Health Insurance

Full-time employees or employees (75%+)  may enroll in health coverage through the state group insurance program.  Enrollment in health insurance must be made within the first 31 days of employment.  Coverage becomes effective on the first day of the month following the completion of one full calendar month of employment if all applicable forms are completed. State Group Health Insurance also includes basic term life and basic accidental death insurance.  New employees will complete insurance forms during new hire orientation.

  • Employees who do not enroll in a health insurance plan during the first 31 days of employment may apply for health coverage if they experience a Special Qualifying Event. (see pg. 3 of the Health/Dental/Vision Enrollment Forms)  Application for enrollment must be made within 60 days of the loss of insurance coverage or within 60 days of a new dependent’s acquire date.

  • Available Health Insurance Options include the Premier PPO, the Standard PPO, and the Health Savings CDHP.  All options covers the same type of services, treatments and products.

Voluntary Cancellation

  • You can cancel medical or dental coverage outside of the Annual  Enrollment period if you and/or your dependent(s) become newly eligible for coverage under another plan (proof is required and only the individual or individuals who become newly eligible for other coverage may cancel).
  • If enrolled in the prepaid dental option and there is no participating general dentist within a 40-mile radius of your home.
  • You have 60 days from the date that you and/or your dependent(s) become newly eligible for coverage to submit documentation. An insurance cancel request application must be submitted along with the required documentation.

 Premier PPO and Standard PPO

  • Pay less in copays and coinsurance with the Partnership PPO versus the Standard PPO
  • Pay deductible first before coinsurance applies
  • The medical and pharmacy out-of-pocket maximums will be combined.
  • Pay for prescriptions with copays
  • When out-of-pocket maximum reached  the plan pays 100% for in-network services
  • Higher monthly premiums but a lower deductible.

Health Savings CDHPs

  • Lower monthly premiums but a higher deductible.
  • A tax-free Health Savings Account – which you own.
  • Must meet your deductible before the plan starts paying for covered expenses.
  • No separate deductible or out-of-pocket maximum for pharmacy.
  • Coinsurance after you meet your deductible.
  • Lower total out-of-pocket maximum compared to PPOs

Employees  can refer to the Comparison Chart for the plans deductibles, co-pays, co-insurance, and out-of-pocket maximum amounts. 

Health Savings Account (HSA)

If you enroll in the Promise Health Savings CDHP, the state will put $250 for employee coverage or $500 for family coverage into your Health Savings Account.

  •  A tax-free savings account that you can use to pay for your deductible and coinsurance expenses.
  • Coinsurance payments instead of copays.
  • The banking vendor who helps administer your Health Savings Account is PayFlex
  • You can have additional funds deducted pretax from your payroll check and deposited into your Health Savings Account. (Form)

Employees can refer to the comparison chart for the plans' deductibles, co-pays, co-insurance, and out-of-pocket maximum amounts. 

Health Insurance Carriers Information

Plans are administered by BlueCross BlueShield of Tennessee(Network S), Cigna(Local Plus Network), and Cigna (Open Access Plus). 

BlueCross BlueShield of Tennessee (Network S) 

Cigna (Local Plus) 

Cigna Open Access Plus

Member Handbooks-Health

 

Introducing ALEX® — Your Personal Benefits Expert

ALEX, your personal online Partners for Health benefits expert can help you choose which insurance option may work best for you.

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