SHOP - Employer

SMALL BUSINESS HEALTH OPTIONS PROGRAM
Marketplace

EMPLOYER ENROLLMENT USER GUIDE

Table of Contents

SHOP Marketplace – Employer Enrollment Application................3

Create a HealthCare.gov account...........................................................4
Create a profile.........................................................................................7
Verify your identity...................................................................................7
Browse SHOP Marketplace plans..........................................................11
Start a SHOP Marketplace application..................................................12
Get help with your SHOP Marketplace application.............................12
Start your eligibility application.............................................................13
Submit a SHOP Marketplace appeal.....................................................22
Withdraw your application.....................................................................22
Create your enrollment criteria.............................................................22
Track employee participation and submit application........................30
Minimum Participation Rate..................................................................36
Cancel or terminate coverage................................................................38

Special Enrollment Period..................................................................39
Forgot your HEALTHCARE.GOV username and/or password?.........39
Username.................................................................................................39
Password..................................................................................................40

Have questions or need help?............................................................40

SHOP Marketplace – Employer Enrollment Application
The online SHOP Marketplace is open for employers with 1-50 or 1-100 full-time
employees (depending on which state your business is located) to enroll in coverage.
If you already have coverage through the SHOP Marketplace, you’ll need to visit
HealthCare.gov to renew your coverage. Learn more about SHOP Marketplace renewals
at marketplace.cms.gov/technical-assistance-resources/shop-renewal-guide.pdf.

If your business is in one of these states, use this document to guide you
through the enrollment process:
Alabama

Maine

Oklahoma

Alaska

Michigan

Pennsylvania

Arizona

Missouri

South Carolina

Delaware

Montana

South Dakota

Florida

Nebraska

Tennessee

Georgia

Nevada

Texas

Illinois

New Hampshire

Virginia

Indiana

New Jersey

West Virginia

Iowa

North Carolina

Wisconsin

Kansas

North Dakota

Wyoming

Louisiana

Ohio

If your business is in a state that’s not listed above, that means the state is running
its own SHOP Marketplace. You’ll need to follow your state’s application enrollment
process.
To find your state’s SHOP Marketplace, visit HealthCare.gov/smallbusinesses
and select your state from the drop down menu, or contact the SHOP Call Center
at 1-800-706-7893, Monday - Friday, 9a.m. - 7p.m. ET. TTY users should call 711 to
reach a call center representative.

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If you’re working with a SHOP Marketplace registered agent or broker, they’ll
follow the same process as employers to complete your application. You may
authorize an agent or broker to help with your application and enrollment at
any time.
Important: You can stop at any point in the application and save your
information. To return to where you stopped, select My eligibility, then
select Edit enrollment in the Actions field.

Create a HealthCare.gov account
To start the SHOP Marketplace enrollment process, visit HealthCare.gov and create
your account. After you create an account, you can store all business, employee, and
coverage information, and access the SHOP Marketplace enrollment application. If
you’re renewing your enrollment or shopping for a new plan, you can use your existing
account.
• Select your state. Visit the small business employer page at
HealthCare.gov/small-businesses/employers and select your state from
the drop down menu. Select the state where your primary business address is
located. Then select APPLY NOW.
Note: If you already have a Marketplace account you created previously for
individual and family coverage, you can select Log in to use the same account
for the SHOP Marketplace (same username and password).

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• Answer a few questions. On the Create an account page, you’ll give
your first and last name, email address, and preferred password.
Next you’ll answer a few security questions. These questions will be helpful in
case you forget your username and/or password and have trouble logging in.
o Select the box about news and updates if you want us to email
information to you.
o Select the box stating that you understand and agree with
HealthCare.gov’s privacy policy and then select CREATE ACCOUNT.
Note: When you create your account, the information you provide is
case sensitive. Remember to enter the information the same way
when you log-in.

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• Verify your email address. You must verify that the email address you gave
for the account is correct. You’ll get an email with a link that’s unique to you.
Follow the instructions on the screen. Note: If you don’t verify your email
address within 48 hours of getting the email, the link in the email will expire.
You’ll need to get another verification email before you try to log into your
account.

After you verify your email address, you’ll see a “Success!” page letting you
know that your account has been created. Select CONTINUE to create your
profile and verify your identity.

If you try to log into your account without verifying your email address, you’ll
get an expiration notice. Select Resend Verification Email on the expiration
notice and follow steps above to verify your email address.

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Create a profile
The next step to prepare for enrollment is to create your profile. This process is used to
verify your identity and protect your privacy.
• Log into your HealthCare.gov account. Enter your new username and
password, then select I ACCEPT on the Terms & Conditions page.
• Select the employer application. On the WELCOME page, select VISIT
EMPLOYER MARKETPLACE.
• Review your information. Carefully review the details on the My Profile
page and add or change any information that’s missing, like your phone
number and address. Select Verify Now.

Verify your identity
To protect your personal information, you must verify your identity.
• Start identity proofing. On the Verify your identity screen, select GET
STARTED. This process will help protect your employees’ and your personal
information. Without this identity verification process, someone else could
create an account in your name without your knowledge.

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• Enter data in required fields. On the Contact information page, enter this
data in the required fields:
o First and last name. Enter as they appear in legal documents, like a
driver’s license or passport, and add any suffixes (like Sr, Jr, II, etc.)
o Date of birth
o Social Security Number (optional)
o Email address
o Street address, City, State, Zip code, preferred phone number, and
phone type
Review and select CONTINUE.

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• Answer questions to verify identity. Answer personal questions on the
Identity questions page to confirm your identity. These questions will be
different for each person. You must answer all the required questions to start
the SHOP Marketplace enrollment process. Select CONTINUE.
Note: If you don’t answer the questions correctly after 2 tries, you’ll get a
failure message.

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On the next screen, you’ll see one of these messages:
• Your identity has been verified.
If your identity is verified, select CONTINUE to start your SHOP
application.

• Your identity wasn’t verified.
If your identity wasn’t verified, follow the directions on the
screen. If you need help call, Experian Verification Services at
1-855-267-1515. In some cases you may be asked to submit
documents to verify your identity. You’ll have to finish this
process before you can complete the SHOP Marketplace
application. To learn more about identity verification, visit
HealthCare.gov/individual-privacy-act-statement.

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Browse SHOP Marketplace plans
Before you get started, you have the option to preview health and dental plans that may
be available to you at HealthCare.gov/see-plans/small-business.

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Start a SHOP Marketplace application
Once you decide that SHOP coverage might be right for you, you can start the
application process. Choose the state where your business is located from the drop
down menu, then select APPLY. You must have a primary business address in the state
where you’re applying for SHOP coverage. If you have multiple businesses or operate
in multiple states, visit HealthCare.gov/small-businesses/provide-shop-coverage/
business-in-more-than-one-state for more information.

• Get help with your SHOP Marketplace application. You can get authorize
an agent or broker to help with your SHOP Marketplace application at any
time. They can help you with the enrollment process, health and/or dental
plan selection, and provide account management support.
Select the Get assistance tab to get SHOP Marketplace enrollment help from
an agent or broker. On the Find an agent/broker page, you can search a list
of agents and brokers registered to work with the SHOP Marketplace in your
area. Enter information about your location and preferred language.

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You’ll have to authorize the agent/broker to act on your behalf. You can
revoke the agent/broker’s authorization if you no longer want help or you
want to change agents/brokers. Note: You can only change agents and
brokers twice within twelve months.
o If you already have an agent or broker, you can enter the
agent/broker’s name and National Producer Number (NPN), if available.
o Make sure your agent or broker has completed their own SHOP
Marketplace registration requirements, so you can authorize them to
act on your behalf.

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• Enter information about your business. On the My account tab, select
My eligibility. Then select Create eligibility. On the Employer details page,
enter details about your business, like business name, business address,
phone number(s), federal tax ID, and employer type.
Select how you want to get official messages from the SHOP Marketplace,
and your preferred language from the preferred method of contact and
preferred spoken language drop down menus.
If you were previously enrolled in the SHOP Marketplace and had a lapse in
coverage, the business information you entered before will display.
Here’s how you complete each field on the Employer details page:
Legal business name
Doing business as name
(optional)
Federal Employer
Identification Number
(EIN)
Business type

Business billing address
Business billing address
phone number

Enter the exact name of your business as listed on your tax
documents.
If your business runs under a different name, list the name
here.
Enter the 9-digit number that your business is registered
under. HealthCare.gov will make sure the EIN is unique within
your chosen state.
Select the best description of your business:
• Church/Church affiliate
• State/Local Government
• Foreign Government
• Non-profit organization
• Tribal government
• Private sector:
• C Corporation
• S Corporation
• Limited Liability Company
• 1040 Schedule C Business (self employed)
• Tax Exempt organization (to include corporation, trust,
or association
Enter the address where all paper correspondence, including
invoices, will be sent.
Enter the phone number to contact you about billing questions.

Primary business address Enter the address of your primary business location. To be
eligible for SHOP, the address must be in the state you’re
requesting coverage.
Primary business phone
number

Enter the phone number of your business.

Note: The county will fill automatically once you enter a ZIP code. If a ZIP
code overlaps counties, you must manually select the county where your
primary business address is located.
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• Enter the primary contact for your business. Enter the information for the
person you want to have access to your account to make premium payments
and update enrollment for the business. The full name will automatically
appear with the name used to create the account. You must enter the title,
email address, mailing address, and phone number of your primary contact.
You can select the preferred method of contact and a language preference. If
you don’t make a selection, the language preference will default to English.
Note: You have the option to add a secondary contact. The secondary contact
won’t have the same rights as the primary contact, but will be authorized to
talk to the health insurance company on behalf of the account.

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• Verify that you meet all SHOP eligibility requirements. On the Eligibility
page, you’ll verify that your business meets the requirements below to be
eligible to participate in the SHOP Marketplace. Select the box next to each
statement.
This business has 50 or fewer full-time equivalent (FTE) employees
(or 100 or fewer FTE employees depending on the state) and has a
primary business address in the state where I’m applying for this SHOP
Marketplace coverage.
All full-time employees of this business will be offered SHOP
Marketplace coverage.
This business has at least one employee who isn’t the owner or
business partner, or the spouse of the owner or business partner.
Select SAVE & CONTINUE.
Note: If you don’t select all boxes verifying that you meet the requirements
above, you’ll see a message that you’re ineligible for SHOP Marketplace
coverage. You can still continue with the application, but you won’t be
considered eligible for SHOP Marketplace coverage.

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• Enter employee information. On the Employee details page, you’ll list
all employees who will get a coverage offer, including you. To complete the
employee roster, you’ll need each employee’s legal first and last name, date
of birth, and Social Security Number. While not required, it’s also important to
include each employee’s email address so they can be notified directly about
your coverage offer. You’ll also enter their address, employment status (like
full or part-time), date of hire, and contact preferences. You can select one of
these 3 options to list your employees:
1. Select ADD EMPLOYEE to enter employee information one at a time
on the employee roster screen.
2. Select BLANK ROSTER to download an Excel roster template.
3. Select COMPLETED ROSTER to upload an Excel file with your
employees’ information. After you select the file from your computer,
the file name will appear in the employee roster dialogue box.
Note: You can download the 1997-2003 Excel template on the employee
roster page. You can only upload the 1997-2003 Microsoft Excel file. You’ll get
an error message if the file isn’t in the right format.
You can also add dependent information, but this is optional. Your employees
may enter this information when they review your coverage offer.
On the employee roster, each employee is assigned a participation code. The
SHOP Marketplace will email this code to employees using the email address
on the employee roster. Your employees need this code to review and
respond to your coverage offer, and complete their applications.
Once you’ve created or uploaded an employee roster, select
SAVE & CONTINUE. You can review and edit the roster as employees are
added.
To update information for a specific employee, you can sort the roster and
perform a search. You can’t upload a new roster if it has an employee that’s
already entered in the current roster.
After you create your enrollment criteria, only employees included on the
roster will be included in your initial Open Enrollment Period.

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• Review and sign your application. On the Signature page, you’ll need
to certify that the information on your application is valid. Select the box
showing that you agree to the terms of the application, enter your full name,
and select SAVE AND CONTINUE (see the Signature screen on the next
page).

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• Get an eligibility confirmation. You’ll get a confirmation letting you know
if you’re eligible to buy coverage through the SHOP Marketplace for your
business.
Select CONTINUE to go to the My eligibility page and start your enrollment
criteria. You can also view, withdraw, or update your application there.
If you’re not eligible, you can select File an appeal or Return to My Account
to withdraw your current application and start a new one.

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Submit a SHOP Marketplace appeal
To submit an appeal, select Create appeal in the Actions field to get the appeal request
form. Print the appeal request form and mail it to the address on the form. You have 90
days from the date in your SHOP eligibility determination notice to request an appeal.
You’ll be notified by mail of the outcome of the appeal request within 90 days of the
date you submit your appeal request form. Learn more about SHOP Marketplace
appeals at Marketplace.cms.gov/outreach-and-education/shop-marketplaceappeals-2016.pdf.

Withdraw your application
If you want to terminate your application, select Withdraw application in the Actions
field. Enter the reason for withdrawing your application from the drop down menu and
select WITHDRAW APPLICATION.

Create your enrollment criteria
Select Create enrollment on the My eligibility page to start your enrollment criteria.
• Set your enrollment period. On the Set enrollment period page, you can set the:
o Enrollment period. Your group’s enrollment period is the timeframe
your employees have to review your coverage offer, and accept or decline
coverage. Remember, you should submit your application by the 15th of the
month if you want your coverage to start on the first of the following month.
o Effective date of coverage. The effective date of coverage is the day you
want to start coverage for your employees.
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• If the last day for employees to enroll is on or before the 15th of
the current month, the effective date will be the first of the following
month.
• If the last day for employees to enroll is after the 15th of the
current month, the effective date will be the first of the second
following month.
o New employee waiting period. You can decide how much time must
pass before coverage can become effective for a new employee hired after
your SHOP Marketplace initial Open Enrollment Period or coverage renewal.
You’re not required to set a waiting period, but if you do, you can choose 0,
15, 30, 45, or 60 days.
Learn how your coverage start date might affect your costs.
Select SAVE & CONTINUE.

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• Select how you’ll offer coverage. On the Decide how you offer coverage page, you’ll
choose whether you want to offer your employees a single plan or a choice of plans (called
“Employee Choice”). You’ll also decide if you’ll offer dental coverage. You’re not required to
offer dental coverage.
Note: You don’t have to offer both health and dental coverage to your employees.
You may choose to offer dental coverage only. There’s no minimum participation rate
requirement to enroll in a dental plan. If dependent coverage is offered, dependents can
enroll in a dental plan without also enrolling in a health plan, and vice versa. Similar to
health plans, employees must enroll in a dental plan before their dependents may enroll
in a dental plan.
You have 2 options to offer SHOP Marketplace coverage:
1. Single health plan. You may select one insurance company and health
plan to offer your employees. If you offer one health plan, you’ll select from a list
of insurance companies in your area. You can make changes any time before
you submit your application.
2. Employee Choice. You may select one plan category (like Bronze or Silver)
and employees can choose any plan from any insurance company in that category.

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• Set your premium contribution. On the Set employer premium
contribution page, decide how much you want to contribute toward
employee premiums. If you offer dependent coverage, you’ll also decide
how much you want to contribute towards dependent premiums.
Note: To qualify for the Small Business Health Care Tax Credit, you must
contribute at least 50% of the total employee premium. Visit the SHOP Tax
Credit Estimator at HealthCare.gov/small-businesses/provide-shopcoverage/small-business-tax-credits to see if you qualify for the tax credit
and how much it may be worth to you.
o If you offer one health plan, you’ll contribute a fixed percentage of the
individual plan premium for each employee and dependent (if you offer
dependent coverage). Under Contribution method, select the fixed
percentage radio button for medical and dental coverage, if applicable.
Then you can enter your percentage contribution in the contribution
box for employees and dependents.
o If you offer your employees a choice of plans, you have 2 options:
1. Contribute a fixed percentage of any individual plan
premiums within a health plan category (like Bronze or Silver)
for each employee and dependent (if you offer dependent
coverage). The fixed percentage amount will vary from employee
to employee based on their age and the plan they choose.
For example: Jane is 25, and her premium is $200 per month.
John is 60, and his premium is $300 per month. You decided to
pay 80% toward your employees’ individual plan premiums
(which varies by their age). This means that you’ll pay $160 per
month toward Jane’s premium and $240 per month toward
John’s premium.
If you choose this option, under Contribution method, select
Fixed percentage for health and dental coverage, if applicable.
Then you can enter your percentage contribution in the box for
employees and dependents.

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2. Contribute a fixed percentage of a specific “reference plan”
premium amount that you choose. The reference plan is used
only to determine the percentage amount you’ll contribute toward
your employees’ premium.
For example: The reference plan premium is $100 for Bob, and
your contribution is 50%. You’ll pay $50 toward Bob’s premium,
even if he chooses a different plan. The reference plan premium
amount will vary from employee to employee based on their age,
but you’ll know up front what your cost will be for each employee
and dependent regardless of the plan each employee chooses.
If you choose this option, select the Reference plan button for
health and dental coverage, if applicable. Then you can enter
your percentage contribution in the box for employees and
dependents.
Select the box next to dependents if you want to contribute to
dependent premiums. If you decide to offer dependent coverage
without contributing toward coverage, add a “0” in the dependents
box.
Whether you offer one plan or a choice of plans, your percentage
contribution will convert to a specific dollar amount that you can
use for budgeting purposes. You’ll see what the employees’ and
your premium contribution will be when you compare plans.
Note: You may revise the percentage contribution any time prior
to submitting the enrollment application.
After you enter your percentage contribution, select SAVE &
CONTINUE.
• Select a plan. You’ll review and select coverage on the Select plans page. If
you’re offering a single health plan, you can look through the available plans in
your area, compare costs and benefits, and choose one that’s right for you and
your employees.
o Review plan details: To review more detailed information
about a plan, like copayments, laboratory and outpatient services,
medical devices, emergency care, prescription drugs, and
inpatient stays, select View Details.
o Compare plans side-by-side: To compare side-by-side, select
the Select to compare checkbox for each plan you want to
compare. You can compare up to three plans at a time. After
choosing each plan you want to compare, select Compare plans.

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Select View Details to see a side-by-side comparison of each
plan’s copayments, deductibles, covered services, and provider
network information.
o Sort plans: You can sort plans using the Sort by drop-down
menu and selecting any of the cost or deductible options listed.
o Filter plans: You can also filter your plan results under
Narrow your results.

• Select a health plan category. If you offer your employees a choice of
health plans, you’ll select one health plan category (like Bronze, Silver, Gold,
or Platinum) and your employees can select any plan in that category. If you
decide to contribute a fix percentage toward your employees’ premium, you
won’t need to select a reference plan.
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• Review dental coverage options. If you’re offering dental coverage, compare
dental plans and choose one that’s right for you and your employees. To do
this, you’ll follow the same process described above to review, compare, and
select a dental plan.
You have 2 options when offering dental coverage through the SHOP
Marketplace:
1. Single dental plan option. You may select one dental plan to offer
your employees. If you offer one dental plan, you’ll select from a list
of insurance companies in your area. You can make changes any time
before you submit your application. If you offer one dental plan, you
can contribute based on a fixed percentage.
2. Employee Choice option. You may select one plan category
(Low or High) and employees are free to choose any plan from any
insurance company in that plan category. If you offer your employees
a choice of dental plans, you can select a reference plan for dental
coverage or contribute based on a fixed percentage.

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• Review coverage selection. Before you submit your application, it’s
important that you review your application and verify business information.
o On the Summary & submit page, review the details of your
coverage. If you need to make any changes, select Edit.
o When you’re done reviewing your coverage offer, select Submit.
o Select the My account tab. Then select My enrollment to view your
enrollment details, like your employee participation rate, coverage
start date, and enrollment period date.
After you submit your application, you’ll get a confirmation that your
application was submitted and your employees are ready to review your
coverage offer and select a plan.

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• Tell your employees about your coverage offer. Once you submit your
coverage offer, the SHOP Marketplace will send an email to all employees
who you provided email addresses with your application. The email includes
your participation code and a link to the SHOP Marketplace website where
employees can fill out the employee application and accept or decline the
coverage offer.
You’re responsible for making sure that all your employees get information
about how to enroll in SHOP Marketplace coverage. If you have employees
without an email address, you’ll have to notify them of your coverage offer and
give them their unique participation code. Select the Manage employees tab
to get the participation code.
Note: The employees’ name, Social Security Number, and participation code
must match exactly what you’ve entered or they won’t be able to access the
SHOP Marketplace application.

Track employee participation & submit application
• View employee enrollment status. Select My enrollment to see the list of
employees who have accepted or declined your coverage offer. Your employees
have to respond by the last day of the enrollment period you set for your
employees.

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• Submit your application. After your enrollment period closes, you can submit
your application. In My enrollment, you’ll submit your enrollment application
after your employees have responded to your coverage offer and you’ve met
your employee minimum participation requirement.
• Review your application carefully. Once your coverage starts, you
won’t be able to make changes to your coverage offer and contribution
until your next enrollment period. Your plan year is a 12-month period
starting with your effective date of coverage.
• Select all of the boxes that apply to your business. Certain
Medicare and COBRA provisions may apply to your coverage,
depending on the size of your business. Select the box next to each of
these statements that apply to you:
Your business had fewer than 20 employees throughout
last year and this year.
Your business had 20 or more employees (both full time
and part time) on each working day of 20 or more weeks
this calendar year or last calendar year.
Your business had 20 or more full-time equivalent
employees on 50% or more of the working days in the last
calendar year.
Your business had an average of 51 or more employees
(both full time and part time) on business days during the
last calendar year.
Your business had 100 or more employees (both full time
and part time) on 50% or more of the working days in the
last calendar year.
• Sign the SHOP Marketplace user agreement. You must agree to
these statements to submit your application:
This business is legal and the total number of employees
is accurate.
This SHOP Marketplace coverage will be offered to all
full time employees and at least one employee works in
the SHOP Marketplace service area.
I’m signing this application under penalty of perjury,
which means I’ve provided true answers to all the
questions to the best of my knowledge. I know that I may
be subject to penalties under federal law if I intentionally

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provide false or untrue information. In addition, I know
that my SHOP Marketplace coverage may be impacted if I
provide false or untrue information.
• Submit your application. Select SUBMIT APPLICATION.
• Activate your coverage. To activate your new coverage, you must
pay the first month’s premium by selecting PAY NOW.

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• Pay your first month’s premium. You must submit your first month’s
premium payment by the enrollment deadline (the 15th of the month prior to
the coverage effective date) for coverage to start on the first of the month. The
fastest way to submit a payment is online. You can also mail in SHOP payments
to:
SHOP Marketplace
PO Box 2130
South Portland, ME 04116
Make checks payable to the SHOP Marketplace.

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Minimum Participation Rate
The minimum participation requirement doesn’t apply between November 15 and
December 15. Outside of this enrollment period, you must meet the minimum
participation rate for your state to qualify for SHOP Marketplace coverage. If you don’t
have enough employees to enroll, you won’t be allowed to submit your application. At this
point, you have 2 options:
1. Change your coverage offer. You can do this if you want to enroll any time
during the year. For example, you can increase the amount you contribute to
employees’ premiums to encourage more of them to participate. If you change
your coverage offer, you’ll need to withdraw your current coverage offer and
start the process over using the information from your initial application. You’ll
also need to set up a new employee enrollment period.
2. Withdraw your coverage offer. If you decide not to offer coverage, go to
the My account tab and select My enrollment. Then select Withdraw on the
Employee enrollment & applications page.

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Calculating the minimum participation rate
• The SHOP Marketplace minimum participation rate is based on the rate
of employee participation in the SHOP Marketplace and in other minimum
essential coverage, including employees enrolled in coverage through another
group health plan, like Medicare, Medicaid, TRICARE, coverage sold through the
individual market, or in other minimum essential coverage.
• The SHOP Marketplace Minimum Participation Rate Calculator is available
to help you predict if you’ll meet the Minimum Participation Rate for your
state. Visit HealthCare.gov/small-businesses/choose-and-enroll/tools-andcalculators.
For more information, visit HealthCare.gov/small-businesses/provide-shopcoverage/qualify-for-shop-marketplace.
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Cancel or terminate coverage
If you decide not to offer coverage, or an employee wants to cancel their
enrollment, you have until 11:59pm EST to cancel before the coverage effective
date. The SHOP Marketplace will provide a refund for any payments collected.
Important: Employees should work with their employers to cancel enrollment.
If you want to terminate enrollment after the coverage effective date, your
coverage will be terminated on the last day of the month in which you
terminated coverage. In this case, you won’t get a refund from the SHOP
Marketplace. For example, if your group enrolls with a January 1 coverage
effective date and you change your mind on or after January 1, the earliest you
can terminate coverage is January 31.
To cancel or terminate coverage:
• Select the My account tab and then select My eligibility.
• On the My eligibility page, select Withdraw application under the
Actions field.
• Enter the reason for withdrawing your application from the drop
down menu and select WITHDRAW APPLICATION.
You can also contact the SHOP Call Center at 1-800-706-7893, Monday–Friday,
9 a.m. - 7 p.m. ET. TTY users should call 711 to reach a call center
representative.

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Special Enrollment Period
Qualified employees and their dependents (if you offer dependent coverage) may have a
right to sign up for your coverage or make changes to their coverage choices outside of
your initial Open Enrollment Period. Job-based plans must provide this Special Enrollment
Period (SEP) of 30 days following certain life events that involve a change in dependent
status or loss of other health coverage. If you don’t offer dependent coverage, an SEP
applies only to qualified employees. Learn more about the Special Enrollment Period
and qualifying life events.

Forgot your HealthCare.gov username and/or
password?
If you forgot your username, enter your name and email address, and select
SEND EMAIL. An email with your username will be sent to the email address in
your account.

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If you forgot your password, enter your Marketplace username and select
SEND EMAIL. An email with a temporary password will be sent to the email
address in your account.

Have questions or need help?
For more information on the SHOP Marketplace, visit HealthCare.gov/small-businesses,
or you can contact the SHOP Call Center at 1-800-706-7893, Monday–Friday,
9 a.m. - 7 p.m. ET. TTY users should call 711 to reach a call center representative.

Product No. 11878
Revised February 2016
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