Behavioral Health
Coordination of Benefits
ParTNers For Health Wellness Program
- Who is eligible to participate in the Partners for Health wellness program?
- How do I set up my Sharecare account?
- Will I be charged for participating in this program?
- Is my health information protected?
- What information is shared with my employer or Partners for Health?
- Can I opt out of participating in this program?
PPACA (Affordable Care Act)
- Where do I locate tax forms in Edison?
- Why is my Form 1095-C not showing the correct monthly premium amount?
- Can I get insurance through the Marketplace?
- What is the Health Insurance Marketplace?
- Do the ParTNers for Health plans meet the health care reform law’s minimum value requirements?
- What if I already have coverage through my spouse’s employer?
Leave of Absence
- If I miss one end-of-the-month payroll check and I have not been enrolled in direct bill, how will my missed premium be caught up?
- Can I pay my bill before I get an invoice?
- What are my options if my benefits are canceled due to nonpayment of premiums?
- When will I get my invoice?
- I received another invoice, but I am back at work. Do I need to pay this amount?
- When am I responsible for the full employee and employer portions of my insurance?
COBRA
- How Do I Cancel COBRA?
- Is COBRA different than active benefits?
- What is COBRA?
- Who is eligible for COBRA?
- How do I enroll in COBRA?
- How long does COBRA last?
Deferred Compensation
- I recently had a change in job status (examples: rehired, transferred from one agency to another or returned from a leave of absence). How is my 401k deferral affected?
- Why is there a 2% 401k deduction on my paycheck? I never enrolled in 401k.
- I recently made a change to my 401k (or 457) contribution amount. When will it be updated in Edison?
- I am a 120-day retiree. Am I eligible to enroll in 401k?
- My 401k loan is paid off, but deductions are still being taken from my paycheck. How can this be corrected?
- I am enrolled in the Hybrid 401k plan, but I should be enrolled in regular 401k. How can this be corrected?
Enrollment and Eligibility
- Divorce FAQs
- Where do I send dependent verification?
- When will I know that my elections have been finalized?
- How do I update my election status from Saved But Not Submitted?
- Have you received everything for my enrollment?
- Can you help me verify if I am signed up for my benefits?
BlueCross BlueShield and Cigna
- Where can I find more information about the BlueCross BlueShield and Cigna networks?
- Do I have to have a referral from my PCP, or primary care provider?
- What happened to the insurance company that used to provide my benefits, and why did the insurance carrier change?
- I am enrolled in a PPO medical plan. My dependents and I have visited the doctor many times this year, but I was told by BCBS/Cigna that we haven’t met our annual deductible. How can this be?
- What is the difference between the telemedicine technology program offered by our agency and the state telehealth program?
- What network options are offered by the state of Tennessee?
CDHP/HSA and Local CDHP/HSA
- What is the CDHP/HSA (or Local CDHP/HSA) insurance plan?
- On what can I spend my health savings account funds?
- On whom can I spend my health savings account funds?
- If I close my health savings account or switch from the Consumer-driven Health Plan or Local CDHP to one of the preferred provider plans, what happens to my HSA balance?
- Why might I choose the Consumer-driven Health Plan option?
- Does enrollment in Medicare impact my HSA eligibility?
Flexible Spending Account
- What is a flexible spending account?
- What kinds of flexible spending accounts are offered?
- How much can I contribute to my flexible spending account(s)?
- What are some common medical expenses that my flexible spending account could pay for?
- Is my entire FSA, limited purpose FSA or dependent care FSA balance available to me at the beginning of the year to use?
- Who manages the flexible spending accounts?
Pharmacy
- My specialty prescription has gone way up in cost. What is going on?
- My pharmacy said my doctor needs to request prior authorization to refill my prescription. How do I do this?
- I would like to appeal my prescription drug benefits paid with Caremark. What should I do?
- There is a quantity limit on my prescription drug; however, my doctor says I need an amount higher than the limit. What do I do?
- I tried to get a prescription filled but my claim was denied because the medication is now available over the counter. Does this mean my pharmacy benefits are becoming more limited?
- What if I take a drug that is not on the Caremark drug list?
Emotional Wellbeing Solutions (formerly called EAP)
- What resources are available through the Emotional Wellbeing Solutions program?
- Why is EAP now referred to as Emotional Wellbeing Solutions?
- If two state employees are individually enrolled in a Partners for Health medical plan, or have dependents under one parent, is an individual able to receive five no-cost, short-term counseling visits for the same issue under each employee?
- I am an employee with medical coverage through Partners for Health. I have a dependent who lives at home with me but is not enrolled in my health plan. They are benefit eligible. Is that dependent able to utilize Emotional Wellbeing Solutions?
- Who is eligible for the Emotional Wellbeing Solutions program?
- Is preauthorization required for outpatient behavioral health?
Voluntary Dental
- What if there is no DHMO participating general dentist within a 25-mile radius of my home?
- Does coordination of benefits pertain to my dental and/or vision insurance?
- How often are the dental insurance companies selected for the state’s insurance program?
- How can I find out how much a procedure will cost under my Delta Dental DPPO plan?
- What if I am out of the area and need emergency care? Will the Cigna DHMO cover some or all of the services?
- How do I find a Cigna DHMO network dentist?
Voluntary Vision
- Who is eligible to enroll in the state EyeMed vision plan?
- Can I use a portion of my allowance during the calendar year and then use the remaining balance during that same calendar year?
- Can I get a discount on additional replacement contact lenses?
- Who should I contact if I have trouble logging into the EyeMed member website?
- How can I request that my provider be added to the EyeMed network?
- Do I need to file a claim?
Disability -- Central State Government, State Higher Education and State Offline Agencies Only
- What is Disability Insurance?
- What is Short Term Disability Insurance?
- What is Long Term Disability Insurance?
- When am I Eligible to Enroll in Long Term Disability Plans?
- How Much Does Disability Insurance Cost?
- What is the Short Term Disability Benefit, and What Amount Will I Receive?
Life Insurance - State and Higher Education Only
- May I continue my voluntary term life insurance when I terminate employment?
- Basic Life/AD&D - How do I designate a beneficiary or see who I have named as a beneficiary?
- Voluntary Universal Life Insurance
- Voluntary Accidental Death and Dismemberment Insurance
- May a spouse, who is also a state or higher education employee, enroll as an employee and as a dependent of the other spouse?
- How can I find out who I designated as the beneficiary?
General Questions
- What do I do when I get a "bad request" error in Edison?
- What are my premiums?
- How do I contact the Payroll Call Center?
- How do I complete a Verification of Employment for a Tennessee State Government employee?
- How do I create a Zendesk Account?
- How do I update my email address in Edison?
Terms and Definitions
Other Covered Services
- Does the State Group Insurance Program cover breast pumps?
- What happens if I have several covered medical expenses within the same year? Will I have to keep paying part of the cost?
- How is durable medical equipment covered?
- How is chemotherapy covered?
- How are maternity benefits covered?
- Does dialysis require a copay or coinsurance?