Trustmark Small Business BenefitsLevel Funded Health Plans
Previously operating asStarmark, the company has recently re-branded themselves as “Trustmark Small Business Benefits®” (Trustmark). Trustmark has been in business since 1913.
Trustmarkspecializes inhelping employers of ALL sizes take control of healthcare spending.For small businesses they provide Level Funded, self-funded plans utilizing both traditional, national and regional PPO networks and innovative Reference Based Pricing provider payment options (see more below).Trustmark plans provide the ultimate in flexibility allowing anyone to customize a benefit plan to fit their cost and benefit needs.
Despite the new brand, their values remain the same. They believe all businesses – regardless of size – deserve affordable, tailored, health benefit plan designs that match their needs, meet business goals and help employees thrive. Customers rave about their service, caring approach and unmatched knowledge and experiencein self-funding.
Trustmark Small Group Level Funded Plans
Trustmark offers three different level funded, partially self-funded plan options. Availability of each plan varies by state. To check which options are available in your state, you can go to our US Health Plans page and click on the link for your state. An easier way is to click on the Trustmark Product Availability link and select your state from the dropdown menu.
Trustmark Healthy Choices –Designed to address rising healthcare costs for small to mid-size employers, these innovative self-funded plan designs without a PPO network help control plan costs while enabling employers to offer freedom of provider choice. These are also known as Reference Based Pricing plans. With these plans, provider reimbursem*nt rates for most covered healthcare services are based on the Reasonable Fee, which is typically calculated at a multiple of the Medicare reimbursem*nt rate.
Trustmark HealthyEdge –In more than 30 states, these plan designs provide employers with control over health benefit solutions and the flexibility to tailor a plandesign to meet specific needs. These plans are paired with your choice of PPO networks in your state (see below). HealthyEdge plans provide your employees with a familiar PPO plan while providing you with the opportunity to save money compared to fully insurance ACA/Obamacare group health plans.
Trustmark Healthy Incentives – In a dozen states, these plan designs provide employers with control over health benefit solutions and the flexibility to tailor a plandesign to meet specific needs.These plans are paired with your choice of PPO networks in your state (see below). Healthy Incentives plans provide your employees with a familiar PPO plan while providing you with the opportunity to save money compared to fully insurance ACA/Obamacare group health plans.
NOTE: On all of the above Trustmark plans, employers must have 5 or more enrolled employees to be eligible. The one exception is North Carolina, which has no minimum eligibility requirement.
About Level Funded Health Plans
As noted on our NAHP Alternative Health Plan Solutions page, Level Funded plan premiums are typically (at least)15-20%lessthan the same plan design on an ACA/Obamacare, fully insured group plan. Plus, in most years with average to below average usage of the plan, there is an opportunity to receive anadditional refundat the end of each plan year.
In addition to typically starting with lower monthly premiums, a Level Funded health plan can save employers more money by paying the claims of their employees with their own money instead of insurance premiums.
With a Level Funded group health plan:
- You pay one, level (fixed) monthly premium(Just like with a fully insured ACA/Obamacare plan).You never have to pay more than this fixed amount each month.
- Your monthly payment is split into three “buckets” to cover:
- Administrative costs of your plan
- Stop-loss insurance and
- Funding your Claims Account to pay for your employee’s claims that are below the limits of yourStop-loss insurance
In most cases there are two separateStop-loss insurancepolicies built in to your Level Funded plan. They protect you:
- Ifany one individual plan member haslarge claimsduring the year and
- If the overall group claims exceed the total of your Claims Account for the year.
After all claims have been paid for the plan year (after a run-out period of a set number of months), you are eligible to get back some or all of the remaining dollars in your Claims Account. When you start your plan, you choose how much you want to get back from the unused funds in your Claims Account. You can choose to get a refund check or use the money to lower your costs for the next year.
Trustmark Healthy Choices and Reference Based Pricing Provider Payment Information
Reference Based Pricing (RBP) is a uniquestrategy that has beenleveraged by large employers, to determine reimbursem*nt rates to providers based on a multiple of Medicare.
Advantages of reference-based pricing are many and include:
- Maximum cost-savings – Reference-based pricing uses fixedpricing across providers for healthcare services based on amultiple of Medicare, preventing provider pricing variancesfor the same services that can be as much as 500%, withno difference in quality.
- True Provider Choice – Plan participants are eligible toreceive care from any provider within the United States.There are no network restrictions.
- Claim Advocacy – Trustmark provides negotiation services with providers on claim amountsabove the reasonable fee (known as “balance billing“), striving to retain savings onbehalf of the plan.
- Unique Approach for Small to Mid-Size Groups –Featuring all of the advantages of self-funded health plandesigns, reference-based pricing also mitigates cost andencourages consumer knowledge of and participation inhealthcare choices.
- Increased Transparency – Trustmark provides the use of HealthcareBluebook, an online transparency tool, to help plan participantsreceive a truer picture of provider cost and quality.
To learn more about Trustmark Healthy Choices plans and their Reference Based Pricing (RBP) payment model, please watch this short Healthy Choices and RBP Video.
Trustmark Provider (PPO) Network Availability
Trustmark works with multiple local and national Preferred Provider (PPO) networks to pair with their Healthy Incentivesand HealthyEdge plans.To see the available networks in your state, click on the Trustmark Network Availability linkand select your state from the dropdown menu.
TrustmarkSmall Group Level Funded Plan Quotes
If you would like to get a group health insurance quote for your business,the first step is to download and complete our group census formhere:
US Insurance Solutions Group Census form.xls
Please email the completed form to:robtavis@ushealthinsurancesolutions.com
Schedule a Call With Me:
Once you have completed and emailed the completed census form, please go to the link above that saysCALL MEto schedule a consultation on my online calendar to discuss your situation and needs so that we can come up with the BEST health plan for your company.
