Frequently Asked Questions
What is included in a MEC plan?
MEC stands for minimum essential coverage which is a definition that was developed when the Affordable Care Act was passed. It is the minimum requirement a health plan must meet for an employer with 50 employees to avoid the “sledgehammer” penalty.
What does a minimum essential coverage plan cover?
There are various levels of MEC plans ranging from the most basic (preventive care only) to as rich of a plan that covers UNLIMITED sick doctors' office visits in addition to specialists, urgent care, mental health, and emergency room admission.
What is the purpose of a MEC plan?
MEC plans serve many different purposes but the most popular purpose is that it serves as a compliance vehicle for an employer with over 50 employees and then is followed up as a low-cost/high-value health insurance plan for employees with a zero-dollar deductible.
What is an ACA MEC plan?
It is any plan that meets the guidelines of minimum essential coverage.
What are the benefits of a MEC plan?
The least expensive MEC plan covers a variety of preventive services ranging from a wellness check-up, preventive blood work, a woman’s preventive gynecology appointment, a list of child preventive immunizations, regular, preventative mammograms for women over the age of 40, to a preventive colonoscopy for people over the age of 50. Please see the complete list, exclusion, and complete information on your benefit summary.
Is a MEC plan fully insured?
They are offered as both self-funded and fully insured.
What does the Affordable Care Act do?
The ACA was designed for the purpose of getting more people insured and containing costs for health insurance.
What are the requirements for MEC?
To meet MEC, there is a list of preventive services that the health insurance must cover at 100% and the insured cannot come out of pocket and pay anything for these services. There also cannot be any lifetime maximum for these services or plans.
What are the disadvantages of MEC?
MEC plans are priced so competitively they cannot cover services such as hospitalization or surgery. Please review your benefits summary for all non-covered services and exclusions.
We recommend you consult a broker to help determine if you are a good fit for a MEC plan.
Is a MEC plan best for my employees?
MEC “minimum essential coverage” is the requirement to not be penalized with the ACA part A penalty “the sledgehammer penalty”. MVP “minimum value plan” is there to avoid the part B penalty.
What are the differences between MEC vs. MVP plans?
To be compliant with the ACA is to offer minimum essential coverage (MEC Plan) and consider also offering a minimum value plan in conjunction with the MEC plan.
What does it mean to be compliant with the Affordable Care Act?
Businesses with 49 employees or fewer are not required to offer health insurance by the ACA.
Are small businesses subject to the ACA?
The large employer mandate means that an employer with 50 or more employees must offer minimum essential coverage or pay a penalty. They must also offer an MVP plan in conjunction with the MEC plan to avoid the part B penalty.
What is the large employer mandate under the ACA?
An employee must not spend more than 9.12% of their annual household income on the plan in order to meet the affordability threshold.
What is the ACA 2023 affordability?
Basic MEC plans are just preventive coverage plans whereas MEC plus plans also cover sick visits for primary care, specialist, and urgent care.
What is the difference between MEC and MEC Plus plans
Employers must meet the affordability threshold where an employee cannot spend more than 9.12% of their annual household income on the plan.
How much do employers pay for group health insurance?
The cost for an employee depends on the plan design and what the employer contribution is.
How much do employees pay for MEC health insurance?
It avoids an employer of 50 or more employees with a significant penalty by the government. You are also providing some coverage for your employees where in many industries employer’s margins couldn’t support offering expensive major medical plan coverage.
What are the benefits of offering MEC to employees?
Please reach out to Essential Benefit Administrators at 888-292-0095 or email info@essentialbenefitplans.com and we will provide you a free quote within 24-48 business hours. All you need is a census and the name of the company.
What is the process for applying for MEC Plans?
They do not cover hospitalization and surgery. Ask your broker about hospital indemnity or voluntary benefit plans.
What do MEC plans not cover?
MEC plans by themself do not meet minimum value. That is why there is a popular strategy of offering a minimum value plan in conjunction with a MEC plan.
Do MEC plans meet minimum value?
MEC stands for minimum essential coverage which is a definition that was developed when the Affordable Care Act was passed. It is the minimum requirement a health plan must meet for an employer with 50 employees to avoid the “sledgehammer” penalty. There is a list of preventive services that the plan is required to cover at 100% and the employee must not pay out of pocket for.
What are MEC plan definition and requirements?
Yes, they meet the requirements of the ACA for a large employer required to offer minimum essential coverage.