Which statement correctly distinguishes a Qualified Health Plan (QHP), Minimum Essential Coverage (MEC), and Essential Health Benefits (EHB)?
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
The three ACA terms serve different functions. A Qualified Health Plan is a plan certified by an exchange (such as Covered California) that meets EHB, actuarial value, and other requirements. Minimum Essential Coverage is the floor of coverage — employer plans, Medicare, Medicaid, and other specified plans — that satisfies the ACA's coverage requirement. Essential Health Benefits are the ten statutory benefit categories, such as ambulatory care, emergency services, hospitalization, maternity, mental health, prescription drugs, and pediatric services including dental and vision, that non-grandfathered individual and small-group plans must cover. Mixing these three definitions is a frequent exam trap under AH-III.C.4.
Why the other options are wrong
- B) MEC and EHB are different concepts: MEC is the minimum coverage that avoids the ACA penalty, while EHB are the benefit categories a qualifying plan must include.
- C) A QHP must cover the full EHB package; catastrophic plans are a separate limited category for young adults and hardship cases, not a QHP description.
- D) EHB apply to individual and small-group (and exchange) plans; large group plans are not subject to the EHB mandate.
Memory hook
QHP = sold on exchange, must cover EHB. MEC = enough coverage to satisfy ACA. EHB = the benefit menu.