Providing creative and innovative health insurance solutions that employers need.

Minor Medical Solutions

Focusing on Affordable Care Act compliance at the lowest cost to the employer with benefits employees can use.

Minor Medical Health Insurance Plans - Innovative Health Insurance Advisors

Our minor medical healthcare plans are designed to focus on “Daily Usable Benefits” employees need/want and employers can afford to offer. Our plan options are centered around complying with the rules and regulations outlined in the Affordable Care Act relating to the employer and employee mandate penalties. These plans have great flexibility, and additional benefits can easily be added to the platform structure that will meet the employee’s additional needs.

In general, employers want to offer benefits to secure their employees and attract new talent. But in some situations Major Medical coverage is just too costly. Our “Minor Medical” is the perfect solution for those employers that are focusing on cost containment and daily usable benefits for their employees.

  • Basic MEC Plan – $35 PEPM

    25 enrolled

    ACA “A” penalty compliant

    Covered Benefits:

    • Minimal Essential Coverage
    • 73 Covered Wellness & Preventative
    • ZERO Copay & Deductible
    • Rx Discount Plan

    Included Administrative Services

    • Cobra Administration
    • Census Enrollment
    • Benefit ID Cards
    • Employer/Employee plan management portal
    • Bilingual enrollment material

    Request For Proposal

    Enhanced MEC Plan – $69 PEPM

    25 enrolled

    ACA “A” penalty compliant

    Covered Benefits:

    • Minimal Essential Coverage
    • 73 Covered Wellness & Preventative
    • ZERO Copay & Deductible
    • Primary Care Doctor – 3x per year with copay
    • Specialties visits with network discount
    • Urgent Care with network discount
    • Laboratory services with network discount
    • Rx Discount plan
    • Telehealth

    Included Administrative Services

    • Cobra Administration
    • Census enrollment
    • Benefit ID cards
    • Employer/Employee plan management portal
    • Bilingual enrollment material

    Request For Proposal

    Superior MEC Plan – $95 PEPM

    25 enrolled

    ACA “A” penalty compliant

    Covered Benefits:

    • Minimal Essential Coverage (MEC)
    • 73 Covered Wellness & Preventative
    • ZERO Copay & Deductible
    • Primary Care Doctor – unlimited visits per plan year (co-pay)
    • Specialist visit – (co-pay)
    • Non-Preventative Well Baby visit & care (co-pay)
    • Urgent Care (co-pay)
    • Laboratory Services (co-pay)
    • X-Rays (co-pay)
    • Telehealth
    • Generic Rx Drugs – (co-pay)

    Included Administrative Services

    • Cobra Administration
    • Census enrollment
    • Benefit ID cards
    • Employer/Employee plan management portal
    • Bilingual enrollment material

    Request For Proposal

    Premiere MEC Plan – $180 PEPM

    25 enrolled

    ACA “A” penalty compliant

    Covered Benefits:

    • Minimal Essential Coverage (MEC)
    • 73 Covered Wellness & Preventative
    • ZERO Copay & Deductible
    • Primary Care Doctor – unlimited visits per plan year (co-pay)
    • Specialist visit – (co-pay)
    • Non-Preventative Well Baby visit & care (co-pay)
    • Urgent Care (co-pay)
    • Laboratory Services (co-pay)
    • X-Rays (co-pay)
    • Telehealth
    • Generic Rx Drugs – (co-pay)
    • Hospitalization
    • Emergency Room
    • In/Outpatient Surgery
    • Ambulance

    Included Administrative Services

    • Cobra Administration
    • Census enrollment
    • Benefit ID cards
    • Employer/Employee plan management portal
    • Bilingual enrollment material

    Request For Proposal

  • Basic-MEC/MVP Plan – $48 PEPM

    (pricing based on 125 enrolled in MEC, minimum enrollment is 25)

    ACA “A and “B” penalty compliant

    Covered Benefits:

    • Minimal Essential Coverage
    • 73 Covered Wellness & Preventative
    • ZERO Copay & Deductible

    Minimum Value offer – ($435.00 Per enrolled)

    • Zero enrollment requirement
    • Meets 60% Minimum Value & Affordability requirements
    • High deductible plan
    • Stop Loss Policy – A.M. Best Rated
    • No Underwriting requirement
    • PHCS MultiPlan Network & Reference Based Pricing model
    • 100% of unused claims funding is returned

    Included Administrative Services

    • Cobra Administration
    • Census enrollment
    • Benefit ID cards
    • Employer/Employee plan management portal
    • Bilingual enrollment material

    Request For Proposal

    Superior-MEC/MVP Plan – $128 PEPM

    (pricing based on 50 enrolled in MEC, minimum enrollment is 25)

    ACA “A and “B” penalty compliant

    Covered Benefits:

    • Minimal Essential Coverage
    • 73 Covered Wellness & Preventative
    • ZERO Copay & Deductible
    • Primary Care Doctor – 3 visits per plan year (co-pay)
    • Specialist – 3 visits per plan year (co-pay)
    • Urgent Care – 1 visit per plan year (co-pay)
    • Laboratory, X-ray, Diagnostic, Pathology Services – 3 visits per plan year (co-pay)
    • Generic Rx Drugs (co-pay)

    Minimum Value offer – ($435.00 Per enrolled)

    • Zero enrollment requirement
    • Meets 60% Minimum Value & Affordability requirements
    • High deductible plan
    • Stop Loss Policy – A.M. Best Rated
    • No Underwriting requirement
    • PHCS MultiPlan Network & Reference Based Pricing model
    • 100% of unused claims funding is returned

    Included Administrative Services

    • Cobra Administration
    • Census enrollment
    • Benefit ID cards
    • Employer/Employee plan management portal
    • Bilingual enrollment material

    Request For Proposal

    Executive/Key Employee – Level Funded Plan Options

    (10ee enrollment requirement, final pricing subject to underwriting)

    ACA “A and “B” penalty compliant

    Plan Options:

    • 12 different plan options – Bronze/Silver/Gold/Platinum
    • Individual – Family deductibles ranging from $6000/$12000 – $250/$750
    • Plan selection can be either PPO network or
    • Reference Based Pricing structure
    • Ability to offer more than one plan option
    • Level funded plan structure
    • 100% of unused claims funding returned
    • Telehealth
    • Medical Questionnaires required
    • Single plan offer has 10ee enrollment requirement, multiple plan offering must have 10ee combined enrolled
    • All plans meet 60% Minimum Value, Affordability and Minimal Essential Coverage requirements
    • First Health National Network
    • 12/18 contract

    Included Administrative Services

    • Cobra Administration
    • Census enrollment
    • Benefit ID cards
    • Employer/Employee plan management portal
    • Bilingual enrollment material

    Request For Proposal

*Minimum enrollment requirement of 25.
*If offering multiple plan, there must be 25 enrolled in one plan and 5 minimum enrolled in the other plans offered.
*Annual setup and implementation fee $750.
*The Provider Network is PHCS MultiPlan.
*All Minor Medical plans are administrated by Staff Benefit Management & Administrators


Minor Medical Health Insurance Plans - Innovative Health Insurance Advisors

Affordable Care Act Noncompliance Penalties

Penalty A: The Employer Mandate:

  • Employers must offer a Minimum Essential Coverage (MEC) to any benefit-eligible employee.
  • Noncompliance will result in a penalty of $2,260 PER all eligible employees.

Penalty B: The Employer Mandate:

  • Employers must offer a Minimum Value (MV) plan that meets 60% actuarial value and must include hospitalization services.
  • The MV plan must be offered at maximum contribution of 9.69% of the employee’s income.
    • Example: $10/hr. employee, working a minimum 30 hours per week, has a maximum employee contribution of $123.50 per month.
    • If the plan cost is $300, employer pays the difference of $176.50 per month.
  • Noncompliance will result in a $3,390 penalty PER employee whom enrolls in coverage through the state exchange and receives a premium subsidy.

The Individual Mandate

An individual who does not have MEC will incur an individual penalty of $695 or 2.5% of their salary, whichever is greater.


Our plan options will be based on a Level Funding platform which allows the employers to regain control of their plan design and cost.

Level Funding is a type of self-funding that is unique to the marketplace. Level funding allows groups to safely transition to self-funding with predictable monthly claim funding and protections to limit liability.


Speak with a Representative

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1.800.413.7487