Mec plan and Mvp Plan: When is a health plan considered to meet the minimum value?

The Affordable Care Act requires insurance plans offered by employers to meet two conditions in terms of minimum value and affordability to be deemed adequate. 

A health plan meets the minimum value when:

• The medical coverage is at least 60% of the expenses incurred for the medical services for an average individual.
• The medical plan covers expenses for doctor and inpatient services in the hospital.

For this, we have the minimum essential coverage (MEC) and the minimum value plan (MVP). Both of these are benefit plans offered in our employee benefit plan packages for hourly workforce and prevailing wage contractors.

What tools can you use to check if your MVP and MEC plan fit the bill?

• Minimum value calculator by the HHS

The Department of Health and Human Services made a downloadable minimum value calculator to check if the health plan meets the minimum value standards. Some may need to present an actual certificate which will prove that its features are compliant. A guide on the minimum value calculator is also available in the DHHS website.

• Employer Coverage Tool

You can also use the Employer Coverage Tool provided by the Health Insurance Marketplace. Request your employer to accomplish the form. You can also use this to gather information about the health plan of your spouse or parent if you are qualified to be a beneficiary. The information you will get from this tool will also be useful should you decide to forego the job-based medical coverage and purchase a health benefit plan from the health insurance marketplace.

Why is it important to check if an employment benefits plan meets the minimum value standard?

Employers who offer medical coverage that doesn’t comply with the minimum value and affordability standards will be required to pay a fee called the Employer Shared Responsibility Payment. On the other hand, if an employer offers an employment benefit plan that complies, the insured worker is longer qualified for a subsidy if he purchases a health plan through an exchange.

Note, however, that if you are an employee and a job-based medical coverage is being offered to you but you still prefer to get a health plan from the Marketplace, the only way to do so is if the medical coverage doesn’t meet the standards for minimum value and affordability.

Contact ARCHER JORDAN for all your questions about MEC and MVP plans

The regulations related to job-based coverage are quite complicated. It is best to consult a professional company like ARCHER JORDAN to help you determine if a job-based coverage is compliant or not. We are a team of experienced insurance brokers, accountants and technology gurus, and we like helping companies set up a way to easily manage benefit plans for employees. Call us for a quick chat today.