Health Insurance
Enrollment
Regular full-time or regular part-time (75%+) appointments are eligible to enroll in one of the three health insurance plans. The University pays 80% of the health insurance premium and the employee pays 20%. Coverage becomes effective on the first of the month following one full calendar month of employment, if all necessary forms are received by the Office of Human Resources. Premiums are paid a month in advance. If you decline coverage when first offered, you may apply as a late applicant, for a $75 non-refundable fee, or you may be eligible under a qualifying event. The State does not have an open enrollment period. Contact Kathy Taylor at 425-4452 for information.
Health insurance plans include your choice of a Preferred Provider Organization (PPO), or Point of Service (POS), or Health Maintenance Organization (HMO). The PPO and POS plans are subject to a 6-month pre-existing condition clause unless the employee provides a certificate of prior coverage. The pre-existing condition requirement will be waived with a certificate of coverage provided there has not been a break in coverage of more than 63 days. The pre-existing condition requirement does not apply to employees currently participating in a health insurance plan with the university who chooses to transfer plans during the Annual Enrollment Transfer Period.
Consider the following when selecting a plan:
- Are the physicians we use participating in the network? (Primary Care, Pediatrician, OB/GYN, specialists)
- Is the hospital that we would use participating in the network?
- I have a dependent/college student that lives outside the State of TN. What type of coverage is provided for them?
- How much will I have to pay each month as my share of the premium?
- What's my share of the medical bill - for an office visit, hospital admissions, lab work, prescriptions, ER?
- Is the pharmacy I use in the provider network?
- Is there a mail order prescription program? Can I use retail pharamacies for maintenance drugs?
- Does the drug formulary (list of approved drugs) include the prescriptions we take? Are there any restrictions on having the prescription filled?
- Is there a vision care benefit?
- Are there specific services like chiropractor or allergy shots that are important? How are they covered?
Full-Time Unmarried Students Age 19-24
If your dependent is a full-time unmarried student age 19 - 24, a letter from their school that confirms the dependent is a full time student is required. If the dependent is a full-time student at UTC, complete this form and submit to the Office of Records, 109 Race Hall. If the dependent is a full-time student at Chattanooga State, complete this form and submit to the Records Office at Chattanooga State.
Other Unmarried Dependent Age 19-24
If your dependent is age 19 - 24 and dependent upon you for support these documents are required:
- Page 1 and signature page of participants prior year Federal Income Tax Return (1040, 1040A or 1040EZ) listing the dependent; or
- Page 1 and Certificate of Electronic Filing of participant's prior year Federal Income Tax Return (1040, 1040A or 1040EZ) listing the dependent.
Enrollment Forms
- Group Insurance Enrollment Form
- Basic Life Insurance Beneficiary Designation must also be submitted
- Primary Care Physician (PCP) Card must also be submitted if you are enrolling in United HealthCare HMO. Claims incurred without having a PCP will not be paid.
Transferring Plans
Transferring health insurance plans may be done only during the Annual Enrollment Transfer Period (October 15 - November 15), with an effective date of January 1st. This is the only time of the year when participants can make changes in their insurance coverage. Changes in coverage will become effective on January 1. If you are not currently participating in a health plan with the University, you cannot enroll UNLESS you apply for medical coverage as a late applicant, for a $75 non-refundable fee, or apply for Special Enrollment by Qualifying Event. Additionally, you cannot add dependents that are not currently covered unless you have a qualifying event.
What's New?
Tobacco Use Surcharge Delayed until 2011 (7/1/09)
The Tobacco Use Surcharge has now been delayed for one year. The December 2010 deduction for January 2011 coverage will be the first to include the surcharge for covered employees and spouses who use tobacco products. Although the surcharge has been delayed for a year, the lowered co-payments for tobacco quit aids will still be available until Dec. 31, 2009. You can use your health insurance card to obtain certain prescription drugs and over-the-counter nicotine replacement therapies for very low copay. To use this benefit, you must have a prescription, even for the over-the-counter products.
