PART 157—EMPLOYER INTERACTIONS WITH EXCHANGES AND SHOP PARTICIPATION Authority: Title I of the Affordable Care Act, Sections 1311, 1312, 1321, 1411, 1412, Pub. L. 111-148, 124 Stat. 199. Source: 77 FR 18474, Mar. 27, 2012, unless otherwise noted. Subpart A—General Provisions § 157.10 Basis and scope. (a) Basis. (1) 1311. Affordable choices of health benefits plans. (2) 1312. Consumer Choice. (3) 1321. State flexibility in operation and enforcement of Exchanges and related requirements. (4) 1411. Procedures for determining eligibility for Exchange participation, advance payments of the premium tax credit and cost-sharing reductions, and individual responsibility exemptions. (5) 1412. Advance determination and payment of the premium tax credit and cost-sharing reductions. (b) Scope. § 157.20 Definitions. The following definitions apply to this part, unless otherwise indicated: Federally-facilitated SHOP Full-time employee Large employer Qualified employee Qualified employer Small employer [77 FR 18474, Mar. 27, 2012, as amended at 78 FR 15539, Mar. 11, 2013] Subpart B [Reserved] Subpart C—Standards for Qualified Employers § 157.200 Eligibility of qualified employers to participate in a SHOP. (a) General requirement. (b) Continuing participation for growing small employers. (c) Participation in multiple SHOPs. § 157.205 Qualified employer participation process in a SHOP for plan years beginning prior to January 1, 2018. (a) General requirements. (b) Selecting QHPs. (c) Information dissemination to employees. (d) Payment. (e) Employees hired outside of the initial or annual open enrollment period. (1) An enrollment period to seek coverage in a QHP in accordance with § 155.725(g) of this subchapter; and (2) Information about the enrollment process in accordance with § 155.725 of this subchapter. (f) New employees and changes in employee eligibility. (1) Newly eligible dependents and newly qualified employees. In a Federally-facilitated SHOP or in a State Exchange that uses the Federal platform for SHOP functions, a qualified employer must provide information about a newly qualified employee on or before the thirtieth day after the day that the employee becomes a newly qualified employee; and (2) Loss of qualified employee status. (g) Annual employer election period. (h) Applicability date. [77 FR 18474, Mar. 27, 2012, as amended at 81 FR 94183, Dec. 22, 2016; 83 FR 17070, Apr. 17, 2018] § 157.206 Qualified employer participation process in a SHOP for plan years beginning on or after January 1, 2018. (a) General requirements. (b) Selecting QHPs. (c) Information dissemination to employees. (d) Employees hired outside of the initial or annual open enrollment period. (e) Participation in the SHOP and termination of coverage or enrollment through the SHOP. (2) If an employer receives a determination of ineligibility to participate in the SHOP or the SHOP terminates its eligibility to participate in the SHOP, unless the SHOP notifies the issuer or issuers of the determination of ineligibility or termination of eligibility, the employer must notify the issuer or issuers of QHPs in which their group members are enrolled in coverage of its ineligibility or termination of eligibility within 5 business days of the end of any applicable appeal process under § 155.741 of this subchapter, which could include when the time to file an appeal lapses without an appeal being filed, when the appeal is rejected or dismissed, or when the appeal process concludes with an adjudication by the appeals entity, as applicable. (3) Employers must promptly notify the issuer or issuers of QHPs in which their group members are enrolled in coverage if it wishes to terminate coverage or enrollment through the SHOP, unless the SHOP notifies the issuer or issuers. (f) Applicability date. [83 FR 17070, Apr. 17, 2018]