Trustmark Life Insurance Group Division-Members FAQ

How can I verify that my coverage is current?	Top
Contact your plan administrator or go to www.trustmarkins.com/group/members/claiminterim.cfm.

How do I check the status of my claim?
Contact the claim office at the benefits and eligibility number listed on your ID card or go to www.trustmarkins.com/group/members/claiminterim.cfm.

I lost my ID card. How do I get a replacement?
Contact your plan administrator.

How do I change my beneficiary?	Top
Click here for a Beneficiary Change Form, or contact your plan administrator.

Where can I get a copy of my group certificate.
Your plan administrator should have a supply of certificate booklets.

Where can I get claim forms?
Contact your plan administrator or go to www.trustmarkins.com/group/members/claims.cfm.

Questions related to PPO/Open Access
What is a provider network?	Top
A provider network is comprised of a group of physicians, hospital and other healthcare providers with whom the managed care organization has an agreement to offer services to our insureds at discounted rates.

How do I know if my doctor or hospital participates in the network?
You can check a list of participating hospitals and physicians in the Physician/Hospital Look-up feature of the website.

Am I limited to only my network of hospitals and physicians?
An important feature of PPO and OpenAccess plans is the freedom to choose any hospital or physician. However, when you choose a provider participating in the network, your out-of-pocket expenses are reduced.

When do I need to precertify?	Top
Precertification is needed for any inpatient hospitalization (for any medical services including maternity, transplants, mental illness, mental or nervous disorders, or for alcohol and chemical abuse treatment). Precertification is now required for the following except AZ Foundation groups with PPO and PPO Plus: Skilled nursing facility admissions Home health care services, such as home infusion and in-home physical, occupational or speech therapy Sub-acute medical and rehabilitation inpatient admissions Hospital care services Residential Behavioral Health Services (Mental/Nervous and Chemical & Alcohol) Precertification is no longer required for any outpatient surgery. You or your physician must call the precertification number on your ID card prior to admission to obtain precertification.

Where can I get information regarding my Wellpoint drug benefit?
Please refer to your Insurance Booklet to review your prescription drug benefit. To access other information, please look through the Prescription Drug Benefit section of this website.

Where can I get information regarding the CORPHEALTH mental health/substance abuse program?
Visit CORPHEALTH's website at www.corphealth.com.

Questions related to HIPAA (Health Insurance Portability and Accountability Act)
I have an ongoing medical condition and have been subject to a preexisting condition exclusion period under my current employer's health plan. I have been continuously enrolled in the plan for more than 12 months. Will HIPAA help me obtain coverage for this condition?	Top
Yes. As long as benefits for the condition are otherwise covered under the terms of the plan, a preexisting condition exclusion period may generally not last longer than 12 months. Because you have been covered by your current plan for at least 12 months without a 63-day break in coverage, your employer will no longer be able to impose the preexisting condition exclusion period when HIPAA becomes effective for your plan.

I hear the HIPAA law makes health insurance portable. How does this work?
Once an individual has health insurance, this coverage can be accumulated as a record to reduce or eliminate any preexisting condition exclusion that might be applied if an individual moves to another employer’s group health plan. The concept of “portability” is one of receiving credit for maintaining health coverage, even under different health plans or policies. “Portability,” in this case, doesn’t mean that individuals can carry health benefits or their current plan or policy with them when moving from one health plan or policy to another (such as when changing or losing jobs).

Can I lose coverage if my health status changes?
Group health plans and issuers may not establish eligibility for enrollment based on your health status, medical condition (physical or mental), claims experience, receipt of health care, medical history, genetic information, evidence of insurability or disability. For example, you cannot be excluded or dropped from coverage which the health plan offers just because you have a particular illness. Although employers may establish limits or restrictions on benefits or coverage for similarly situated individuals under a plan, they may not require an individual to pay a premium or con-tribution which is greater than that for a similarly situated individual based on health status. They may also change plan benefits or coveredservices if they give participants notice of any “material reductions” within 60 days after the change is adopted.