See if you qualify for the SHOP Marketplace

See if you qualify for the SHOP Marketplace

In order to use the SHOP Marketplace to offer coverage to your employees, your business needs to meet certain requirements:

  • You must have 50 or fewer full-time equivalent (FTE) employees. Use our FTE Calculator to see if you have 50 or fewer FTEs as they’re counted for SHOP eligibility.
  • You must offer coverage to all of your full-time employees. Generally this means those working 30 or more hours per week on average. You don’t have to offer coverage to your part-time employees – generally those who work 29 hours per week or fewer.
  • In most states, at least 70% of your full-time employees must enroll in your SHOP plan. To see what percentage applies in your state, see the question “How many of my employees must enroll in SHOP?” at the bottom of this page.
  • Employers who enroll in SHOP coverage between November 15 and December 15 each year can offer SHOP coverage without meeting this percentage requirement.
  • You must have an office or employee work site within the SHOP’s service area. Use the dropdown menu on this page to find out if your SHOP Marketplace is operated by the federal government or your state. If it’s operated by your state, we’ll send you to the right place. If it’s operated by the federal government, we’ll tell you your next steps.

Get more details on SHOP eligibility (PDF).


More answers

How many of my employees must enroll in SHOP?

In most states, at least 70% of the employees you offer coverage to must enroll in order for you to buy insurance through the SHOP Marketplace. This percentage may be different in your state

States that use different minimum participation rates:

Arkansas: 75%
Iowa: 75%
Nevada: 75%
New Hampshire: 75%
New Jersey: 75%
South Dakota: 75%
Tennessee: 50%
Texas: 75%

Who is included and not included in the minimum participation rate?

  • Employees with coverage through another employer plan, Medicare, Medicaid, the military, or veterans’ programs are not included in the calculation.
  • Employees with individual private coverage (the kind they buy themselves, not through an employer) are included in the calculation.

Example (assuming a 70% participation rate is required)

You offer coverage to 14 full-time employees

2 have coverage through a spouse’s employer
1 is covered by Medicare
1 is covered by TRICARE
14 employees total, minus 4 who aren’t included in the calculation = 10 employees who count toward the 70% requirement

70% of 10 employees = 7

At least 7 of your employees must enroll for you to qualify for a SHOP plan.

If you can’t meet the minimum participation rate you can apply for coverage from November 15 through December 15 every year. This is designed to let employers that don’t meet the participation rate offer a SHOP plan.

Find out what to do if you don’t meet the minimum participation rate (PDF).

How can I anticipate whether I’ll reach the required participation level to participate in SHOP?

To make it easier, you may want to find out from your employees ahead of time if they’re interested in health coverage you may offer or whether they already have coverage.

This will give you an idea of how many of your employees may enroll.

You won’t know exactly how many employees will enroll until you choose your coverage and contribution amount and offer it to your employees.