February 2001
Trustmark Takes Action to Control Drug Costs
Because prescription drug costs are rising even faster than other healthcare
costs, Trustmark Insurance Company
took action to help keep costs under
control. Pending state availability, the
following options are now available.
Three-Tier Copayment
Employees may choose a three-tiered
prescription drug copayment plan.
The Generic/Preferred Brand-Name/
Non-Preferred Brand-Name deductible
choices are:
•
•
•
•
•
•
•
$5/10/20
$5/10/25
$5/10/30
$5/15/25
$5/15/30
$5/20/30
$5/25/35
•
•
•
•
•
•
•
$5/30/40
$10/20/30
$10/25/35
$10/30/40
$10/35/45
$15/25/35
$15/30/40
Two-Tier Coinsurance (Retail Only)
Employees may choose a coinsurance
level after the copayment is met. The
two-tiered coinsurance levels (Generic/
Preferred Brand-Name) include the
following options:
• 100/100
• 100/90
• 100/80
• 100/70
• 100/100/80
• 100/100/70
• 100/90/90
• 100/80/80
• 100/80/70
• 100/70/70
MIP Deductibles
Employees may choose a separate prescription drug deductible (in addition
to the medical deductible) with the
Managed Indemnity Program (MIP),
when the drug card is not selected.
The deductible choices are:
• $50
• $75
• $100
• $150
• $200
• $250
Three-Tier Coinsurance (Retail
Only)
Prescription Drug Dispensing
Changes
The three-tiered coinsurance levels
(Generic/Preferred Brand-Name/
Non-Preferred Brand-Name) include
the following options:
Effective March 1, 2001 for new
groups, and May 1 for renewal groups,
the contract language has been
changed for quantity dispensing of
prescription drugs at a retail pharmacy.
Quantity will now be restricted to a
34-day supply, with the maximum of
• 100/100/100 • 100/90/80
• 100/100/90 • 100/90/70
100 tablets or dosage units to be dispensed per individual prescription,
whichever is less.
The following examples explain how
the new changes are applied:
1. Those members whose medication only
required one pill per day could have
received up to a 100-day supply. They
will now be limited to a maximum of
34-day supply.
2. Those members whose medication is
dosed multiple times per day (i.e. 4x
per day) were able to receive the full
34-day supply (136 units). As of
March 1, 2001, they will only receive
a maximum of 100 units (25-day
supply).
If you have any questions about
Trustmark prescription benefits or
state availability, please contact your
Trustmark representative.
Mental Health/Substance Abuse Benefit
Now Available to Alternate Funding Groups
Here’s another reason groups seeking
alternate funding options may want to
choose Trustmark: their mental health
and substance abuse benefit will now
be administered by CORPHEALTH,
Inc., an independent managed behavioral health care company. Employees
of these groups will benefit from
quicker diagnosis, appropriate levels
of treatment, better discounts and
redirection to in-network facilities,
all of which help to reduce charges
associated with unnecessary and often
expensive initial treatment.
CORPHEALTH was selected by
Trustmark in 1999 to administer its
mental health and substance abuse benefit for fully insured, non-TPA administered groups. Benefits such as behavioral health, prescription drugs, dental
and lab services are often managed
through single service plans.
Trustmark has contracted with CORPHEALTH to manage the benefit for
alternate funding groups on a per
employee fee basis. CORPHEALTH is
offered to ASO and Flex ASO groups,
but is offered only after state contract
approval for Experience Refund and
Minimum Premium groups. No reinsurance is used because the employer
essentially bears the risk for claims
under the pooling/attachment point
levels.
For fully insured groups of 100 or
fewer employees, Trustmark automatically adds CORPHEALTH coverage
for new and renewal groups following state contract approval. For
employers with more than 100
employees on a fully insured basis,
CORPHEALTH is a recommended
addition to the group’s benefit plan,
in lieu of higher rates.
New Transplant Network to Offer Insureds More Facilities
Clients and prospects will appreciate the recent change to a larger
network for transplant coverage.
By the end of the first quarter,
coverage for transplants will be
offered through United Resource
Networks (URN), the nation’s
leading transplant network with
54 transplant facilities throughout
the country.
Insureds will continue to maintain
the same benefits, while gaining
access to more facilities to meet
their specific needs. When an
insured is in need of a transplant,
the employee should call Trustmark
at the number on the back of the
insurance card to begin the approval
process. Upon approval, URN’s
patient referral program takes over
to match the individual with the
transplant facility closest to the
patient’s home and best suited for
the transplant needed.
Precertification of the transplant is
still required after approval is given.
For more information on URN’s
transplant network, contact your
Trustmark representative.
Help Safeguard Your Clients from Claim Liability
To better protect your clients
from potential
claim
liability,
Trustmark
is advising
employers
against waiving
the eligibility
waiting period
for employees, unless absolutely
necessary.
Once reserved as an option extended
to key employees, the use of this
“opt-out” arrangement has flourished
recently as benefits have become
a negotiating tool for employment
among rank and file employees.
This trend had led to its overuse,
exposing numerous groups to potential
claim liability because benefits are
granted to individuals who don’t stay
on as permanent employees. Additionally, waiving eligibility waiting periods
can result in employers providing full
benefits to employees with little or
no limitations on preexisting
conditions.
In lieu of waiving eligibility requirements, Trustmark recommends that
groups offer to pay the COBRA coverage
for individuals or reimburse insureds for
COBRA expenses. Please contact your
Trustmark representative with questions
or concerns about the new procedure.
“Never let the fear of striking out get
in your way.”
—Babe Ruth
The Basics of Features and Benefits
You’ve heard it a hundred times: Emphasize benefits, not features. What do those
terms really mean? Here’s the lowdown: Features are qualities or aspects of your
product or service. Unfortunately, they don’t always make the strongest appeal
to customers.
A benefit, on the other hand, is what that product or service will do for your
customers. Bottom line: Benefits are the key to making the sale. Review the list
of features and benefits in the column below.
Feature:
Benefit:
Transfer of benefits
You won’t be caught without
coverage if carriers change.
Stop loss protection
Claims above a certain amount
are paid by Trustmark.
Wellness Incentive Program
Recoup part of your premium
cost by helping employees stay
healthy.
Helmet/seat belt benefit
The life benefit survivors receive
increases if the insured wore a seat
belt or, as a cyclist, a helmet.
—adapted from Everybody Sells, John W. Connors & Robert E. Frare, Partner Selling Group, as seen
in The Competitive Advantage
Pumping Up Your Sales Desire
Create and maintain a positive attitude
by concentrating on your level of
DESIRE:
• Determination. Devise clear sales
goals. That helps focus your efforts
on customers and their needs.
• Education. You can’t match
prospects’ needs with products and
services unless you’re well-versed
in your company’s offerings.
• Self-confidence. Believe in your
knowledge and your ability to
communicate. Role playing can
be an important part of your
preparation.
• Integrity. Never overpromise,
inflate or otherwise mislead
prospects or customers. Even so
called “little white lies” can cause
your sales to plummet.
Keep Your Eyes on
the Prize
If you find your attitude—or your
sales—slumping, review your goals.
Success has a lot to do with setting
and meeting aggressive goals. And
keeping your eye on the future helps
you fight through the mass of daily
activities that can easily swamp you
and dampen your enthusiasm.
—adapted from Streetwise Customer-Focused
Selling, Nancy J. Stephens with Bob Adams,
Adams Media, as seen in The Competitive
Advantage
If you want it, you’ve
got to ask
Consider these research findings:
• 46% of salespeople ask for the order
only once before giving up
• 24% ask twice before they shy away
• 14% give it a third try
• 12% are brave enough to ask a
fourth time before they quit
The interesting thing about this
research? The same study revealed that
more than 60% of all sales occur after
the salesperson asks for the order five
times—or more.
What that means to you: You may hesitate to ask for the order. You don’t
want to come across as a hard-sell,
high-pressure salesperson. But keep in
mind that asking for the order is the
only way you can succeed in sales.
• Enthusiasm. Customers respond
favorably to positive attitudes.
That means they’re more likely to
be in the mood to buy.
So ask enthusiastically and ask confidently. And continue asking until the
prospect accepts your invitation to buy.
—adapted from Trade Show Ideas as seen in
The Competitive Advantage
—adapted from Closing Strong, Myers Barnes,
MBA Publications, as seen in The
Competitive Advantage
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400 Field Drive
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www.trustmarkinsurance.com/group
Inside this Issue of
Trustmark Acts to Control Drug Costs
New Transplant Network Offers Insureds More Facilities
Group Producer
Pump Up Your Sales Desire
Outlook...
Corrections and Clarifications:
An article in the August issue of Group Producer
Outlook stated that Trustmark insureds would not
be steered into the new Shared Savings program
administered by United Payors and United Providers
(UP&UP). In fact, insureds and UP&UP hospitals
receive communication advising them of Trustmark’s
participation in the program. Insureds are given a
phone number to call to find providers in the network.
Questions about the program can be directed to
your Trustmark sales representative.
REGIONAL OFFICES
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(Home Office)
1-800-621-4784
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Regional Sales Director
[email protected]
Bruce Tirakian,
Regional Manager
(Central Illinois)
[email protected]
Dennis Walsh,
Regional Manager
(Northern Illinois)
[email protected]
Atlanta
Ruth Szabo,
Regional Manager
1-800-745-3162
[email protected]
We Want to Hear From You.
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Jeff Wintersteller,
Regional Manager
1-800-601-0808
[email protected]
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please contact Robert White at
[email protected].
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Sr. Regional Manager
1-800-887-5567
[email protected]
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Regional Manager
1-800-886-9642
[email protected]
Philadelphia
Jim O’Connor,
Regional Manager
1-800-492-2234
[email protected]
Houston
Brent Schultz,
Sr. Account Executive
1-800-704-1603
[email protected]
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Regional Manager
1-800-227-9642
[email protected]
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1-800-345-0555
[email protected]
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Regional Manager
1-800-482-2234
[email protected]
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Regional Manager
1-800-407-2345
[email protected]
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1-800-501-2235
[email protected]
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[email protected]
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[email protected]