California’s new individual health insurance mandate (2019 Ch. 38, SB 78) requires state residents to maintain minimum essential coverage (MEC) for themselves and their dependents starting on Jan. 1, 2020, or pay a state tax penalty. The mandate resembles the previous federal ACA individual mandate. 

The penalty for failure to maintain Minimum Essential Coverage is as follows:

• The annual penalty is the greater of: (1) $695 (adjusted based on the Consumer Price Index) per individual, up to a maximum of 3 or (2) 2.5% of household income. The penalty is assessed monthly; the monthly amount is 1/12th of the annual penalty. The penalty will apply to all uninsured members of a household that are reported in the individual’s tax return, including registered domestic partners (if filing a joint tax return).

How does this affect our Sedera membership?

Because Sedera health care sharing is not insurance, Sedera membership does not make an individual compliant with any state-level mandate recently passed or being considered in a given state. Any and all applicable penalties would still apply for employers and individuals who do not meet the coverage mandates. 

A Solution for Our Members?

We definitely have a solution available and are already utilizing it for many of our members! This solution includes a partnership with Apex Management Group. Apex began offering Minimum Essential Coverage (MEC) Plans as a way to support employer groups and individuals needing to meet the Federal Individual Mandate requirements. Not only does this protect individuals from the penalty, but it offers access to all 80 of the mandated preventive care services, inclusive of 21 preventive care services for adults, 28 for women and 31 for children. To see a complete list of covered preventive care services, please visit: www.healthcare.gov/coverage/preventive-care-benefits/.

One final benefit of adding this MEC plan is that it is HSA compatible. Health Savings Accounts can be great vehicles to set aside money, tax-free, for eligible medical, dental, and vision expenses both now and in the future.

To learn more, please contact us at care@wearefithealth.com