded

Test must be ordered by a physician and done at an approved lab.

Humana will waive out-of-pocket costs, where allowed within state

and federal law, associated with testing for COVID-19 for patients who meet

CDC guidelines at approved laboratory locations. Self-insured plan sponsors will be able to opt-out of the program at their discretion.

 

IRS Guidance for COVID-19 Testing & Coverage + HDHP/HSAs

HIGH DEDUCTIBLE HEALTH PLANS AND EXPENSES RELATED TO COVID-19 Notice 2020-15

PURPOSE

To facilitate the nation’s response to the 2019 Novel Coronavirus (COVID-19),

this notice provides that, until further guidance is issued, a health plan that otherwise satisfies the requirements to be a high deductible health plan (HDHP) under

section 223(c)(2)(A) of the Internal Revenue Code (Code) will not fail to be an HDHP under section 223(c)(2)(A) merely because the health plan provides health benefits associated with testing for and treatment of COVID-19 without a deductible, or with a deductible below the minimum deductible (self only or family) for an HDHP. Therefore,

an individual covered by the HDHP will not be disqualified from being an eligible individual under section 223(c)(1) who may make tax-favored contributions to a health savings account (HSA).

Part of the response to COVID-19 is removing barriers to testing for and treatment of COVID-19. Due to the nature of this public health emergency, and to avoid administrative delays or financial disincentives that might otherwise impede testing for and treatment of COVID-19 for participants in HDHPs, this notice provides that all medical care services received and items purchased associated with testing for and treatment of COVID-19 that are provided by a health plan without a deductible, or with a deductible below the minimum annual deductible otherwise required under

section 223(c)(2)(A) for an HDHP, will be disregarded for purposes of determining the status of the plan as an HDHP.

BACKGROUND

Section 223 of the Code permits eligible individuals to deduct contributions to HSAs.1 Among the requirements for an individual to qualify as an eligible individual under section 223(c)(1) is that the individual be covered under an HDHP and have no disqualifying health coverage. As defined in section 223(c)(2), an HDHP is a health plan that satisfies certain requirements, including requirements with respect to minimum deductibles and maximum out-of-pocket expenses.

RELIEF

Due to the unprecedented public health emergency posed by COVID-19, and the need to eliminate potential administrative and financial barriers to testing for and treatment of COVID-19, a health plan that otherwise satisfies the requirements to be an HDHP under section 223(c)(2)(A) will not fail to be an HDHP merely because the health plan provides medical care services and items purchased related to testing for and treatment of COVID-19 prior to the satisfaction of the applicable minimum deductible.

As a result, the individuals covered by such a plan will not fail to be eligible individuals under section 223(c)(1) merely because of the provision of those health benefits for testing and treatment of COVID-19.

1 Tax-favored contributions may also be made on behalf of eligible individuals by their employers. See

Q&A 19 of Notice 2004-2 (2004-2 I.R.B. 269)

This guidance does not modify previous guidance with respect to the requirements to be an HDHP in any manner other than with respect to the relief for testing for and treatment of COVID-19. Vaccinations continue to be considered preventive care under section 223(c)(2)(C) for purposes of determining whether a health plan is an HDHP.

This notice provides flexibility to HDHPs to provide health benefits for testing and treatment of COVID-19 without application of a deductible or cost sharing. Individuals participating in HDHPs or any other type of health plan should consult their particular health plan regarding the health benefits for testing and treatment of COVID-19 provided by the plan, including the potential application of any deductible or cost sharing.

DRAFTING INFORMATION

The principal author of this notice is Jennifer Solomon of the Office of Associate Chief Counsel (Employee Benefits, Exempt Organizations, and Employment Taxes), though other Treasury Department and IRS officials participated in its development.

For further information on the provisions of this notice, contact Jennifer Solomon at (202)

317-5500 (not a toll-free number)

Louise Norris Health insurance & health reform authority April 16, 2019

Key takeaways:

Q. Can small businesses use the ACA’s health insurance marketplaces (exchanges)?

A. The Affordable Care Act created an enrollment platform called SHOP (Small Business Health Options Program), an exchange where businesses could compare plans and enroll in coverage for their employees. Originally, the SHOP exchange was an option in every state, but in the 39 states that use HealthCare.gov, the availability of small-business plans in the exchange changed in 2018. And even among the states that run their own exchanges, some are no longer offering SHOP coverage due to lack of insurer participation.

Instead of having small businesses use the exchange to enroll in coverage, HealthCare.gov now directs them to seek out a broker or contact an insurance company directly. And although the site still maintains a tool where employers can check to see if there are SHOP plans available in their area (for purchase directly from an insurer or with the help of a broker), the tool no longer shows any available plans.

SHOP enrollment lagged from the start

The Small Business Health Options Program (SHOP) never really took off. As of 2017, HHS reported that there were fewer than 39,000 people enrolled in SHOP coverage across the 26 states with fully federally-run SHOP platforms. Hawaii was the first state to obtain approval for a 1332 waiver, and its purpose was to eliminate the state’s SHOP exchange as of 2017.

Arkansas, Mississippi, and Utah used to run their own SHOP platforms (although all three states used HealthCare.gov for individual market enrollments), but had switched to the federal SHOP platform or a direct-to-carrier process by 2019. Arkansas noted that they would no longer have a SHOP option because insurers were no longer participating in SHOP in Arkansas.

And the lack of insurer participation in SHOP has not been limited to states that use the federally-run exchange. The same thing happened in Washington state as of 2018. And Minnesota, which has a functional state-run exchange for individuals, has discontinued its SHOP platform.

Individual market QHP issuers were allowed to stop offering SHOP plans in 2018

The decline in SHOP participation was due in part to lackluster enrollment in the early years, and also to a rule change that HHS finalized in late 2016. Under the new rule (which took effect for plan years starting in January 2018), insurers that offer individual market coverage through HealthCare.gov are no longer required to offer SHOP coverage, even if they (or an affiliate) have more than 20 percent of the small-group market share in the state.

Prior to 2018, those insurers were required to offer at least one silver and one gold SHOP plan in order to be allowed to offer individual market coverage in the exchange. But HHS eliminated that requirement for plan years starting in 2018 or later.

Some state-run exchanges have fairly robust SHOPs

Although SHOP participation and enrollment was underwhelming in most states, enrollment in SHOP coverage in some of the state-run exchanges has been fairly brisk (although in most cases, far lower than enrollment in individual market plans).

Covered California’s SHOP exchange had 47,000 members as of 2018. And DC’s SHOP exchange had more than 77,000 members as of 2018, although that’s driven in large part by the fact that all small-group plans in DC must be purchased through the exchange, and members of Congress also obtain their coverage through the DC SHOP exchange.

HealthCare.gov no longer maintains an enrollment portal for SHOP plans, but most of the state-run health insurance exchanges still have SHOP platforms for small businesses. Some use a direct-to-carrier enrollment approach, while others still offer a full-service enrollment platform:

Washington and Minnesota have state-run health insurance exchanges, but they no longer have SHOP plans available.

Small-business health care tax credit

If your business qualified for the small-business health care tax credit, you may be able to pay less in taxes by offering health benefits to your employees — although the tax credit is only available for up to two years, so small businesses cannot count on it for long-term support.

Employers can claim the tax credit on Form 8941 (instructions here). Initially, the small business health care tax credit was only available to employers that purchased their coverage via the SHOP exchange. But as SHOP options dwindled, the IRS issued transitional relief that allowed small businesses to obtain the tax credit even if their plan was purchased outside the SHOP exchange.

However, that provision (most recently in IRS Notice 2018-27) only applies to businesses that initially purchased a plan through the SHOP exchange, and then transitioned to a non-SHOP plan (in 2017 or later) within the two-year window during which they’re eligible to claim the tax credit, because SHOP plans ceased to be available during that two-year window. This is highlighted in Example 3 in IRS Notice 2018-27: The IRS clarifies that the tax credit would not have been available in 2017 for a small business that began operations in 2017 but was in an area where no SHOP plans were available.

The instructions for Form 8941 (see page 5) confirm that this provision applies to all years after 2016. So if an eligible employer began its two-year tax credit window in 2017 or 2018 under a SHOP plan, and was unable to purchase a SHOP plan the following year due to lack of availability, they would be able to enroll in a non-SHOP plan in the second year and still obtain the tax credit.

The IRS notes that employers in most states (those that use HealthCare.gov) can use HealthCare.gov’s search tool to see if there are SHOP plans available. That tool does still work, although most areas that use the federally-run health insurance exchange do not have SHOP-certified plans available as of 2019 (if SHOP plans are available in your area, the tool on HealthCare.gov will show them to you; otherwise, the tool will simply say that there are no SHOP plans available).

According to Public Use Files published by CMS (see the Business Rules PUF), there are very few areas where SHOP plans are available in 2019 in states that use HealthCare.gov. There are quite a few dental-only SHOP plans, but if we limit it to medical SHOP plans, they’re only available in the following states (and coverage areas are often limited to only certain parts of the state; for example, although there are SHOP plans available in Arlington, Virginia, there are none available in some other major cities in the state, including Richmond and the Norfolk/Virginia Beach area):

In addition, there are still SHOP-certified plans in most of the states that run their own exchanges (detailed above). This includes California, Colorado, Connecticut, DC, Idaho, Maryland, Massachusetts, New Mexico (uses HealthCare.gov for individual plans but has its own exchange for small group plans), New York, Rhode Island, and Vermont.

So if a business is in an area that still has SHOP plans available, the small business health care tax credit is still available to newly-enrolling businesses. And the tax credit is also still available to a business that began its two-year tax credit window under a SHOP plan but then had to transition to a non-SHOP plan because SHOP plans were no longer available. But businesses trying to claim the tax credit for the first time might be out of luck if they’re in an area where there aren’t any SHOP plans available.

Read the rest here: Source: https://www.healthinsurance.org/faqs/ive-heard-a-lot-about-health-insurance-exchanges-but-what-are-shop-exchanges/
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