Starmark Healthy Incentives®

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Presentation transcript:

Starmark Healthy Incentives® Self-funded plan designs and stop-loss insurance for small to mid-size businesses

Starmark® and Trustmark A Trustmark company founded in 1985 Provides healthcare benefits administration for small to mid-size businesses Stop-loss insurance is provided by Trustmark Life Insurance Company Trustmark Companies Providing employee benefits for more than 100 years More than 2 million covered lives or plan participants Trustmark Life Insurance Company is rated A- (Excellent) by A.M. Best

Starmark Healthy Incentives® A self-funded health plan design with stop-loss insurance that feels like a fully insured plan for members The Healthy Incentives Difference Flexibility in plan design Set monthly payments Opportunity to get money back Transparency on how claim dollars are spent Stop-loss coverage included

Starmark Healthy Incentives® Thousands of plan design combinations with NO set plan designs PPO CDHP Therapy Copays HSA Office Copays Out-of-Pocket Limits X-Ray and Lab Prescription Benefits HRA Alternative Medicine Copays CareChampion 24/7® Health Advocacy Program Inpatient Admission and Outpatient Surgery Access Fee Choices Urgent Care Chiropractic Copays Maternity Emergency Room Copay YourCare Health and Wellness Program Coinsurance Health Benefits Packages Supplemental Accident Embedded Deductibles

Starmark Healthy Incentives® [Network] Individual Deductible [insert amount] Coinsurance Individual Out-of-Pocket Limit Office Visit Copay Urgent Care Copay Emergency Room Copay X-Ray and Lab Prescription Benefit For costs and further details, including exclusions and limitations, contact your Starmark® representative.

Starmark Healthy Incentives® Plan Design 1 Plan Design 2 Network [insert name] Individual Deductible [insert amount] Coinsurance Individual Out-of-Pocket Limit Office Visit Copay Urgent Care Copay Emergency Room Copay X-Ray and Lab Prescription Benefit For costs and further details, including exclusions and limitations, contact your Starmark® representative.

Self-Funding Monthly Cost Monthly Cost Breakdown 1 2 Monthly Cost Employee [23] [$ 354.53] Employee + Spouse [0] [$ 815.41] Employee + Child [$ 673.60] Full Family [$ 1,134.48] [$ 8,154.19] Monthly Cost Breakdown Stop-Loss Premium [$ 3,924.26] Administrative Fee [$ 1,799.98] Claim Pre-funding [$ 2,429.95] [$8,154.19] Claim Pre-funding x 12 months = Aggregate Attachment Point 3 Stop-Loss Insurance Limits Aggregate Attachment Point [$ 29,158.00] Specific Deductible [$ 15,000.00] Runout Period [9 months] Specific Deductible is the limit to which a covered person’s covered claims can be paid from the Claim Pre-funding Dollar figures are used for illustrative purposes only. Final rates are subject to underwriting review. Actual figures will vary by group and plan design.

Self-Funding Monthly Cost Monthly Cost Breakdown 1 2 Monthly Cost Plan Design 1 Plan Design 2 Employee [59] [$ 313.26] [10] [$ 268.53] Employee + Spouse [0] [$ 720.50] [$ 617.62] Employee + Child [$ 595.19] [$ 510.20] Full Family [$ 1,002.43] [$ 859.29] [$ 15,349.74] [$ 2,685.30] Monthly Cost Breakdown Plan Design 1 Plan Design 2 Stop-Loss Premium [$ 5,598.74] [$ 1,051.50] Administrative Fee [$ 2,378.46] [$ 428.70] Claim Pre-funding [$ 7,372.54] [$ 1,205.10] [$ 15,349.74] [$ 2,685.30] Claim Pre-funding x 12 months = Aggregate Attachment Point 3 Stop-Loss Insurance Limits Annual Aggregate Attachment Point [$ 102,933.00] Specific Deductible [$ 25,000.00] Runout Period [15 months] Specific Deductible is the limit to which a covered person’s covered claims can be paid from the Claim Pre-funding Dollar figures are used for illustrative purposes only. Final rates are subject to underwriting review. Actual figures will vary by group and plan design.

Express Connect® Paperless Enrollment 2 easy ways to enroll Phone – Employees enrolling or waiving call a toll-free number Online – Simple, secure enrollment via the Internet Minimizes back and forth for missing information Traditional paper enrollment is also available.

Reporting Transparency Comprehensive reports help clients better understand and manage their healthcare spending.

CareChampion 24/7® Healthcare simplified Optional health advocacy service Advisors are available anytime, day or night Advisors can help members find a doctor or hospital in-network, understand healthcare benefits and claim payments, identify cost-saving opportunities, handle eldercare issues and more!

ID Card

Why do groups choose Starmark®? Competitive rates and flexible plan designs with great benefits -- We can tailor a plan the way you want it! Excellent reputation for processing claims timely and accurately Enrollment is easy with Express Connect® Unparalleled personal service CareChampion 24/7® helps simplify healthcare Nearly 30 years of expertise in group healthcare benefits Trustmark Companies, an employee benefits company for more than 100 years Trustmark Life Insurance Company is rated A- (Excellent) by A.M. Best

Terminating a Plan Off-Anniversary If the stop-loss insurance contract terminates before the end of the contract period: There is no aggregate stop-loss insurance available for the months the contract was in force. The employer is responsible for reimbursing Trustmark Life Insurance Company and/or Starmark® for any aggregate advances and aggregate stop-loss insurance claims paid. The employer is also responsible for paying all covered claims, below the specific deductible, that were incurred and not paid while the plan was in force. If the 2/3 Administrative Fee Credit Surplus or the 2/3 Administrative Fee Credit, 2/3 Cash Surplus option was selected, the employer forfeits the surplus.    

Get Started Today! MBS Rep Name Title first.last@trustmarkins.com 000.000.0000, ext. 0000 123 Main Street • City, ST 00000 For costs and further details, including exclusions and limitations, contact your Starmark® representative. Plan design availability and/or stop-loss insurance coverage may vary by state. Self-funded plans are administered by Starmark, and stop-loss insurance is provided by Trustmark Life Insurance Company, Lake Forest, Illinois. T500-266-br (11-14)