Employer Connection

Starting January 1, 2026, Medicare Part D will cap annual out-of-pocket prescription drug costs at $2,100 (up from the $2,000 cap set for 2025).¹

Why It Matters:
This change could cause some employer-sponsored prescription drug plans that were previously “creditable” to now be classified as non-creditable. Creditable coverage means your plan’s prescription drug benefits are expected to pay, on average, as much or more than Medicare Part D.

Reminder:
Employers must notify Medicare-eligible employees every year whether their prescription coverage is creditable or not. If notices aren’t sent, employees could face penalties for late Medicare Part D enrollment—and employers risk compliance issues.
 
What You Need to Do:
If you offer a group health plan administered by Star Marketing and Administration, Inc.:

1. Log in at TrustmarkSB.com/login
2. Open your Administration Kit
3. Use the 2026 Medicare Calculator to check your plan’s creditable status
4. Review results now to confirm compliance and send notices before Oct. 15, 2025, if required

 
If Your Plan Is Non-Creditable:
You Are Required to:

• Notify all Medicare-eligible members 60 days prior to the plan start date
• Provide CMS required notices
• Understand that failure to act may result in penalties and compliance exposure

¹Final CY 2026 Part D Redesign Program Instructions. CMS.gov. 4/7/2025.

As flu season ramps up, we’re helping your employees stay healthy with timely education and resources. This month’s campaign includes:

• A flu prevention blog authored by Dr. Matt
• Tips on hygiene, vaccination, and plan benefits
• A reminder that flu shots are covered at no cost when received at in-network providers or a pharmacy in the CVS caremark retail pharmacy network now through April 30, 2026.*

Members are receiving this information via email, with a direct link to the blog and encouragement to reach out to Trusted Member Care for support.

Want to see what they’re reading?
READ BLOG

*To view CVS caremark retail pharmacy network, members can log in to their CVS account on the Caremark website at www.caremark.com.
 

Avoid coverage mistakes and billing headaches.

When an employee leaves or loses eligibility, let us know right away. Delays can cause coverage errors, billing issues, and confusion for everyone.

Here’s What to Do:

• Use the Manage My Group Portal
  Submit terminations securely at TrustmarkSB.com/login. You’ll get confirmation emails when we receive and complete your request—so you know it’s done.
• Include the Right Termination Date
  The exact date matters. It ensures coverage ends correctly and claims don’t go through for someone who’s no longer eligible.
• You’re Still Responsible for Accuracy
  Even if you use a payroll or benefits administrator, it’s your job to make sure enrollment info is correct. If you use EDI feeds, remember open enrollment changes won’t come through EDI.
• Avoid Overpayments and COBRA Delays
  Late reporting can lead to extra premium charges and slow down COBRA notices. Timely updates help you stay compliant with federal regulations and support employees who want continuation coverage.

Why It Matters:
Quick terminations protect your plan’s integrity, keep your plan clean, reduce administrative work, and make sure benefits are handled properly. It’s a small step with a big impact.

Help save money. Avoid surprise bills.

Choosing in-network providers is one of the easiest ways employees can cut healthcare costs. These providers offer lower out-of-pocket expenses and fewer billing surprises.

Here’s How You Can Help:

• Share the Network Directory
  Encourage employees to log in at TrustmarkSB.com/login to find in-network doctors, hospitals, and specialists. The directory is easy to use and helps employees make informed choices.
• Remind Them to Double-Check Network Status
  Even if they’ve used a provider before, it’s smart to confirm they’re still in-network before booking. Networks can change and verifying ahead of time helps avoid unexpected costs.
• Give Real-Life Examples
  Show employees how choosing in-network providers pays off: For example, a lab test might cost $50 in-network vs. $200 out-of-network.

Why It Matters:
In-network care helps lower costs for employees—and for your plan. Everyone wins.

Catch internal changes before they cause issues.

Your monthly invoice reflects current enrollment and coverage. Trustmark works hard to keep it accurate, but your monthly review helps catch internal updates that may not have been submitted yet.

Here’s What to Look for:

• Missed Terminations or New Hires
  If someone left or joined recently and wasn’t reported, your invoice might be off. A quick check helps you catch and correct it early.
• Coverage Tier Changes
  If an employee switched from single to family coverage (or vice versa), make sure it’s updated those updates are reflected in your records and the invoice.
• Avoid Retroactive Fixes
  Reviewing monthly helps prevent retroactive corrections, billing adjustments or delays in claim processing.

Why It Matters:
Your monthly review keeps records clean and your plan running smoothly. It’s a simple habit that saves time.

Accurate info = smooth communication and uninterrupted benefits.

Encourage employees to update their contact details—like address, email, and phone number—so they don’t miss important plan communications.

What to Check:

• Mailing Address
  So ID cards and notices go to the right place.
• Email Address
  For digital EOBs, plan updates, and reminders.
• Phone Number
  Helps customer service reach them quickly if needed. (We won’t text them.)

How to Update:
Employees can log in at TrustmarkSB.com/login, go to their profile, and make updates in just a few clicks.

Why It Matters:
Up-to-date contact info helps avoid delays, missed communications, and confusion. As a result, they are better informed and supported.

Remember that you can provide your covered employees with instant access to their medical and dental digital ID cards. These cards offer convenience and peace of mind until physical cards arrive or if they are lost.

To access, log in at TrustmarkSB.com/login, go to Manage My Group, and select Digital ID Cards.

Sharing is simple! Open the digital ID card file to view, print, or save. You can print it out or email it to your employee.

Note: Each digital ID card displays the name of the covered employee, not spouses or dependents. Cards are available within one to two business days after the order is received.
Keep your employees covered and stress-free with digital ID cards!

Encourage your covered employees to switch to secure, digital versions of their Explanation of Benefits (EOB) and enjoy the convenience of going paperless. By registering at TrustmarkSB.com/login, employees can easily opt for paperless EOBs and manage their preferences in their profile.

Employees will receive email notifications whenever new documents or EOBs are available online. With 24/7 access at TrustmarkSB.com/login, they can view, save, or print important documents anytime, anywhere.

Make the switch today and experience the benefits of going digital! 

Encourage your covered employees to register at TrustmarkSB.com/login for round-the-clock access to essential benefits and self-service resources. By registering, employees can:

• View benefits, claims, Explanations of Benefits (EOBs), and network information.
• Access digital ID cards to save, share, or print.
• Retrieve important documents, including their Plan Document and Summary of Benefits and Coverage.
• Explore "My Resources," a library of key materials personalized to their health benefit plan.
• Utilize the Service Center for updates to member or dependent information, designating a personal representative, responding online, and more.

Registration is simple! Share this flyer with your covered employees to help them get started.

Manage My Group is an easy-to-use tool designed to help you securely administer your group’s self-funded health plan with ease. With Manage My Group, you can complete your requests within 24 to 72 hours and receive email confirmations for both receipt and completion of your requests.

Here are some of the key features:

• New Enrollee: Easily enroll new employees or dependents by completing the Employee Eligibility Statement.
• Newborn or Adopted Dependent: Add coverage for an employee's newborn or adopted dependent within 31 days of birth.
• Terminate/Waive Coverage: Terminate coverage for multiple employees or waive coverage for dependents.
• Address Update: Update your business email or mailing address.
• Member/Dependent Update: Submit updates for mailing address, names, date of birth, gender, and social security numbers.
• Replacement ID Cards: Order replacement ID cards for delivery to an employee's mailing address.
• Digital ID Cards: View, print, save, and share individual medical and dental digital ID cards.
• Employee Census: Generate an employee census report for your health benefit plan.
• Member Summary of Benefits: Review individual, employee-specific benefit information.
• Electronic Funds Transfer: Sign up for EFT by submitting an authorization agreement for preauthorized payment.
• Paperless Billing: Receive billing notices via email instead of USPS.

Simplify your plan administration with Manage My Group. Experience the convenience and efficiency this tool brings to managing your health benefit plan.

This week, we're sending an email to your employees with a level-funded plan. It highlights the benefits of our Trusted Member Care customer service, ensuring they receive personalized assistance and quick resolutions. The email includes a link to a detailed blog article about Trusted Member Care support. Be sure to read the email and follow the link to the blog for all the information you need.

Trusted Member Care is dedicated to providing your employees with the best possible experience. Our team is available to help them navigate their benefits, answer any questions they may have, and address any concerns promptly. Whether it's understanding their coverage, finding the right healthcare provider, or resolving claims issues, Trusted Member Care is here to support them every step of the way.

A non-grandfathered group health plan’s in-network out-of-pocket maximum for essential health benefits (EHBs) for the 2026 plan year cannot exceed $10,600 for self-only coverage and $21,200 for other-than self-only coverage.

The in-network out-of-pocket maximum applies to all individuals, regardless of whether an individual has a self-only plan or other-than single coverage. Self-funded group health plans are not required to cover EHBs. But, if they do, they cannot impose lifetime or annual dollar limits on those benefits.

For high-deductible health plans (HDHPs) for the 2026 plan year, the out-of-pocket limit will be $8,500 for self-only coverage and $17,000 for other-than self-only coverage. The minimum deductible is changing to $1,700 for self-only coverage and $3,400 for other-than self-only coverage.

Supporting Healthier Futures for Active Teens – Starting 7/1/2025

We’re excited to announce an enhancement to our virtual musculoskeletal (MSK) treatment benefit. Effective July 1, 2025, dependents ages 13–17 will now have access to comprehensive virtual MSK treatment through Vori Health. This expansion builds on the current offering, which is already available to adult members aged 18 and up.

This benefit is included with Trustmark major medical plans and gives your employees’ teen dependents convenient access to high-quality, expert-guided care, right from home.

What’s Changing?

• New Age Group Added: Dependents ages 13–17 now eligible
• Effective Date: Applies to all groups on 7/1/2025
• Eligible Plans:
  • HealthyEdge℠ (HE)
  • Healthy Incentives^® (HI)
  • Healthy Choices℠ (HC)
• Excluded Plan: Preventive Plus plans do not include this benefit

What’s Included with Virtual MSK Treatment
Teenagers now have access to a full suite of Vori Health MSK services, designed specifically to address the unique needs of adolescents:

Conditions Treated

• Sports injuries (e.g., sprains, strains, knee/shoulder injuries)
• Growth-related discomfort (e.g., Osgood-Schlatter disease, growing pains)
• Back and neck pain
• Overuse injuries (e.g., tendonitis, shin splints)
• Post-injury rehabilitation

Care Components

• Virtual visits with board-certified physicians and licensed physical therapists trained in adolescent MSK care
• Personalized digital Care Plan, including:
  • Tailored treatment protocols
  • Motion Guide: Computer vision tech for real-time movement feedback
• Progress tracking and expert support in one easy-to-use digital platform

Cost and Coverage Details

• For members enrolled under Trustmark HealthyEdge℠ PPO, Trustmark Healthy Incentives^® PPO, or Trustmark Healthy Choices℠: Services are covered at 100%
• For members enrolled in Trustmark HealthyEdge℠ CDHP, Trustmark Healthy Incentives^® CDHP, or Trustmark Healthy Choices℠ CDHP: Services are subject to deductible and coinsurance

Why This Matters
Teenagers today face rising rates of sports-related and postural MSK issues. By providing early, expert-driven care, employers can help families manage injuries before they become chronic and support better health outcomes for the next generation. Vori Health’s virtual care is designed for modern families: it’s accessible, evidence-based, and personalized.

Healthcare costs are rising, but you can take control with these six smart strategies:

• Learn health plan lingo: Navigate coverage confidently by understanding terms like copay, coinsurance, deductible, and out-of-pocket limit.
• Choose in-network providers: Save money by opting for healthcare providers within your PPO network.
• Leverage telehealth: Access convenient, non-emergency care via video, phone, or mobile app. 
• Stay current with preventive care: Catch issues early with vaccines, screenings, and tests covered at no cost.
• Opt for generic drugs: Reduce prescription costs by choosing generic medications, which are as effective as brand-name drugs.
• Make the most of HRAs and HSAs: Use pre-tax accounts to manage healthcare expenses and save money.

Empower yourself and your employees with these tips to effectively control healthcare costs. 

Read the full article

Our second email in our Ways to Save campaign is designed to encourage employers and their covered employees to learn about healthcare coverage terms.

Via a link in this email, Do You Understand Health Plan Lingo?, readers can access an article discussing how mastering the language of health coverage helps healthcare consumers more effectively manage their care and healthcare costs.

Our Ways to Save campaign promotes approaches to help consumers save on healthcare costs.

Members covered by a major medical plan with a PPO administered by Star Marketing and Administration, Inc. will be sent this email shortly.

Congress did not extend telehealth benefit flexibility for high-deductible health plans beyond Dec. 31, 2024. As a result, changes were made to the virtual musculoskeletal (MSK) treatment benefit for our major medical CDHP designs with plan years beginning Jan. 1, 2025, and after.

Learn more.

To help make tax filing for 2024 easier and more convenient for employers, electronic versions of Form 1095-B (in a PDF format) are now available in the Document Center on our website.

Employers can log in at TrustmarkSB.com/login. Tax documents are not available for brokers.

Please reference the information below for further assistance. 
 

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11/8/2024
Electronic Form 1095-B for Employers’ Tax Filing Available in Early January

An electronic version of Form 1095-B (in a PDF format) will be available in the Document Center on our website in early January 2025. Employers should log in at TrustmarkSB.com/login.

If employers need to reference the data used to populate the forms, it will also be available in a CSV format in the Document Center.

The Affordable Care Act requires employers with fewer than 50 employees to annually file Form 1095-B to report certain information about individuals who are covered by minimal essential coverage.

Form 1095-B will be available to all active and terminated employers with fewer than 50 enrolled employees who had coverage administered by Star Marketing and Administration, Inc., at any point during the 2024 calendar year. The forms will be generated for all active and terminated covered employees and dependents of these groups. 

Employers must distribute Form 1095-B to covered employees by Jan. 31, 2025, and file those forms with the IRS via paper by Feb. 28, 2025, or electronically by March 31, 2025.

Employers with questions about the IRS requirements should consult a tax advisor.

For additional information and instructions on Form 1095-B, please review this IRS link: About Form 1095-B, Health Coverage