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Life Health > Health Insurance

CMS: small-group activity is far below expectations

Your article was successfully shared with the contacts you provided. may take in about 6,000 exchange coverage applications from small employers per year.

That’s about 3 percent of the group application activity level the program managers were originally expecting. managers estimated in 2012 that would get about 200,000 Small Business Health Options Program (SHOP) applications per year.

See also: 5 ways small-group exchange plans went wrong

Officials at the Centers for Medicare & Medicaid Services (CMS) have published the new SHOP application flow figure in an paperwork review notice that appeared today in the Federal Register and a paperwork review packet posted on its own website.

The figure includes only SHOP application activity. The figure does not include SHOP application activity at the state-based Patient Protection and Affordable Care Act (PPACA) exchange programs.

CMS is the arm of the U.S. Department of Health and Human Services (HHS) that runs the PPACA exchange enrollment system and related back-office administration systems.

The federal Paperwork Reduction Act of 1995 (PRA) requires CMS to put efforts to collect information through a review process, and then to give members of the public a chance to comment on each information collection effort every three years.

In 2012, CMS estimated when it first described the SHOP application process that completing an application would take a small employer an average of about 15 minutes. The agency now estimates completing the application process will take a small employer an average of about two hours.

Employees of companies with SHOP coverage have to file applications of their own. CMS estimates is getting about 60,000 SHOP coverage applications from employees per year, or about 6 percent of the 1 million in employee application flow the agency estimated in 2012.

CMS has increased its estimate of the time it takes an employee to complete an employee application to about an hour, up from an estimate of about 6 minutes given in 2012.

The CMS figures suggest that the average employer applying for SHOP coverage has about 10 employees who file employee applications. Originally, CMS was expecting the average SHOP-using employer to have about five application-filing employees.

Over the years, officials at CMS and HHS have repeatedly declined to give SHOP enrollment or application activity estimates.

See also: Collins: Where’s the PPACA group plan enrollment data?

Some locally based exchanges have published SHOP activity or enrollment data.

The District of Columbia, for example, requires all small groups to get their health coverage from the DC Health Link exchange, and that exchange provides health benefits coverage for members of Congress and some of the lawmakers’ aides. Officials there said in November that DC Health Link SHOP plans were providing coverage for 16,614 people on Oct. 29.

Covered California officials said in a report to state lawmakers that their SHOP program was covering 17,308 people in 2,607 employer groups as of May 31.

See also: Covered California reboots its small-group division

Officials at Connect for Health Colorado say their SHOP program ended October with 2,797 SHOP plan employee enrollees, or 50 percent more employee enrollees than it had a year earlier.

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