Employees
PPACA (Affordable Care Act)
- Can I get insurance through the Marketplace?
- What is the Health Insurance Marketplace?
- If I drop my health coverage, am I subject to the healthcare reform law’s penalty?
- Do the ParTNers for Health plans meet the healthcare reform law’s minimum value requirements?
- What if I already have coverage through my spouse’s employer?
- The healthcare law states that employees must now have health insurance coverage. Does that mean I have to sign up now if I do not have coverage?
Workers Compensation
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?
Disability-State and Higher Education Only
- What is Disability Insurance?
- What is Short Term Disability (STD) Insurance?
- What is Long Term Disability (LTD) insurance?
- Am I required to enroll in the Short Term and Long Term Disability plans?
- When am I eligible to enroll in Short Term and Long Term Disability plans?
- Is Disability Insurance right for me?
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 percent 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 has been paid off, but deductions are still being deducted 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?
COBRA
- ★ What do I do when I get a "bad request" error in Edison?
- How Do I Cancel COBRA?
- Is COBRA different than active benefits?
- What is COBRA?
- Who is eligible for COBRA?
- How do I enroll?
General Questions
- ★ What are my premiums for 2018?
- ★ Does sick leave run concurrent with the Disability Elimination Period
- ★ Payroll Call Center
- ★ I am attempting to enroll in Benefits in Edison, but cannot click the "Benefits Enrollment" link.
- ★ Higher Education Online Enrollment Guide
- ★ How do I add my new spouse/family to the State Group Health Insurance coverage due to a recent marriage?
Announcements
- ★ The state will offer voluntary vision benefits through a new vendor in 2018, Davis Vision.
- For general information about the Wellness Program including wellness and fitness discounts and Weight Watchers at Work, visit the Wellness Program page (http://partnersforhealthtn.gov/wellness.shtml).
- For general information about EAP including services and behavioral health information, visit the EAP page (http://partnersforhealthtn.gov/behavioral_health.shtml) or www.Here4TN.com.
- For general information about carrier information including provider directories and premiums costs, visit the Carrier Information page. (http://partnersforhealthtn.gov/hlth_carrier_information.shtml)
- When looking at the CDHP and the HSA, it is best to consult a tax professional regarding your personal finances and the impact on our federal income taxes.
- For general information about pharmacy including finding a network pharmacy, flu and pneumococcal vaccine and tobacco quit aids, visit the Pharmacy page http://partnersforhealthtn.gov/pharmacy.shtml
Terms and Definitions
Payflex
- HSA Debit Card
- HSA Retail Account
- When will I receive my Form 5498?
- Debit Card Wait Time
- FSA Beneficiary
- PayFlex Address Correction
Flexible Spending Account (FSA)
- What is a flexible spending account (FSA)?
- How much can I contribute to my flexible spending accounts (FSAs)?
- Can I have both a health savings account (HSA) and a medical flexible spending account (medical FSA)?
- Does a flexible spending account (FSA) hurt my other benefits?
- What is the benefit of a medical flexible spending account (medical FSA)?
- What are some common medical flexible spending account (medical FSA) eligible expenses?
Life Insurance - State and Higher Education Only
- May I continue my voluntary term life insurance when I retire or 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 (AD&D) Insurance
- What option do I have for voluntary term life if I am rehired?
- May a spouse, who is also a state or higher education employee, enroll as an employee and as a dependent of the other spouse?
Voluntary Dental
- What happened to my Delta Dental/Assurant Benefits dental?
- How can I find out how much a procedure will cost under my MetLife DPPO plan?
- How do I find a network dentist in the MetLife network?
- What if I am out of the area and need emergency care? Will Cigna Prepaid Dental cover some or all of the services?
- How do I find a Cigna Prepaid Dental network dentist?
- Do I have to select a primary dentist in the Cigna Prepaid Dental plan? Can I change my dentist?
Voluntary Vision
- If I work for a Tennessee Board of Regents (TBR) institution can I enroll in the state EyeMed Vision Program?
- The Tennessee Board of Regents’ (TBR) separate vision plan with VSP will terminate as of January 1, 2017.
- Who is eligible to enroll in the state Davis Vision 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 Davis Vision member website?
ParTNers Employee Assistance Program (EAP)
- I am an employee with health coverage through State sponsored insurance, and I have a dependent that lives at home with me but is not enrolled in my health coverage but they are benefit eligible. Is that dependent able to utilize the EAP/Behavioral Health
- If I am contacted by Optum for case management, am I required to participate?
- Is preauthorization required for outpatient behavioral health?
- What happens if I utilize all of my available EAP sessions, but would like to continue seeing my provider?
- How many sessions do I have through the EAP?
BlueCross BlueShield and Cigna
- BCBST Network S Hospitals 2017 as of 7/17/2017
- What network options are offered by the State of Tennessee?
- What happens when I go to a provider outside LocalPlus but within other Cigna networks?
- Is the plan design any different for the Cigna LocalPlus, Cigna Open Access Plus or the BCBS Network S?
- What is the Informed Choice Outreach Program offered by Cigna?
- If I live in the east region, does that mean I can only go to doctors in that region?
Other Covered Services
- 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 (DME) covered?
- How is chemotherapy covered?
- How are maternity benefits covered?
- Does dialysis require a copay or coinsurance?
- Do advanced imaging and outpatient surgery require a copay or coinsurance?
Pharmacy
- Help! My specialty prescription has gone way up in cost (even to $150). 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?
CDHP/HSA and Local CDHP/HSA
- ★ HSA Account Funds Deposit and FSA Previous Year Balance
- ★ I am an active employee enrolled in CDHP, what actions do I take to stay enrolled for next year?
- ★ Can I change from the CDHP to one of the PPO options next year and then rejoin the CDHP the following year?
- ★ Who is eligible for the CDHP?
- I am turning 65 next July and will be taking Medicare. I am currently on the CDHP plan. Do I need to change my plan during Annual Enrollment or will that be a special qualifying event in July?
- Do the Funds in My HSA Accrue Interest?
ParTNers for Health Wellness Program
Enrollment and Eligibility
- Can any school board member enroll in the State's health insurance plan?
- Is my newborn baby automatically covered for 30 days after he/she is born?
- Return to Active Employment Within 13 Weeks
- Are preexisting conditions covered?
- Can a dependent be dropped from coverage in the middle of the plan year?
- If two employees in the same plan (state, local education or local government) are married, are you required to choose the employee + spouse premium level, or can each sign up for employee only coverage? What if there are children?