Need MEC to meet the QSEHRA requirements? Here's a round-up of your best options.
QSEHRA is the new, tax-efficient way for small employers to offer health benefits. If your employer is offering you a QSEHRA, congrats! It may take a little bit to get the hang of, but we bet you'll quickly learn to love it. It's the only setup that allows employees to get reimbursed for individual health premiums and medical expenses (if allowed by the QSEHRA). Essentially, you're being handed a blank-check of pre-tax money to spend on what you need.
However, before you can participate in your employer's QSEHRA, you must provide proof of Minimum Essential Coverage (MEC). This is easy if you have a major medical plan or are covered by your spouse's group plan--you probably already have MEC! But what if you would like to use an alternative plan like a sharing ministry, short-term plan, indemnity plan, or another type of plan? These types of plans will not meet the MEC requirement on their own. The good news is there are options to purchase MEC for yourself and your family that will allow these plans to work with QSEHRA. MEC plans can also be a nice compliment to sharing ministries, short-term, and other alternative plans by covering preventive services not typically covered by alternative plans.
Important! The following vendors sell what's called P-MEC or "Preventive-Only MEC". These plans meet the MEC requirements by providing 100% of your and your families preventive care. These plans will not protect you if you're sick or injured and should not be considered insurance. They will just pay for your physicals, well visits, immunizations, screenings, and other preventive needs (you can see a full list of what they cover here) and nothing else. So please, make sure you've purchased adequate coverage to go along with these plans. We do not endorse these plans, although some vendors are offering discounts to our members. You will need to complete any applications with these vendors on your own. We simply are providing a list for you. Here you go!
SafeGuard Health offers three tiers of MEC plans, depending on how much coverage you’re looking to get from this plan. It provides some flexibility for you. In general, you may not want to pay for a lot of extra things built into the cost of the MEC, especially if you’re happy with your current plan and just need a MEC plan to get QSEHRA-compliant.
On the other hand, if you’re concerned about needing a little more coverage, you can look into the higher tiers, which provide some prescription coverage and even some specialist coverage.
Here is an overview of their plan pricing:
Before enrolling, you’ll want to read through their plan brochure to understand the benefits of each plan.
SafeGuard Health uses the First Health Network. If you want to use the preventive benefits of the plan, you'll want to make sure your primary care physician is in network with First Health. Their doctor search tool is a little outdated. Make sure to select "Physician" as the provider type you're searching for, select state or zip code, and then click "[+] Show more options" to enter your physician's name. Try Last Name, First Name and a few other variations if your doctor doesn't come up.
North American Health Plans
North American Health Plans offers a preventative MEC plan called SelectMed. There are also three levels of SelectMed plans available, and you can read through the benefits in each tier on their brochure here.
The basic plan covers just your preventative & wellness services. The higher tiers begin to add in some basic benefits for specialists, treatment of injuries, prescriptions, mental health, MRIs, etc. Be sure to read up on each plan, and the limitations on the benefits, to make sure you know what each one covers.
This MEC plan is not available in Alaska, Hawaii, Massachusetts, and New Hampshire.
To enroll, you can reach out directly to Lynne Timm, LUTCF, insurance advisor, at North American Health Plans, at firstname.lastname@example.org or 214-762-4247. Lynne can also help you research to find your doctors, and help you figure out what plan is best for you.
Essential Benefit Administrators
Essential Benefit Administrators (EBA) offers a basic MEC plan without many frills. This is good because you don't want to pay for a lot of extra things built into the cost of the MEC and can save your QSEHRA reimbursement dollars.
EBA is offering a discount on their prices to Take Command Health members. You can purchase a plan for yourself only or a combination for your spouse and kids (or both, which is "family"). Here is their pricing:
EBA uses the First Health Doctor network. If you want to use the preventive benefits of the plan, you'll want to make sure your primary care physician is in network with First Health. Their doctor search tool is a little out-dated. Make sure to select "Physician" as the provider type you're searching for, select state or zip code, and then click "[+] Show more options"t o enter your physician's name. Try Last Name, First Name and a few other variations if your doctor doesn't come up.
To enroll, you'll need to go through EBA. You can get the discounted Take Command Health price using this website or by calling EBA (1-888-292-0095) and mentioning our name.
Shared Health Alliance
Shared Health Alliance (SHA) created MEC plans to compliment sharing ministry programs like Medi-Share, Liberty Share, Christian Healthcare Ministries, and Samaritan Ministries among others. It also can work great with short-term or indemnity plans that provide sufficient catastrophic coverage.
SHA offers two versions of their MEC, "Preventive" and "Preventive Premier". We'd generally suggest going with the cheaper "Preventive" option and saving more money in your QSEHRA. However, you can download their plan brochure to compare yourself.
SHA pricing is based on single person enrolling, a "+1" option which could be a spouse or dependent, and finally the "Family" option which is anything more than one extra person. Here's SHA's pricing:
|Plan||Single||Single + 1||Family|
SHA does have some extra things baked in, even in their basic Preventive Plan. These include telemedicine and some prescription benefits. Upgrading to the Premier plan includes doctor visit copays and outpatient testing.
SHA uses the PHCS/Multiplan doctor network. If you want to use the preventive benefits associated with the SHA plan, you'll want to use the PHCS/Multiplan doctor search tool to make sure your physician is in network. Try searching by last name and pay attention to the zip code field which can throw the whole search off.
To enroll in an SHA plan, contact Billy Jordan at The Jordan Insurance Agency by email (email@example.com) or phone (704-817-4608). There is no discount available to Take Command Health members but Billy and SHA are familiar with the QSEHRA requirements.