MEC Plans
MEC Max™
A fully insured Minimum Essential Coverage (MEC) solution that provides ACA compliance, fixed monthly costs, and a worry-free employer experience with no claims funding responsibility.
MEC Max™
Fully Insured Minimum Essential Coverage with Fixed Monthly Premiums
MEC Max offers a selection of fully insured Minimum Essential Coverage (MEC) plans with fixed monthly premiums and no employer claims liability. Employers can choose from multiple pre-designed plan options that satisfy applicable ACA Minimum Essential Coverage requirements while providing predictable costs, simplified administration, and no exposure to medical claims risk.
MEC plans are designed primarily to cover preventive and wellness services required under the Affordable Care Act, including annual wellness exams, immunizations, and other preventive care services when received from participating providers. Depending on the selected plan, additional limited benefits such as primary care, specialists, urgent care, x-rays, or prescription discounts are available.
Unlike comprehensive major medical plans, MEC Max does not provide broad hospitalization or major medical coverage. Inpatient hospital services, most surgeries, specialty care, and other high-cost medical services are generally not covered unless specifically included through a supplemental benefit or separate medical plan.
MEC Max is an ideal solution for employers seeking a low-cost, fully insured benefit option that satisfies ACA Minimum Essential Coverage requirements while offering complete budget certainty, simplified administration, and no exposure to unexpected medical claims.
Fixed monthly premium
Predictable, budget-friendly cost with no funding surprises.
No claims risk
Carrier assumes all claims liability — fully insured structure.
ACA-compliant
Satisfies Minimum Essential Coverage requirements.
Plan Options
Available Plan Options
Basic
Designed for employers seeking the lowest-cost MEC solution.
- Preventive and wellness services only
- ACA-required preventive care and screenings
- Satisfies Minimum Essential Coverage (MEC) requirements
Basic Plus
Includes all Basic benefits, plus:
- Up to 3 primary care physician office visits
Premium
Includes all Basic benefits, with enhanced access:
- Up to 3 combined primary care physician and specialist office visits
- Up to 3 urgent care visits
- Up to 3 laboratory services
- Up to 3 diagnostic X-ray services
Premium Unlimited
Includes all Basic benefits, with unlimited access:
- Primary care physician and specialist office visits
- Urgent care visits
- Laboratory services
- Diagnostic X-ray services
Advantages
MEC Max — Advantages
Core Advantages
- Fully insured structure with no employer claims risk
- Fixed monthly premiums for predictable budgeting
- Simple plan design with minimal administrative burden
- Satisfies ACA Minimum Essential Coverage (MEC) requirements
- No stop-loss, claims funding, or actuarial variability exposure
Financial Advantages
- No exposure to high-cost or catastrophic medical claims
- Stable, predictable monthly cost structure
- Eliminates volatility associated with self-funded claims experience
- Easier budgeting and forecasting for HR and finance teams
- Reduced need for reserve or claims funding accounts
Operational Advantages
- Streamlined enrollment and eligibility administration
- Carrier-managed claims processing and customer service
- No employer involvement in claims adjudication or funding cycles
- Simplified compliance reporting and plan administration
- Reduced reliance on TPAs for claims management functions
Strategic Advantages
- Ideal entry point for employers new to health benefits
- Can be paired with supplemental benefits or buy-up options
- Supports workforce compliance without financial complexity
- Useful as a foundational layer in multi-plan benefit strategies
- Predictable alternative to self-funded or hybrid funding models
MEC Max — FAQs
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Plan Disclosure: MEC Max™ is a Minimum Essential Coverage (MEC) plan designed to provide specified benefits and support applicable ACA coverage requirements. MEC coverage is not comprehensive major medical insurance and should not be represented as providing the same level of coverage as a traditional major medical plan. Benefits, limitations, exclusions, eligibility, and ACA compliance depend on the specific plan selected and applicable requirements. In the event of any discrepancy, the official plan documents shall govern.