The Centers for Medicare and Medicaid Services (CMS) yesterday approved applications by 18 state insurance commissioners to delay offering the "employee choice" option on their Small Business Health Options Program (SHOP).

Under "employee choice," individual employees of a qualifying small business would be able to pick and choose among policies.

The states that will not offer "employee choice" in 2015 are Alabama, Alaska, Arizona, Delaware, Illinois, Kansas, Louisiana, Maine, Michigan, Montana, New Hampshire, New Jersey, North Carolina, Oklahoma, Pennsylvania, South Carolina, South Dakota and West Virginia. In 2016, these states will have to implement "employee choice."

In these states, employers buying health insurance from SHOP will have only one option, employees none, until 2016. Originally, SHOP was to allow a variety of options, but insurance commissioners in these 18 states voiced concern that insurers would inflate premiums under "employee choice" out of fear that too many sick customers would sign up.