Minimum Essential Coverage (MEC)
A Minimum Essential Coverage (MEC) plan is a self-funded benefit plan that covers preventative services only outlined by the Affordable Care Act (ACA). These services are determined by the U.S. Preventive Services Task Force.
MEC Plan Designs
Minimum Essential Coverage (MEC) plans are for specific preventative services only. Covered services are outlined by the Affordable Care Act (ACA) and determined by the U.S. Preventative Services Task Force. The ACA requires that employers with 50 or more full-time equivalent employees provide Minimum Essential Coverage to all eligible employees. By offering a MEC plan, your client can avoid fines and penalties associated with not providing their employees with minimum essential coverage.
With an ASi MEC plan, there are two options for networks to choose from. They are based on whether your client’s company is located in the state of California or out of the state of California. For more information about the in-network providers for each network, please visit the websites below:
MEC Plus ASi Plans
MEC Plus plans with ASi can be customizable. Although the ACA states which preventive services are covered your client is able to determine what other services can be covered by the plan. MEC Plus plans follow the same guidelines as the MEC plan stated above as far as preventative services. With a MEC Plus plan your client can add select services such as office visits, lab work, diagnostic testing, urgent care visits, prescriptions, and other services if they would like to provide a limited non-preventative benefit to their employees.
For more information on services your client can add and/or how to tailor their MEC Plus ASi plan to benefit your client’s employees, please contact our Sales department at firstname.lastname@example.org.
What Expenses Are Eligible?
Preventative services include screenings, check-ups, patient counseling and certain prescriptions that are used to prevent illness, disease, and other health problems. If your client’s participants choose to see an in-network provider, we will reimburse the provider 100% of their contracted network rate for this service. If your client’s participant chooses to see an out of network provider, we will reimburse the provider 130% of the Medicare allowable rate for the service, and the participant may be balance billed by the provider.
For a complete list of eligible services, please review our Eligible MEC Services Fact Sheet.
Your clients become part of the ASi family, which means providing them with the best features within the industry. The features listed below are included as part of our administrative services.
- Low Cost, Affordable Alternative to Comprehensive Health Plans.
- It Satisfies the Employer Shared Responsibility Mandate for Minimum Essential Coverage
- Customizable Benefit Plan and Materials
- Assist in Plan Design, Including Plan Design Options and Features
- Draft Plan Documents, Including the Basic Plan Document, Adoption Agreement, and Summary Plan Description
- Eligibility Reporting
- Dedicated ASi Teams Who Provide Personalized Customer Service
- Assist in Group Enrollment
- Provide Participant ID Cards (if applicable) and Plan Materials
- Marketing Materials for Your Employees
- Timely Claims Processing
- Provide Standard Reports Upon Request
- Provide Annual Plan Review
We know your client’s employees are the heart of their business, which means we provide them with great tools and resources to help them manage their benefits.
- It Satisfies the Individual Mandate for Minimum Essential Coverage
- Easy to Understand Benefits Breakdown
- Preventative Care Covered at 100% Through In-Network Providers