Anyone Know of MEC Wellness Plan that Provides a 1095-A to Avoid Penalty?

[kgarv]

Hey everyone,

I came across a $67.99 per person MEC wellness plan that is designed to be used with STM and indemnity plans that will provide the needed basic MEC benefits in order to meet ACA guidelines. It also provides a 1095-A to use for tax/penalty purposes.

Problem is, I thought I bookmarked that page but I didnt and no matter how hard I search, I can't seem to find it again. Anyone have any insight on who offers this type of supplemental benefit?

BTW, just joined today although I have used the forums as a great resource over the years. I value all the input that comes from this site. Glad to be a member of the group.

KGarv

 

[mschlange]

Did you find out who sells the individual MEC?

 

[Northeast Agent]

I recently contracted with an IMO in TX called North American Life Plans. They are offering a MEC that supposedly keeps you out of the ACA penalty box for $68.40 monthly for a single person, which offers wellness visits, etc. You pair it with a particular hospital indemnity plan. Other ancillaries may be added, like dental, prescription coverage, critical illness, etc.

I received an email the other day that there's now a new TPA. The contact person I have at NALP was out for 2.5 weeks and just came back. I've had some questions which are still unanswered. I need a better clarification on how to better explain indemnity/MEC vs major medical to potential clients.

One issue that I see with the MEC is that mammograms are only covered every other year, instead of yearly, like ACA plans are. Another example with the HIP is someone going to see a dermatologist to have a mole removed. This service would only be allowed under the office visit benefit, even if the visit and procedure were billed at the same time. So, you'd get a certain dollar amount for the office visit and that's it. There was a short term medical plan you could offer with this which would have provided more coverage as well to fill in more gaps, but as of April 1st you can only sell them for three months at a time before they have to be re-written. And only complications of maternity are covered.

When I do the math, if they get a subsidy they are better off with an ACA plan.

 

[mschlange]

Is this a captive agency or how do I get information on this product?
Are there commissions on this?

 

[Northeast Agent]

Watch this video. There seem to be some changes going on with the product, TPA etc right now.

https://www.youtube.com/watch?v=YAv6wNBDeKo&feature=youtu.be

 

[junkman]

I'd only buy that if it was worth it to avoid the penalty. The presenter talks as if it solves insurance coverage problems. It does not provide much. Subtract commissions and any over rides from the premium then subtract overhead expense at say 80% if it follows the loss ratio of regular medical coverage and you have the net available to cover premiums - ie not much.

People subject to the tax by definition have some money and can afford to pay for their own physical. Premiums are so high that many can avoid the tax. The lowest (old) family of 3 premium in a county I have a cabin in is $20,600. 20,600/.0825 = 249,745 MAGI that will not have the penalty. Subsidy stops for this family at 80,000 if numbers on exchange are accurate.

 

[TN_agent]

I'd only buy that if it was worth it to avoid the penalty. The presenter talks as if it solves insurance coverage problems. It does not provide much. Subtract commissions and any over rides from the premium then subtract overhead expense at say 80% if it follows the loss ratio of regular medical coverage and you have the net available to cover premiums - ie not much.

People subject to the tax by definition have some money and can afford to pay for their own physical. Premiums are so high that many can avoid the tax. The lowest (old) family of 3 premium in a county I have a cabin in is $20,600. 20,600/.0825 = 249,745 MAGI that will not have the penalty. Subsidy stops for this family at 80,000 if numbers on exchange are accurate.

Jeez, how old are you junkman???

 

[junkman]

Jeez, how old are you junkman???

Old - with a young wife - who helps me save money instead of spend it. Best of both worlds.

Of course, young is relative especially after you've kept them for a while - but I don't suggest trading unless you need to.

 

[Rosebud Girl]

I came on here to check out North American Health Plans or North American Life Plans, same company. Trying to evaluate them, sounds almost captive even though they say it's not. Seems to me like they pay a pretty low commission on a lot of their stuff. They do say they make it up with training, support and marketing dollars but if you're even just a moderate producer it doesn't make financial sense to me. Anyone else had any experience with them?

They do have a cheap MEC plan to use with short term, etc.

They do seem to be attracting a lot of agents.

 

[SusieQ2]

I recently contracted with an IMO in TX called North American Life Plans. They are offering a MEC that supposedly keeps you out of the ACA penalty box for $68.40 monthly for a single person, which offers wellness visits, etc. You pair it with a particular hospital indemnity plan. Other ancillaries may be added, like dental, prescription coverage, critical illness, etc.

I received an email the other day that there's now a new TPA. The contact person I have at NALP was out for 2.5 weeks and just came back. I've had some questions which are still unanswered. I need a better clarification on how to better explain indemnity/MEC vs major medical to potential clients.

One issue that I see with the MEC is that mammograms are only covered every other year, instead of yearly, like ACA plans are. Another example with the HIP is someone going to see a dermatologist to have a mole removed. This service would only be allowed under the office visit benefit, even if the visit and procedure were billed at the same time. So, you'd get a certain dollar amount for the office visit and that's it. There was a short term medical plan you could offer with this which would have provided more coverage as well to fill in more gaps, but as of April 1st you can only sell them for three months at a time before they have to be re-written. And only complications of maternity are covered.

When I do the math, if they get a subsidy they are better off with an ACA plan.

I'm curious to know what you think of North American Health Plans after you've been contracted for a while. I know another agent that likes them but they are friends with the owner, so not sure how "honest" their opinion is.