What’s New for 2011

The Trustmark Companies medical plan already provides many of the benefits mandated by the Patient Protection and Affordable Care Act. Trustmark estimates that 2.5 percent of the 9.5 percent total plan cost increase is due to provisions of healthcare reform; the balance is due to the rising cost of healthcare. Below are the plan changes effective for 2011.

Preventive Care Covered at 100 Percent

Beginning Jan. 1, preventive care services will be covered at 100 percent, with no dollar limit, when you use a network provider. Out-of-network preventive care services are covered at 60 percent after deductible, while office visits and covered immunizations are subject to the out-of-network deductible and coinsurance.

No Lifetime Coverage Limits

There are no longer any annual or lifetime limits on the dollar value of health benefits.

No Pre-existing Condition Limits for Children

The plans do not have pre-existing condition limitations for children under age 19.

Children Covered Up to Age 26

In June 2010, the medical plan proactively extended health coverage to currently covered dependents up to age 26. Employees who would like to add their children for coverage effective Jan. 1, 2011, can do so during open enrollment or during a special enrollment period in January 2011. Full-time student status is not required.

$25 Network Copay for Mental Health and Substance Abuse for the PPO 750 Plan

Visits to in-network doctors for mental health and substance abuse issues will be covered for the cost of a $25 copay in the PPO 750 plan. For all other in-network services related to mental health and substance abuse, the plan pays 80 percent after your deductible is met. Out-of-network services are covered at 60 percent after your out-of-network deductible is met.

Frame or Contact Lens Allowance Increased to $150 for Enhanced Vision Plan

Employees who opt for the Enhanced Vision Plan will enjoy a higher allowance for frames or contact lenses. The amount has been increased from $130 to $150.

Lower Optional Life Insurance Rates

Rates for optional life insurance have decreased by an average of 10 percent.

FSA and HSA Funds Cannot Be Used for OTC Without a Prescription

To comply with new federal regulations, you will no longer be able to use HSA or FSA funds to pay for over-the-counter medications unless you have a prescription (except insulin). Due to this change, your Benny card can no longer be used to pay for OTC medications.

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