blue markerPlan D: MEC Heavy™ & Fully Insured Limited Medical Benefits

MEC Benefits

  • Minimum Essential Coverage (MEC) will cover 100% of the 63 CMS listed preventive services.
  • The MEC coverage is self-funded with an aggregate only policy with a monthly aggregate
    accommodation provision.
  • By only offering the MEC, employers can prevent being taxed $2,000 per full-time employee.
    Employers employing 50 to 99 employees will be exposed to this penalty tax starting 1/1/2016 for
    all full-time employees, less 30. Employers employing 100 or more employees will be exposed to
    this penalty tax starting 1/1/2015 for all full-time employees, less 80 for 2015 only, then less 30
    thereafter.
  • Employees were subjected to the individual penalty tax on 1/1/2014. All employees can prevent
    paying the individual penalty tax by purchasing the MEC coverage.
  • The employee penalty tax progresses over a three-year period. In 2014, it is the greater of 1% of
    modified adjusted household income or $95 per adult plus $47.50 per child; in 2015, it is the
    greater of 2% of modified adjusted household income or $325 per adult plus $162.50 per child;
    thereafter the greater of 2.5% of modified adjusted household income or $695 per adult plus
    $347.50 per child.
  • Employers can charge employees any reasonable amount for the MEC.

MEC Heavy™ Plan Benefits

  • The MEC Heavy™ Plan is self-funded with an appropriate stop loss policy with a monthly aggregate accommodation provision.
  • The MEC Heavy™ Plan incorporates MEC benefits, other strategically selected medical benefits, a nationally acclaimed patented Chronic Disease Management (CDM) program, online explanation of benefits, online plan summaries and much more.
  • By offering MEC Heavy™ Plan, employers can offer an affordable Non MVP with significant and meaningful benefits.

Fully Insured Limited Medical Benefits

  • The Fully Insured Limited Medical benefits are provided on an indemnity platform and constructed to be exempt from the ACA rules.
  • There is one Fully Insured Limited Medical benefit structure that KBA has designed to fit into Plan D
  • The Fully Insured Limited Medical benefit structure incorporates 5 benefits which focus on in-hospital care, hospital admissions, surgery, accident and critical illness benefits.
  • This Fully Insured Limited Medical benefit structure does not qualify the plan offering as an affordable MVP but supplements the MEC Heavy™ benefits, so Plan D is not a qualified MVP.

    

This can be accomplished at suprisingly affordable costs to both employees and employers!