Health care reform is confusing.  There are so many new terms and concepts.  One concept that has been getting a lot of attention lately is MEC.  MEC stands for “minimum essential coverage” and is a fancy name for basic health coverage. MEC is important for two main reasons –

  • First,      starting in 2014, individuals who don’t have MEC, and don’t qualify for an      exemption, will have to pay a penalty tax.
  • Second,      starting in 2015, large employers who don’t offer MEC to substantially all      of their full-time employees and their dependents (i.e., natural and      adopted children) will have to pay a nasty penalty under Code Section      4890H(a) (the “subsection (a) penalty”).

Employers who offer MEC to their employees help their employees avoid the individual penalty tax and, at the same time, help themselves avoid the subsection (a) penalty.

So what exactly is MEC?   MEC is broadly defined to include any group health plan or group health insurance that is not a HIPAA-excepted benefit.  Most group health coverage meets the very broad definition of MEC unless the coverage provides only limited benefits, such as dental or vision-only coverage.  MEC also includes government coverage (such as Medicare and Medicaid), individual health insurance, and various other types of coverage.