Minimum Essential Coverage

Affinity MEC Plus

THE AFFORDABLE CARE ACT (“ACA”) requires companies with 50 or more full-time employees to offer Minimum Essential Coverage (“MEC”) or pay an annual penalty of $2,320 per employee.

Affinity MEC Plus was specifically designed for hourly-paid worksite populations earning less than $20/hour.

Traditional group health plans are expensive ($300-$700 per employee per month) and require deductibles so high that employees feel like they have no insurance at all.

On the other hand, Affinity MEC Plus:

• typically costs just $125-$150 per month per employee
• pays first-dollar benefits (no deductibles) that employees can use and appreciate
• avoids the employer penalties for non-compliance
• minimizes the likelihood of incurring employer penalties for not providing “Minimum Value” coverage
• has no minimum participation requirements
• exempts covered employees from the individual penalty for not having insurance
  (note: individual penalty repealed effective 1/1/2019)

Part A (the “MEC” part) provides preventive coverage (for example: annual physicals, mammograms, colonoscopies, contraception) without any deductibles or other cost to the employee. Part A meets the ACA requirements for Minimum Essential Coverage. The employer pays the full cost of Part A including administration fees and claims incurred.

Part B (the “Plus” part) provides fixed benefit payments, depending on the type of medical service used, to help the employee pay for health care. Each plan is custom designed for the group. For example, a Part B plan might pay $100 per doctor office visit for up to 5 visits per year or $1,000/day for hospitalization for up to 100 days. The premium for Part B can be fully paid by the employer or shared with the employee.