Minimum Value

Going hand-in-hand through the ACA regulations with Minimum Essential Coverage (MEC), which we posted about earlier this week, is Minimum Value (MV). 

What is Minimum Value?
Healthcare plans meet a Minimum Value (MV) if they’re designed to pay for at least 60% of the total cost of medical services for a standard population, according to the Affordable Care Act (ACA). This minimum standard is the equivalent of a Bronze plan sold on the Health Insurance Marketplace. The plan’s benefits must also include a substantial amount of any inpatient hospital and physician services necessary.

In order to remain completely compliant with the ACA, the healthcare plan you as an employer offer your employee(s) must offer both Minimum Essential Coverage and meet the Minimum Value allowed. If the plan you offer doesn’t meet MEC or MV standards, you might have to pay an employer shared responsibility payment.

An employer shared responsibility payment is incurred when their employee receives a premium tax credit when purchasing additional insurance from the Marketplace. Since the employee would only receive this tax credit if their existing insurance didn’t meet MEC or MV guidelines, this could launch an IRS investigation into your coverage offers and you could end up paying out of pocket for each full-time employee considered under-covered.

However, just because an employee seeks additional insurance from the Marketplace doesn’t mean he/she will automatically receive the premium tax credit. If the insurance you provide meets MEC and MV, the employee will still be able to purchase additional coverage but they won’t be eligible for the credit.

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