---
kind: "section"
citation: "45 C.F.R. § 156.286"
title: "45"
number: "156.286"
heading: "Additional standards specific to SHOP for plan years beginning on or after January 1, 2018."
url: "https://uscodex.org/cfr/45/156.286"
---

# §156.286. Additional standards specific to SHOP for plan years beginning on or after January 1, 2018.

- (a) **SHOP rating and premium payment requirements.** QHP issuers offering a QHP through a SHOP must:
  - (1) Accept payment from a qualified employer or an enrollee, or a SHOP on behalf of a qualified employer or enrollee, in accordance with applicable SHOP requirements.
  - (2) Adhere to the SHOP timeline for rate setting as established in [§ 155.706(b)(6)](/cfr/45/155.706.md?p=b-6) of this subchapter;
  - (3) Charge the same contract rate for a plan year; and
  - (4) Adhere to the premium rating standards described in [§ 147.102](/cfr/45/147.102.md) of this subchapter regardless of whether the QHP being sold through the SHOP is sold in the small group market or the large group market.
- (b) **Enrollment periods and processes for the SHOP.** QHP issuers offering a QHP through the SHOP must adhere to enrollment periods and processes established by the SHOP, consistent with [§ 155.726](/cfr/45/155.726.md) of this subchapter, and establish a uniform enrollment timeline and process for enrolling qualified employers and employer group members.
- (c) **Enrollment process for the SHOP.** A QHP issuer offering a QHP through the SHOP must:
  - (1) Provide new enrollees with the enrollment information package as described in [§ 156.265(e)](/cfr/45/156.265.md?p=e); and
  - (2) **Enroll all qualified employees consistent with the plan year of the applicable qualified employer.**
- (d) **Participation rules.** QHP issuers offering a QHP through the SHOP may impose group participation rules for the offering of health insurance coverage in connection with a QHP only if and to the extent authorized by the SHOP in accordance with [§ 155.706](/cfr/45/155.706.md) of this subchapter.
- (e) **Employer choice.** QHP issuers offering a QHP through the SHOP must accept enrollments from groups in accordance with the employer choice policies applicable to the SHOP under [§ 155.706(b)(3)](/cfr/45/155.706.md?p=b-3) of this subchapter.
- (f) **Identification of SHOP enrollments.** QHP issuers offering a QHP through the SHOP must use a uniform enrollment form, maintain processes sufficient to identify whether a group market enrollment is an enrollment through the SHOP, and maintain records of SHOP enrollments for a period of 10 years following the enrollment.
- (g) **Applicability date.** The provisions of this section apply for plan years beginning on or after January 1, 2018.

## Notes

### Amendments

[83 FR 17069, Apr. 17, 2018]

### Source

Source: 77 FR 18469, Mar. 27, 2012, unless otherwise noted.

### Authority

Authority: 42 U.S.C. 18021-18024, 18031-18032, 18041-18042, 18044, 18054, 18061, 18063, 18071, 18082, and 26 U.S.C. 36B.

### Source

Source: 76 FR 77411, Dec. 13, 2011, unless otherwise noted.

### Amendments

[83 FR 17069, Apr. 17, 2018]