December 31, 2018

New Limited Medical Benefit Plan Design Focuses on Savings

LAKE FOREST, Ill., December 31, 2018 - Starmark has introduced a health benefit plan design allowing self-funded employers to provide limited medical benefits for lower monthly costs. The Starmark Limited PlusSM plan design was developed as a cost-effective alternative to comprehensive major medical benefits.

“Our limited medical benefit plan design is for members who want some financial protection in the event of an unforeseen illness or injury, but they either cannot or do not want to pay for major medical coverage,” said Angela Paret, Director, Product Development, Starmark.

The limited medical benefit plan design offers:
  • Freedom of provider choice for doctors and hospitals in the U.S.
  • Coverage of limited services, such as three doctor office visits and one inpatient hospital stay for the plan year
  • 100% coverage for eligible preventive-care services
  • An outpatient prescription benefit for generic drugs 
  • Wellness and cost-saving services, such as telemedicine doctor consults at a $0 copay, a medical second opinion service, a quality and cost comparison tool, and access to a 24/7 nurse line.
“We believed small to mid-size employers would be interested in a lower-cost option,” said Jim Howe, Executive Director, Product Development and MGA Sales, Starmark. “We conducted a broker survey, and the feedback helped us decide to move forward.”

The survey showed:
  • 92 percent of the brokers said they encountered opportunities to provide their employer clients with a low-cost plan for low-wage employees who cannot afford the premiums of the employer’s major medical plan.
  • 63% percent of those same brokers said they didn’t have a low-cost plan to offer to their employer clients for their low-wage employees.
To help control costs, the plan design uses a provider reimbursement strategy known as reference-based pricing. Under this approach, a multiple of Medicare is used to calculate provider reimbursement for most covered healthcare services up to the plan limits. 

The Limited Plus plan design does not provide comprehensive major medical benefits. It covers limited medical expenses only. Benefits are limited to the coverage described in the Plan Document and Schedule of Benefits. Exclusions and limitations apply.

About Starmark
Star Marketing & Administration, Inc. (Starmark) administers self-funded health benefit plans, offering extensive plan design choices, exceptional personal service and nationwide provider access for small to mid-size businesses. Stop-loss insurance and ancillary coverage are provided by Trustmark Life Insurance Company. Starmark® is a registered trademark of Trustmark Insurance Company. Additional information is available at www.starmarkinc.com.