Limited Medical & MEC —
Coverage That Goes Where Major Medical Doesn't.
Whether it’s ACA compliance for your large employer groups or basic benefits for your hourly workforce, OptiMed has the plan.
Minimum Essential Coverage (MEC)
ACA Compliance Without the Major Medical Price Tag
For businesses with 50 or more full-time equivalent employees, the ACA employer mandate is not optional. Failing to provide qualifying coverage can cost employers up to $3,340 per full-time employee in IRS penalties — a real liability for any applicable large employer (ALE).
OptiMed’s MEC plan is an employer-sponsored, self-funded plan that satisfies the ACA preventive care mandate. It delivers 100% coverage for ACA-required preventive services, a national provider network, and $0 copay on preventive prescriptions at a cost that makes compliance attainable for businesses of all sizes.
For employers who want more than the baseline, MEC Pro+ adds physician office visits, mental and behavioral health coverage, diagnostic X-rays and labs, imaging, and emergency room benefits making it a comprehensive and cost-effective solution.
MEC Plan Highlights
- 100% coverage for ACA-required preventive services
- National provider network access
- $0 copay on ACA preventive prescriptions
- Employer sponsored, self-funded structure
- MEC Pro+: includes physician visits, mental/behavioral health, X-ray/lab, ER coverage
- Protects applicable large employers (ALEs) from ACA penalty exposure
Limited Medical Indemnity Plan
Real Benefits for the Workers Who Need Them Most
For part-time, hourly, and seasonal employees who are ineligible for major medical, OptiMed Health’s Limited Medical Indemnity Plan gives employers a way to offer real benefits at a realistic price point.
The plan pays pre-defined benefit amounts for the most common medical needs: doctor visits, emergency care, hospital stays, diagnostic testing, and more. Employees get financial support when they need care most, and employers get a benefits story that helps attract and retain workers in competitive labor markets.
These plans are a strong fit for franchise operators, multi-location retailers, restaurants, and any employer with a workforce that has historically been left without benefits options.
Covered Benefits Include
- Outpatient physician visits
- Urgent care
- Emergency room — sickness or injury
- Diagnostic lab and X-ray
- Advanced diagnostic testing (CT, MRI)
- Ambulance
- Surgery and anesthesia
- Daily hospital confinement
- ICU confinement
- Skilled nursing facility
- Indemnity outpatient prescription drugs