Minimum Essential Coverage
The Affordable Care Act (ACA) requires that nearly all Americans must have health insurance coverage that meets a minimum value standard (called minimum essential coverage or MEC).
MEC and Affordability Standards
If a consumer has access to employer-sponsored insurance (ESI), but is not enrolled, the employer-sponsored insurance must meet BOTH of the following standards to disqualify the consumer for MinnesotaCare or advanced premium tax credits (APTC).
- Minimum value standard: the plan covers 60 percent of the total allowed costs of benefits provided to the employee under the plan (the equivalent of a bronze plan).
- Affordability standard: the employee portion of the annual premium for self-only coverage is not more than 9.66% of the employee's annual household income (percent is decided by the IRS, and is subject to change).
If the ESI meets these two standards, the individual is treated as eligible for MEC and is not eligible for MinnesotaCare or APTC.
To find out if your job-based plan meets the minimum standard, have the employer fill out this form (PDF).