Help Center

Answers to your questions about Benefi MEC health plans, enrollment, claims, and member benefits.

Browse by topic

• Getting Started — What Benefi is, how it works, and how to get in touch.
• Plans & Coverage — Compare plans, understand coverage, and set up dependents.
• Quoting & Proposals — Quoting clients, building proposals, and positioning Benefi.
• Virtual Primary Care — Virtual doctors, mental health, labs, and 24/7 care.
• Account & Access — Sign in, reset passwords, and manage your account.
• Commissions & Payouts — How commissions work, renewal structure, and rate card access.
• Enrollment — How employees enroll, eligibility rules, and ongoing changes.
• Prescriptions — Filling prescriptions, the $0 formulary, and pharmacy tips.
• Billing & Payroll — Payroll integration, invoicing, and deduction reporting.
• Client Management — Certification, client implementation, and renewal support.
• In-Person Care — Preventive care, in-person visits, and finding providers.
• Troubleshooting — Common issues — invitations, ID cards, and quick fixes.
• ACA Compliance — ALE status, penalty math, affordability, and 1095-C filing.
• Plan Changes — Adding dependents, life events, and leaving coverage.

All articles

• Getting the Benefi rate card — Apply on the Brokers page — card in hand in 24 hours.
• How broker commissions work — PEPM, paid monthly via ACH. Same rate card for every broker.
• Getting lab work through Benefi — Your doctor can order labs and review results with you.
• Can Benefi be my primary care doctor? — Yes — or keep your existing PCP. Or both. Up to you.
• Care navigation: help figuring it out — Not sure what you need? A navigator walks you through it.
• Where to fill your prescription — Nationwide pharmacy network — chains and most independents.
• Deductibles and out-of-pocket max — Why MEC works differently than traditional insurance.
• How employee enrollment works — Invitations go by text and email. Employees enroll from their phone.
• How to submit a claim — Most providers bill Benefi directly. Here's what to do when they don't.
• Finding an in-network provider — Search the First Health network through the app.
• Plus: in-person medical visits — 5 primary + 1 specialist + 2 urgent care visits per year.
• 1095-C and 1094-C: what we file — Forms generated, distributed, and filed. You review and approve.
• How $0 prescriptions work — 500+ generics on Essential, 1,000+ on Plus — at $0.
• Pharmacy won't accept my card — First things to try before calling support.
• 1095-A vs. 1095-C: which do I get? — Employer coverage = 1095-C. Marketplace = 1095-A.
• Am I an Applicable Large Employer? — If you averaged 50+ FTEs last year, you're an ALE.
• Can I do a visit by phone? — Yes — text, phone, or video. Pick what works.
• Downloading the Benefi app — Free on iOS and Android. Use your invitation link to set up.
• Dependent coverage and pricing — Add spouse, domestic partner, or children under 26.
• If I leave my job — Coverage ends soon after — here's your options.
• My ID card is missing or wrong — Digital ID cards live in the app and update instantly.
• If your Rx isn't on the list — Ask your Benefi doctor about a covered alternative first.
• ACA penalties: 4980H(a) vs. (b) — Learn the difference between ACA's 4980H(a) and (b) penalties, how they're calculated, and proven strategies to avoid costly employer mandate fines.
• I didn't get my enrollment invitation — Check spam, confirm contact info, or ask us to resend.
• How to reach Benefi support — Phone, email, and in-app chat — English and Spanish.
• Positioning vs. MEC and major medical — Compliance + real care — neither cheapest nor priciest.
• Offering different plans by class — Segment by full-time, seasonal, or location — both plans allowed.
• When your situation changes — Marriage, birth, job loss — update your plan anytime.
• What Virtual Primary Care treats — Everyday conditions, refills, chronic check-ins, and more.
• How payroll integration works — 200+ systems — ADP, Gusto, Paychex, Toast, and more.
• Renewal commissions and BOR — Renewals pay as long as your client stays with Benefi.
• Continuous enrollment, not annual — New hires, terminations, dependent changes — anytime, no lock.
• Annual benefits check-in (optional) — Optional yearly re-verification window — great for census hygiene.
• Virtual urgent care, 24/7 — Faster than a clinic. Always open. Always $0.
• MEC vs. traditional health insurance — What Minimum Essential Coverage is — and what it isn't.
• Understanding your Benefi invoice — Enrollments, new hires, terms, and auto-reconciled credits.
• Affordability and safe harbor rules — Coverage is "affordable" under the IRS income threshold.
• Client implementation: what to expect — Most clients live in 5–7 days. You stay looped in.
• In-person preventive care at $0 — Annual physicals, screenings, vaccinations — fully covered.
• Eligibility rules and waiting periods — Standard 90-day wait or a custom rule — enforced automatically.
• Weekly, biweekly, or monthly billing — Pick the cadence that matches your payroll cycle.
• Is my health info private? — Yes — HIPAA-compliant. Mental health visits stay private.
• If I also have other insurance — Benefi works alongside a spouse's plan or marketplace coverage.
• What's included in Benefi coverage — Virtual care, $0 generics, mental health, preventive, and more.
• Adding dependents anytime — Spouse, domestic partner, or kids under 26 — no QLE needed.
• Essential vs. Plus: which to offer — $59 vs. $129 per employee. The difference is in-person access.
• What is Benefi? — ACA-compliant MEC with real virtual care, built for hourly workforces.
• How to count FTE employees — Full-time plus part-time hours — here's the IRS formula.
• How to talk to a doctor — Text, phone, or video, 24/7. Most visits connect in minutes.
• I can't sign in — what to try — Most sign-in problems come down to three things.
• Signing in to your Benefi account — Members, employers, and brokers each have their own sign-in.
• Downloading deduction reports — Export deduction files aligned to your payroll cycle.