QUESTION

The company I work for is buying SHOP coverage. Can I choose any plan I want?

Individuals with coverage | Coverage for Employees of a Small Employer
ANSWER

If your employer elects to purchase SHOP coverage, your employer can either select your plan options for you or provide you with greater choice. Since 2016, all SHOPs must allow (but not require) employers to let their employees pick any plan within a level of coverage. For example, your employer may allow employees to pick any plan at a given precious metal level of coverage (for example, any silver level of coverage plan). In some states, your employer may also allow employees to pick among multiple plans offered by a selected insurer (for example, any metal level of coverage offered by a particular insurer), or to pick from a wider selection of plans. Typically, if your employer chooses to provide greater choice to you and your co-workers, they will select a “reference plan” to calculate how much they will contribute to your premium. If you choose to purchase a more expensive plan than the “reference plan,” you may be responsible for the additional cost. If you choose to purchase a less expensive plan, you may be able to reduce your portion of premium expenses compared to what you would owe if you selected the reference plan. (45 C.F.R. § 155.705).

Individuals with no coverage
Individuals with coverage
Coverage for small employers
Post enrollment issues