ParTNers for Health website provides information about insurance options, FAQs, etc. or phone 1-888-741-3390.
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% (pre-tax). 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
The employee also has 60 days to provide a Social Security Number for newborns or other dependents.
Certain documents are required for dependent eligibility verification. Please refer to this list.
Note: Documentation required for dependents must accompany paperwork.
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.
Cancellation is not permitted outside of Annual Enrollment unless the covered person experience a qualifying event or family status change.
Pharmacy benefits are administered by CVS Caremark. The covered drug list is identical under both the Partnership PPO and Standard PPO, although copays 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 copays; lower co-insurance; lower out-of-pocket maximums.
The 2013 Partnership Promise for members and covered spouses must:
- Complete the online Healthways Well-Being Assessment™ (health questionnaire) by March 15
- Engage in ONE ParTNers for Health wellness activity by July 15
- Keep your contact information current with your employer
- Engage in the tobacco cessation program if you are a tobacco user
Members and covered spouses identified as at risk must also:
- Complete a biometric screening at your health care provider's office between July 15, 2012, and July 15, 2013
- Participate in health coaching and/or case management, if identified
If it is unreasonably difficult because of a medical or mental health condition for you to achieve the standards to fulfill the Partnership Promise, or if it is medically inadvisable for you to attempt to fulfill the Partnership Promise, call our ParTNers for Health Wellness Program at 1.888.741.3390, and they will work with you to develop an alternate way to fulfill the Promise.
A health screening for all members is not required in 2013.
New employees (as of 1/1/13) will be required to complete the online Well-Being Assessment and screening within 120 days of their insurance coverage effective date.
Both you and your covered spouse must meet the 2013 Partnership Promise requirements to remain eligible for the Partnership PPO in 2014. All members enrolled in the Partnership PPO must fulfill the Partnership Promise even if the Partnership PPO is not the primary insurance plan. Children do not have to meet the requirements of the Partnership Promise.
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)