MEC 'Base' Plan

In order to avoid all PPACA penalties an employer must offer a plan that meets 60% actuarial value, covers all the MEC benefits and costs less than 9.5% of an employee's income. A self-funded employer is allowed to exclude Essential Health Benefits from their plan as long as the plan meets the 60% threshold.

​How minimum essential coverage differs from qualified health plan
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There are two meanings within the definition of MEC; one as defined by the CMS and the other by the IRS.

• CMS version – States that an employer must provide a health plan offering at least 60% actuarial value and offer all 10 essential health benefits
• IRS version – Allows employers who offer plans of lesser value than the CMS version (Qualified Health Plan) to meet the requirements of the CMS version when an employer obtains acceptance from the employees on the lesser plan and that plan is sponsored by the employer. The IRS deems the employee and the employer to have met the requirement of ‘Minimum Essential Coverage’

MEC plans differ from Qualified Health Plans in that they are less expensive.  MECs offer healthcare coverage that is in accordance with the United States Preventive Task Force (USPF) schedules A & B for preventive care. It is also in compliance with the Affordable Care Act (ACA) under the IRS definition of minimum essential coverage. Employer Essential plans offer some MECs that have hospital coverage in accordance with CMS requirements. It also has some that still meet the IRS requirements for MEC coverage that do not have hospitalization coverage. Employers have the opportunity to offer their employees full preventive coverage from choices that don’t have to kill the bottom line.

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Trillium Insurance Services, Inc.
1932 E. Deere Ave., Ste. 220
​Santa Ana, CA 92705
(949) 752-8300 - phone
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support@trilliuminsurance.com

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