• Allows SHOPs to assist employers in the administration of continuation coverage (COBRA) enrolled in through a SHOP
• Allows a SHOP to elect to renew an employer’s offer of coverage, where the employer remains eligible to participate in the SHOP and has taken no action to modify its offer of coverage or withdraw from the SHOP during its annual election period, so long as the offered coverage remains available through the SHOP
• Modifies the calculation of minimum participation rates in the SHOP to align with the current practice of issuers in many states and to include other types of coverage in the calculation of the group’s rate (this policy is limited to the federally facilitated SHOP, effective for plan years beginning on or after Jan. 1, 2016; states may decide how to calculate minimum participation rates for state SHOPs and the non-SHOP small group market)
• Aligns SHOP qualified health plan (QHP) certification in SHOPs that certify QHPs on a calendar year basis with rolling enrollment in the SHOP, so that employers can start coverage through the SHOP at the beginning of any month, with coverage lasting for 12 months
• Finalizes an exception to the rule regarding 12-month plan years in the SHOP for states with merged individual and small group risk pools under federal law
• Specifies that a qualified employer that fails to pay its premium for federally facilitated SHOP coverage in a timely manner can be reinstated in its prior coverage only once per calendar year
• Specifies that, effective Jan. 1, 2016, certain termination notices will be provided by the SHOP.
• The reinsurance program’s annual contribution rate for 2016.
• The 2016 open enrollment period.
• The 2016 annual limitations on cost-sharing.
