Understanding minimum essential coverage (MEC) can be complicated when comparing MEC to Minimum value, essential health benefits, and actuarial value. Let’s start by answering what is MEC and what does it cover? MEC is a plan that meets the Affordable Care Act requirement for getting health coverage. Some of these programs under MEC include marketplace plans, job-based plans, Medicare, and Medicaid.

So what is the difference between MEC and minimum value?

Minimum value is a higher threshold than MEC. Minimum value is when a plan pays 60% of the actuarial value of allowed benefits under the plan. If a large employer offers benefits and meet MEC requirements, but they do not meet the minimum value they meet the ACA employer requirements. 

What about MEC and Essential health benefits?

Essential health benefits are the core benefits that “qualified health plans” must cover. MEC also has a lower threshold than Essential Health Benefits. If a group health plan doesn’t provide all the benefits under the essential health benefits, the coverage will likely meet MEC, so companies will be ACA compliant.

Why is it important to understand the differences? 

Each of these coverage specifications are important to ensuring large employers provide proper coverage to their employees. As an employer, you must understand your legal liability in providing benefits, as well as understanding what coverage you need to be offering your employees to give them the best options and ensure compliance with the ACA.

At SBMA, all of our plans are compliant with MEC regulations to ensure your employees have coverage for whatever comes your way. Want more information? Visit our site to understand your coverage options better.