Minimum Essential Coverage (MEC) Advanced Plan

Self-Funded Minimum Essential Coverage Plan (MEC)

MEC Advanced
MVP Covered Benefits Network Non-network
Deductible: $0 / $0 $500 / $1,000
Coinsurance: 100% 40%
Out of Pocket Maximum: $1,850 / $12,700 N/A
Monthly Rates MEC Advanced
Option 1:
Voluntary
Option 2:
25-50% Employer
Contribution
Option 3:
51%+ Employer
Contribution
Employee Only $ 190.00 $ 183.00 $ 177.00
Employee + Spouse $ 285.00 $ 273.00 $ 261.00
Employee + Child(ren) $ 280.00 $ 269.00 $ 257.00
Family $ 380.00 $ 363.00 $ 346.00




MVP Covered Benefits Network Non-network
PPO Network Multiplan
Emergency Room Services $ 400 Copay Ded / Coins
Primary Care Visit to Treat an Injury or Illness
(excludes Well Baby, Preventative and X rays)
$ 15 Copay Ded / Coins
Specialist Visit $ 25 Copay Ded / Coins
Imaging (CT, PET Scans, MRIs) $ 400 Copay Ded / Coins
Laboratory Outpatient and Professional Services $ 50 Copay Ded / Coins
X-rays and Diagnostic Imaging $ 50 Copay Ded / Coins
Preventative Care / Screening / Immunization (MEC) 100% Covered Ded / Coins
Chronic Disease Management Benefit 100% Covered Ded / Coins
Prescription Drugs
Generics $ 15 Copay Ded / Coins
Preferred Brand Drugs $ 25 Copay Ded / Coins
Non-Preferred Brand Drugs $ 75 Copay Ded / Coins




Notes

  • Minimum Essential Coverage (MEC): MEC plans must cover 100% of the coverage requirements outlined by ERISA and ACA. Generally these are preventative and wellness related test and treatments.
  • Employers that have >50 employees can prevent the $2,000 penalty on all benefit eligible employees by offering a MEC plan.
  • An individual enrolled in a MEC plan can avoid the personal tax assessed for not being enrolled in qualifying coverage by being enrolled in such a plan.
  • An employer can charge any amount they choose to an employee for MEC (not subject to the 9.5% limitation).
  • Participation Requirement is 10 enrolled on MEC.

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