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Life Health > Health Insurance > Health Insurance

Like your plan? Keep your parent (or spouse) alive

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The spouses, children and other dependents of a worker who like their Small Business Health Options Program (SHOP) exchange coverage should take good care of the worker.

Dependents of workers who get coverage through a SHOP exchange division run by the U.S. Department of Health and Human Services (HHS) can enroll in SHOP coverage only if the worker signs up for coverage, according to officials at the Centers for Medicare & Medicaid Services (CMS).

“When an employee dies, this event will trigger a termination transaction for the entire family,” CMS officials say in an answer to a question from the public. The family members would then be eligible to buy individual exchange plan coverage through a special enrollment period (SEP), officials say.

CMS is the HHS arm in charge of managing the Patient Protection and Affordable Care Act (PPACA) public exchanges administered by HHS. The guidance has a direct effect only on SHOP plan enrollees in states with HHS-run exchanges, not on SHOP plan enrollees in states with state-based exchanges.

See also: Why don’t brokers love PPACA small-group exchange programs?


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