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The Tennessee Plan is an employer-sponsored, self-insured plan that is similar to a National Association of Insurance Commissioners Model D Medicare Supplement Plan. This plan is not offered to the general public and is not subject to the federal Medicare open enrollment rules. The state does not offer the opportunity to enroll in the plan outside of the retiree’s initial eligibility without receiving late applicant approval. Find more information here: https://www.tn.gov/partnersforhealth/other-benefits/tennessee-plan.html You may apply for The Tennessee Plan if you meet the eligibility requirements listed below. Eligibility Requirements for Retiree Plan Coverage. A person is eligible to be a Plan Participant in the “Retiree Plan Coverage” provision of the Plan from the first day that he or she is: (1) A retired state of Tennessee employee or higher education employee receiving a monthly retirement allowance from the Tennessee Consolidated Retirement System or is participating in the higher education optional retirement system who is covered under Medicare (Part A), and whose initial employment with the state or other governmental agency qualifying the person for Plan membership commenced prior to July 1, 2015; (2) A retired Local Education employee participating in the Tennessee consolidated retirement system provided that the retired employee is covered by Medicare benefits and is also drawing a monthly retirement allowance from the Tennessee consolidated retirement system, and whose initial employment with a qualifying employer commenced prior to July 1, 2015; or (3) A retired county judge (as defined in TCA 8-34-101), county official (as defined in TCA 8-34-101), county employee, or employee of employer participating in TCRS receiving a monthly retirement allowance from the Tennessee Consolidated Retirement System (TCRS) who is covered under Medicare (Part A), and whose initial employment with a qualifying employer commenced prior to July 1, 2015. The application must be submitted within 60 days of your initial eligibility to enroll without answering health questions. The initial eligibility date is: the date of TCRS retirement, the date active state group basic health coverage terminates or date of Medicare eligibility, whichever is later. For more information on initial eligibility dates, coverage effective dates and dependent eligibility for this plan, please consult the plan document for The Tennessee Plan on our website at https://www.tn.gov/partnersforhealth/publications/publications.html. If you did not apply for The Tennessee Plan when you were initially eligible or due to experiencing an acquire event or loss of eligibility for other coverage event, you can apply throughout the year (including during Medicare’s open enrollment period), but your application will be subject to late applicant review. Late applicant review is based on a few health questions about your health history in the last five years. The claims administrator will review the answers to the health questions for those submitting late applications and determine if enrollment will be approved or denied based upon their standard medical underwriting guidelines. For approved late applicant enrollment, the effective date of coverage will be on the first day of a month following approval of enrollment by the claims administrator. |
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