CMS Readies Small Business Coverage Applications, Seeks Comment

The Centers for Medicare and Medicaid Services is finalizing standard application forms for employers and employees to enroll in the reform-mandated Small Business Health Options Program under which insurance can be purchased through state health insurance exchanges.


The Centers for Medicare and Medicaid Services is finalizing standard application forms for employers and employees to enroll in the reform-mandated Small Business Health Options Program under which insurance can be purchased through state health insurance exchanges.

CMS in two notices published Jan. 29 and available here explains the application process and seeks public comment. The application period for both employers and employees will start during initial open enrollment in October 2013. Either application, which will be used to determine eligibility to buy insurance through an exchange, can be filled out online, on paper, over the phone through exchange call centers, or in person through an insurance agent or broker.

In an earlier round of public comment in the summer of 2012, CMS was informed of duplicate or overly burdensome data collections related to the applications and has worked with states to minimize required document submission and duplication, according to the notices.

The government estimates about three million individuals, representing one million employees and their dependents, will complete an application in fiscal year 2014 and it will take approximately 10 minutes to complete. The government estimates approximately 200,000 small employers, will apply in 2014, taking an average of 13 minutes to complete the form.

Under a third notice available with the other two, CMS will provide states a standard, streamlined form for individuals not covered under the small business program to apply for Medicaid , the Children’s Health Insurance Program and the new Basic Health Program through exchanges. States may develop their own form application contingent on CMS approval. The agency estimates more than 7.8 million individuals will submit applications between 2014 and 2016.