"SHOP" options for health insurance


Open Enrollment is now closed.  To see if you qualify to enroll now, click here


Maine’s Health Insurance Marketplace gives private and nonprofit small business owners with 2 - 50 full time employees comprehensive health insurance plan options through the Small Business Health Options Program (SHOP).

Sole proprietors and people who are self-employed can find health plan options though the Individual Marketplace. Depending on their annual income, they may qualify for financial assistance that can lower premiums and out of pocket costs.

You can enroll in SHOP at any point during the year.

How do I apply for a SHOP health plan?

We recommend working directly with an agent, broker, or insurance company.  While you can review your options on the Health Insurance Marketplace, these Maine-based professionals can help you compare your business’ health plan options for your employees and help you fill out the application for SHOP eligibility.  They can also help get you and your employees enrolled.  Here are some key tips about working with a broker or agent.  Learn More...

What are the benefits of using SHOP?

The SHOP Marketplace offers high-quality health and dental plans designed to meet the needs of your business and your employees. You can enroll in SHOP any month, any time of year.

We encourage you to work with your current insurance agent or broker to help you enroll. If you don’t have an agent or broker, you can find professionals in your area who are familiar with SHOP plans by using the “Find Help” ZIP code locator.  Learn more…

  • Flexibility:  SHOP offers flexibility, choice, and the convenience of online application and account management.  You can choose a SHOP plan or plans, complete your coverage offering, manage employee participation, and pay your premiums online. Your employees can enroll online too.
  • Employer Choice:  As the business owner, you select the coverage offered through your business and determine how much you will pay toward employee premiums. You choose whether to offer dependent coverage and dental insurance. You choose how long your employees’ Open Enrollment Period is, and the waiting period before new employees can enroll.
  • Waiving Minimum Participation Requirements:  Employers do not have to select their health plan during the open enrollment.  As a business owner, you can select a plan any time.  However, minimum participation requirements that are usually in place for small employers are waived annually between the Marketplace open enrollment period from November 1 to December 15.
  • Tax Credits:  If you enroll in SHOP coverage and have fewer than 25 employees, you may qualify for a Small Business Health Care Tax Credit worth up to 50% of your premium costs. The tax credit is available only for plans bought through the SHOP Marketplace.

Key Facts:

Small businesses are not required to provide health insurance. There is no penalty if a small business chooses not to do so.

If you do offer health insurance and want to utilize SHOP, you must offer coverage to all full time employees, which are generally those employees working at least 30 hours a week.  The SHOP Full-time Equivalent Employee (FTE) Calculator is a quick way to see if you qualify for SHOP, especially if you have a mix of full-time and part-time employees.

If you don't offer health insurance, your employees may qualify for discounted individual coverage on the Health Insurance Marketplace. Depending on their annual income, individuals may qualify for tax credits to make coverage more affordable. NOTE: individual premium tax credits are not available to employees who receive (or are offered) affordable coverage through their employer.

Need help reviewing your options?

  • Review your health plan options and sign up for coverage through your insurance agent or broker if they have registered with the SHOP.  You won’t pay more if you use a SHOP agent or broker but the agent or broker can still collect their commission.
  • Trained customer service representatives are available to assist small business employers interested in plan through the SHOP at: 1-800-706-7893 and 1-800-706-7915 (TTY).

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