Health Insurance
ParTNers for Health website provides information about insurance options, FAQs, etc. or phone 1-888-741-3390.
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 the 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 during Annual Enrollment, or be eligible under a qualifying event. Contact Kathy Taylor at 425-4452 for information.
Health insurance plans are subject to a 12-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.
Dependent Eligibility Verification Documents
Certain documents are required for dependent eligibility verification. Please refer to this list.
Note: Documentation required for dependents must accompany paperwork.
Transferring Plans
Transferring health insurance plans may be done only during the Annual Enrollment (October 1 - November 1), 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.
Cancelling Insurance
Cancellation is not permitted outside of Annual Enrollment unless the covered person experience a qualifying event or family status change.
Pharmacy Benefits
Pharmacy benefits are administered by CVS Caremark. The covered drug list is identical under both the Partnership PPO and Standard PPO, although co-pays differ.
Making your Selection
You have three important decisions to make when it comes to selecting your health insurance option:
1. Partnership PPO or Standard PPO
The Partnership PPO and Standard PPO cover the same types of services. If you choose the Partnership PPO, you must commit to a Partnership Promise, and the State will reward you with lower monthly premiums; lower annual deductible; lower pharmacy co-pays; lower co-insurance; lower out-of-pocket maximums. The Partnership Promise commits you to taking these actions toward healthier living by:
- Employees participating in the Partnership PPO plan will be required to keep their contact information up to date with the university in 2012. If a member’s information changes during the year, it is the member’s responsibility to make sure the university has the correct information on record.
- Work with an APS health coach to reduce your risk factors.
- Completing a Health Questionnaire. You will need to answer questions about your current health, including your age, what you eat, how much you exercise and whether you use tobacco or alcohol.
- Take a Health Screening. You will also need to take part in a health screening. This screening measures your height, weight, blood sugar, blood pressure and cholesterol level. You can do the screening with your doctor or at one of the health screening sites that will be set up around the state.
- Reduce your Health Risk Factors. Depending on the results of your questionnaire and screening, you may be eligible for professional support services to help lower your health risks. For example, the State’s independent health and wellness manager may recommend that you work with one of their health coaches. You will have a number of options—and be able to choose whichever works best for you.
2. Insurance Carrier
Blue Cross/Blue Shield of TN 'Network S' or CIGNA 'Open Access Plus'
Each carrier has its own network of preferred doctors, hospitals and other health care providers. Check the networks carefully when making your selection.
3. Premium Level (select East and Middle TN)
Employee; Employee + Spouse; Employee + Child(ren); Employee + Spouse + Child(ren)
