What are MEC Plans?

Navia’s Minimum Essential Coverage (MEC) plans are separated into two different solutions – MEC and MEC Plus Plans.

MEC Plan

A Minimum Essential Coverage (MEC) plan is a self-funded benefit plan that covers preventative services only as outlined and required by the Affordable Care Act. These services are determined by the U.S. Preventive Services Task Force. With a MEC plan, we offer an open access network. Our participants are not limited to any provider list. Navia has a relationship with an open access network that allows members to choose any doctor of facility. Our open access network negotiates with all providers, to provide a reasonable allowance for services rendered.

MEC Plus Plan

MEC Plus plans with Navia can be customizable.  Although the ACA states which preventive services are covered, employers can determine what other services can be covered by the plan. MEC Plus plans follow the same guidelines as the MEC plan stated above as far as preventative services.  With a MEC Plus plan employers can add select services such as office visits, lab work, diagnostic testing, urgent care visits, prescriptions, and other services if they would like to provide a limited non-preventative benefit to their employees.

Participant Features

  • Easy to understand benefits breakdown
  • Dedicated MEC service team
  • Preventative care covered at 100% through our open access network

Employer Features

  • Configurable support for MEC plan types
  • Comprehensive enrollment and communications assistance
  • Dedicated MEC support team
  • Plan documents, SPDs, and non-discrimination testing
  • Responsive and experienced employer service team

Eligible Expenses

Our Navia Open Access network allows you to freely choose the medical providers and facilities you prefer. We are offering this approach to healthcare benefits to guide you to higher quality, lower cost healthcare. Navia Open Access will deliver the preventive services you need to stay healthy. We believe Navia Open Access also gives all of us a new level of transparency to ensure you are paying a fair and reasonable price for your care.

 

Interested in learning more?

Contact our sales team at 425.452.3498 or sales@naviabenefits.com

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For Individuals

Minimum Essential Coverage (MEC)
Fully covered preventative services

What is a MEC plan?

A Minimum Essential Coverage (MEC) plan is an employer funded benefit plan that covers preventative services only, as outlined by the Affordable Care Act. These services are determined by the U.S. Preventative Services Task Force.

Who and What is Covered?

A MEC plan covers preventative services you for your eligible dependents.

Preventive services include health care screenings, annual check-ups, and other specific services that are indicated to prevent illnesses, disease, and other health problems. All services must be ordered by your licensed physician or health care professional.

For a complete list of eligible services, please view our Eligible MEC Fact Sheet.

How Does it Work?

  • Enroll in a MEC plan. During your open enrollment select the MEC plan available.
  • Learn about your specific plan. Since each MEC plan is different, you will need to make sure you know your plan details.
  • See provider for services. Once you’ve received healthcare services from a provider, they will bill Navia.
  • Receive determination and payment. We will process the claim and send you an Explanation of Benefits (EOB) and payment with the benefit determination.

Price Transparency Compliance

Navia supports the need for transparency and the protection from surprise medical bills. To assist our participants with knowledge of average negotiated costs for certain eligible expenses, we will be providing information as required based on a 6-month look-back for all claims repriced since the inception of our open access network as of August 2022.

All information cannot be made available at this time as we do not have a historical look-back since changing to an open access network. Once this information is available, we will post the data, and update the information monthly.

If you have any questions relating to this information, please reach out to our office at 866-777-1320 and ask to speak a representative for MEC or MEC Plus claims.

Questions?

Call us at 866-777-1320 and ask to speak to a MEC representative.