Introducing the 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.

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.

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.

It is any plan that meets the guidelines of minimum essential coverage.

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.

They are offered as both self-funded and fully insured.

The ACA was designed for the purpose of getting more people insured and containing costs for health insurance.

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.

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.

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.

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.

Businesses with 49 employees or fewer are not required to offer health insurance by 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.

An employee must not spend more than 9.12% of their annual household income on the plan in order to meet the affordability threshold.

Basic MEC plans are just preventive coverage plans whereas MEC plus plans also cover sick visits for primary care, specialist, and urgent care.

Employers must meet the affordability threshold where an employee cannot spend more than 9.12% of their annual household income on the plan.

The cost for an employee depends on the plan design and what the employer contribution is.How much do employees pay for MEC health

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.

Please reach out to Essential Benefit Administrators at 877-841-9779 or email info@ucgrps.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.

They do not cover hospitalization and surgery.  Ask your broker about hospital indemnity or voluntary benefit plans.

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.

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.

Yes, they meet the requirements of the ACA for a large employer required to offer minimum essential coverage.