CMS Postpones PPACA Group Exchange Website Deadline

State-based exchanges can enroll groups through brokers, and directly through insurers, this year and next year.

Some states may continue to make their small-group health insurance exchange programs manual operations until 2017.

The Centers for Medicare & Medicaid Services (CMS) will require state-based exchanges to put Small Business Health Options Program (SHOP) exchange enrollment systems online for the 2017 plan year, but not for coverage for the rest of 2015, and not for 2016 coverage.

State-based exchanges without working SHOP systems can have groups enroll in SHOP plans directly through insurers, or through agents and brokers. As PPACA’s exchange open date rolls near, brokers wonder, “Will I actually get paid for this?”

Officials at the Center for Consumer Information and Insurance Oversight (CCIIO), the arm of CMS in charge of exchange operations, talked about the SHOP enrollment Web system deadline extension in a new set of answers to frequently asked questions.

Originally, the Patient Protection and Affordable Care Act of 2010 (PPACA) was going to require exchange programs to have Web-based SHOP enrollment systems ready for the 2014 plan year.

But managers of the state-based exchanges, like managers of the HealthCare.gov exchange network established by the U.S. Department of Health and Human Services (HHS), have had troubles with technology  and unexpected budget cuts, and many have required small employers to sign up for coverage through paper-based systems.

HHS, the parent of CMS, has not yet released SHOP enrollment figures, but SHOP enrollment is believed to be modest.

In most areas in the country, employers that want to use the small-group health insurance tax credit provisions included in PPACA must use the tax credits to pay for SHOP plan coverage.

PPACA puts constraints on how long state-based exchanges can use HHS grants to build and run their systems.

Managers of state-based exchanges can use existing, approved PPACA grant money to build SHOP enrollment systems if doing so is part of a state’s exchange work plan, officials say.