MEC Plans

MEC PLANS SATISFY THE "A" PENALTY

What Are MEC Plans and Why Are They Important?

Minimum Essential Coverage (MEC) and Essential Health Benefits (EHB): Minimum Essential Coverage is a lower threshold than Essential Health Benefits (EHB). MEC is the coverage an individual must have to comply with the individual mandate and avoid the individual mandate penalty tax – and that large employers may be required to offer to avoid the “non-offering employer” penalty. Essential Health Benefits are the 10 core benefits that “qualified health plans” (QHPs) must cover. Even if a group health plan does not provide EHB, the coverage still will likely meet MEC, and an individual who has MEC will not be subject to the individual mandate tax.

Exclusions & Limitations (MEC & MEC Plus Plans)

Costs for the plan include the following: plan documents, MultiPlan network access, ID cards, enrollment guides, COBRA administration, and claims management.
The plans do not cover out-of-network services and only include the services specified above and those listed on the Preventive Care Benefits page.
Claims are processed through the MultiPlan PHCS network. For services that are eligible for a network discount, members will be responsible for paying the remaining balance after the discount is applied. The discounts vary based on provider contracts.
Prescription (Rx) benefits are subject to the formulary drug list. The copayment amounts provided apply to a 30-day supply of medication, based on a unit quantity of 30. Pricing may differ based on the quantity and availability of the medication.
Virtual Health Benefits are available through Recuro Health. Members can access: 1) physician visits via phone or video, with prescriptions sent directly to the member's pharmacy when medically necessary, and 2) therapist consultations via video at a cost of $50 each (the first three visits are $85 each, and the price increases after that).
Please note that the WellCare plan does not include behavioral health services.
There is a minimum participation requirement of 10 enrolled lives, and a $750 annual fee is due at the time of implementation.
This plan qualifies as a Qualified Health Plan, meeting the standards of Minimum Essential Coverage (MEC) under the Affordable Care Act (ACA).

Prime Care Employee Benefits

PrimeCARE Offers the Most Affordable Fully ACA Compliant Coverage in the US

MEC PLANS SATISFY THE "A" PENALTY

What Are MEC Plans and Why Are They Important?

All Plans Shown Below Satisfy Either ACA "A" or "B" Penalty

Exclusions & Limitations (MEC & MEC Plus Plans)

Prime Care Employee Benefits

PrimeCARE Offers the Most Affordable Fully ACA Compliant Coverage in the US

MEC PLANS SATISFY THE "A" PENALTY

What Are MEC Plans and Why Are They Important?

All Plans Shown Below Satisfy Either ACA "A" or "B" Penalty

Exclusions & Limitations (MEC & MEC Plus Plans)

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