Are we offering coverage that meets the employer mandate for all eligible employees (30+ hours/week)?

To comply with the Affordable Care Act (ACA), large employers (those with 50 or more full-time employees) must offer affordable Minimum Essential Coverage (MEC) to at least 95 percent of employees working 30 or more hours per week and their dependent children up to age 26. The coverage must also meet Minimum Value (MV) standards for full-time employees.

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Understand the two parts of the employer mandate:

• Offer of Coverage (4980H(a)): Employers must offer MEC to at least 95 percent of full-time employees (those working 30 or more hours per week).
• Affordability and Minimum Value (4980H(b)): The plan must be affordable, meaning the employee-only premium does not exceed 8.39 percent of household income for 2024, and it must provide Minimum Value by covering at least 60 percent of expected healthcare costs, including hospital and physician services.

Failing either test can result in ACA penalties.

How different plan types meet these standards:

• Traditional major medical plans (PPO, HMO, EPO, HDHP): Typically meet both MEC and MV requirements.
• MEC-only plans: Meet the “offer of coverage” rule (4980H(a)) but not the Minimum Value requirement (4980H(b)). These are often used for part-time or lower-wage employees as a cost-effective compliance option.
• ICHRA (Individual Coverage HRA): Meets both MEC and MV when employees use employer contributions to purchase ACA-compliant individual coverage.
  
  

Best practice: Ensure all full-time employees (30 or more hours per week) are offered plans that meet both MEC and MV. Offer MEC-based options to part-time or variable-hour employees for affordable compliance coverage.

• Ensure affordability: Keep employee-only premium costs below 8.39 percent of household income by using one of the ACA’s safe harbor methods. Including $0 primary and preventive care helps employees actually use their coverage while maintaining compliance.
• Pair compliance with accessibility: Meeting ACA requirements is essential, but employees also need care they can afford and access easily. Plans with built-in primary care increase engagement, reduce emergency room visits, and improve satisfaction (turning compliance into meaningful coverage).

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Vitable works seamlessly with MEC, HDHP, and ICHRA plans to help employers maintain ACA compliance while improving affordability and access. Every member receives $0 virtual and in-home primary care, mental health support, and prescriptions, making compliant coverage simple and easy to use.

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To meet the ACA employer mandate:

• Offer MEC to at least 95 percent of full-time employees (30 or more hours per week).
• Ensure coverage is affordable and meets Minimum Value standards for full-time staff.
• Use Vitable alongside your existing plan to make compliance simple, affordable, and effective for your workforce.

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