What is covered under a MEC plan?

Asked by: Jayden Crooks  |  Last update: September 3, 2025
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A minimum essential coverage (MEC) plan is a type of healthcare that meets the minimum standards established by the Affordable Care Act (ACA). A MEC plan is intended to offer members a basic form of healthcare with essential benefits like preventative services, discounts on prescriptions, and telemedicine options.

What does a MEC plan cover?

Standard MEC plans are ACA compliant and include coverage for wellness, preventative services, prescription discounts, and telehealth services.

What is a MEC insurance policy?

A modified endowment contract (MEC) is a cash value life insurance policy that gets stripped of many tax benefits. 2. MECs ended a popular way to shelter money from taxes. 3. The “seven-pay” test determines if a policy will become a MEC.

Is the Mec plan worth it?

MEC plans can be a viable choice for some businesses, especially those with budget constraints and a focus on complying with ACA regulations. However, they may not provide sufficient coverage for all employees, and careful evaluation of your workforce's needs is crucial.

What is included in minimum essential coverage?

Plans that qualify as minimum essential coverage include employer-sponsored plans (including "skinny" employer-sponsored plans that don't provide minimum value), individual major medical plans (including new ACA-compliant plans, grandfathered plans, and grandmothered plans), TRICARE, Medicare, most Medicaid plans, and ...

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Are all MEC plans self-funded?

Is a MEC plan fully insured? They are offered as both self-funded and fully insured.

What is the primary disadvantage when a life insurance policy is classified as a MEC?

Here are some of the main disadvantages: Taxation on Withdrawals: One of the biggest drawbacks is the tax treatment of withdrawals and loans. Money taken from a MEC is taxed on a last-in-first-out (LIFO) basis, meaning that gains are taxed as ordinary income before any contributions are touched.

What is the best health plan in USA?

Investopedia's analysis ranks Kaiser Permanente as the best health insurance company for 2025 because of its blend of affordability and low customer complaints. UnitedHealthcare and Aetna also earned top marks. We evaluated nine insurers using dozens of criteria, such as customer satisfaction, plan types, and costs.

What are the benefits of a MEC?

Pros
  • MECs still provide tax-deferred growth. If you don't plan on withdrawing from your policy, an MEC allows you to build a large cash balance on a tax-deferred basis.
  • Your life insurance death benefit still isn't taxed.

What is an example of a MEC?

For example, if a MEC contract comes with a principal of $200,000 and pays a 10% interest, then the contract will grow by $20,000 in the year. If the policyholder decides to withdraw the gain, it is considered ordinary income and would be taxed first.

What policies are deemed a MEC?

A modified endowment contract (MEC) is a cash-value life insurance policy that has been overfunded—typically in the first seven years--causing the IRS to strip it of its status as an insurance contract and consider it an investment vehicle.

How to avoid MEC life insurance?

If you use a policy to accumulate cash value, one solution to avoid MEC status is to increase the death benefit through paid-up additional insurance (PUA), which raises the corridor's ceiling. PUA insurance is added whole life insurance coverage purchased with the policy's dividends.

Is the spouse offer of MEC coverage conditional?

A. Line 16 – 2C Page 5 ACA: FAQs on Form 1095-C Page 5 of 9 The employer will enter 1J on Line 14 if MV coverage is offered to the employee, no MEC is offered to dependents, and a conditional offer of MEC is made to the spouse/domestic partner.

What is the MEC 7 rule?

This is called the 7-pay limit or MEC limit, and is based on rules established by the Internal Revenue Code, setting the maximum amount of premium that can be paid into the contract during the first seven years from the date of issue in order to avoid MEC status.

What happens when a life insurance policy becomes a MEC?

A Modified Endowment Contract is a life insurance policy that has received more money in premiums than the IRS (Internal Revenue Service) allows for favorable tax treatment. This means that an MEC does not get some of the tax benefits that regular life insurance policies do.

What is the 7 year rule for Iul?

The 7 Pay rule is a common guideline for purchasing an Indexed Universal Life (IUL) insurance policy. It stipulates that a purchaser should pay the initial premium over seven years rather than one lump sum. This allows the cash value to accumulate more quickly and helps to maximize the returns of the policy.

What is the best Medicare plan that covers everything for seniors?

Original Medicare with Medigap likely offers the most comprehensive coverage, but it may also be the most costly. A person can consider their income and how much they are able to spend before choosing a Medicare plan. Original Medicare with Medigap also offers a lot of flexibility when choosing a doctor or specialist.

Why are people dropping Medicare Advantage plans?

Among the most commonly cited reasons are excessive prior authorization denial rates and slow payments from insurers. In 2023, Becker's began reporting on hospitals and health systems nationwide that dropped some or all of their Medicare Advantage contracts.

What are the 6 things Medicare doesn't cover?

Some of the items and services Medicare doesn't cover include:
  • Eye exams (for prescription eyeglasses)
  • Long-term care.
  • Cosmetic surgery.
  • Massage therapy.
  • Routine physical exams.
  • Hearing aids and exams for fitting them.

Are MEC plans worth it?

MEC plans are viable healthcare options for individuals, families, and many types of businesses, but they are especially important for ALEs. If your business employs at least 50 full-time or FTE employees, you can face thousands of dollars in annual tax penalties for not offering MEC plans to enough of your employees.

Do employers have to contribute to MEC plans?

Some employers must provide a health insurance plan with minimum essential coverage (MEC) to avoid penalties under the Affordable Care Act (ACA) and ensure employees have access to essential healthcare services. In some cases, these employers may consider a type of group plan called a MEC plan.

How do you tell if a plan is self-funded or fully funded?

But there may be language on the card that says something like, “this insurance company provides claims processing only and assumes no financial risk for claims.” That is a sign that it is a self-insured plan. If you can't tell from your insurance card, you can call your insurance company to ask.