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SHOP –  Covered CA for Small Business (CCSB) Employer Plans

SHOP Covered CA for Small Business Program 
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Ask about the “Employee #only” plan
Which Allows  Subsidies for Dependents in Covered CA
Avoid the Family Glitch 

  • Employees who have dependents seeking subsidy assistance through the individual exchange cannot qualify.
  • Spouse/parents enrolled in an employer group ACA qualified plan in most cases disqualifies the subsidy eligibility – Family Glitch –  9.61% Rule
  • Most employers do not contribute to the dependent portion of the premium, but because the offer the coverage the dependents technically have “Access” to a ACA qualified plan.
  • Dependent coverage is perceived as “unaffordable” to the employee; result = low to no dependent participation
  • Why have an employer offer a benefit that is not utilized and unintentionally penalizes??




  • Implement an “employee only” plan; dependents do NOT have “Access” thereby receiving subsidies. 9.17.2015  Covered CA Email 
    • Covered California for small business filed their contract to support this feature.
    • If  the dependents of your employees qualify for Covered CA subsidiesFREE Quote and Subsidy Calculation and the employer is not contributing, then we need to get you into a SHOP program and write it up as employee only, by NOT selecting dependents on the SHOP employer application.  
      • employee coverage only

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