Health Insurance

Category: Features

Open Enrollment

From Sept. 30 through Oct. 11 at 4:30 p.m. CDT, all regular employees working at least 75 percent time will have the opportunity to sign up and make changes to health, dental and vision insurance as part of the state of Tennessee’s open enrollment period. Employees will also have the opportunity to make changes to their term life, long-term care and optional special accident insurance. Visit Partners For Health – TN.gov to enroll or make changes.

There will be no premium increase for active employees. See prices below.

  • Premier PPO: Higher premiums, but lower out-of-pocket costs for deductibles, copays and coinsurance.
  • Standard PPO: Lower premiums than the Premier PPO, but you’ll pay more out-of-pocket for deductibles, copays and coinsurance.
  • CDHP/HSA: Lowest premiums, but you pay your deductible first before the plan pays anything for most services, and then you pay coinsurance, not copays.

PLAN

Primary Doctor’s
Visit Copays

Deductible

Out-of-pocket Maximums

State Contribution to Tax-Free Health Savings Account

Monthly Premiums (Cost may vary based on plan type and insurance carrier / network): Below refers to BCBST &
Cigna LocalPlus

Premier PPO

$25

Employee: $500

Employee + Child(ren): $750

Employee + Spouse: $1,000

Employee + Spouse +
Child(ren): $1,250

Employee: $3,600

Employee + Child(ren): $5,400

Employee + Spouse: $7,200

Employee + Spouse + Child(ren): $9,000

N/A

Employee Only: $136

Employee + Child(ren): $204

Employee + Spouse: $284

Employee + Spouse + Child(ren): $352

Below refers to Cigna Open Access

Employee Only: $176

Employee + Child(ren): $244

Employee + Spouse: $364

Employee + Spouse + Children: $432

Standard PPO

$30

Employee Only: $1,000

Employee + Child(ren): $1,500

Employee + Spouse: $2,000

Employee + Spouse + Child(ren): $2,500

Employee Only: $4,000

Employee + Child(ren): $6,000

Employee + Spouse: $8,000

Employee + Spouse + Child(ren): $10,000

N/A

Below refers to BCBST and Cigna LocalPlus carriers

Employee Only: $92

Employee + Child(ren): $139

Employee + Spouse: $195

Employee + Spouse + Child(ren): $241

Below refers to Cigna Open Access carrier

Employee Only: $132

Employee + Child(ren): $179

Employee + Spouse: $275

Employee + Spouse + Child(ren): $321

CDHP / HSA

20% coinsurance
after deductible

Employee Only: $1,500

Employee + Child(ren): $3,000

Employee + Spouse: $3,000

Employee + Spouse + Child(ren): $3,000

Employee Only: $2,500

Employee + Child(ren): $5,000

Employee + Spouse: $5,000

Employee + Spouse + Child(ren): $5,000

Employee Only: $250

Employee + Child(ren): $500

Employee + Spouse: $500

Employee + Spouse + Child(ren): $500

Below refers to BCBST and Cigna LocalPlus carriers

Employee Only: $60

Employee + Child(ren): $89

Employee + Spouse: $125

Employee + Spouse + Child(ren): $154

Below refers to Cigna Open Access carrier

Employee Only: $100

Employee + Child(ren): $129

Employee + Spouse: $205

Employee + Spouse + Child(ren): $234

Carrier Networks

All carrier networks will remain the same including:

– BlueCross BlueShield Network S
– Cigna LocalPlus
– Cigna Open Access

  • The surcharge for Cigna’s large OAP statewide network will remain $40/$80
  • Providers, hospitals and doctors do move in and out of networks, so it is important to check closely to ensure preferred options are in the plan you choose.

New Acupuncture Benefit

  • The new acupuncture benefit will function the same as the chiropractic benefit. Each person will have 50 visits for each service.
  • For your first 20 visits, you will pay the PCP copay. For visits 21-50, you will pay the specialist copay.
  • Currently, this is a very small statewide network because of a limited number of licensed providers in the state.

New Preferred Substance Use Disorder (SUD) Treatment Facility Network

  • Optum, a leading health services innovation company, will guide members to the preferred facilities that demonstrate the best clinical and cost-effective outcomes for substance use treatment.
  • The benefit is designed to incent members to utilize the preferred substance use facility at no member cost share.
  • PPO members won’t have to pay copays or coinsurance.
  • CDHP members must meet their deductible first before the coinsurance is waived.
  • Benefit applies to facility-based substance-use treatment. Copays and coinsurance apply for standard outpatient treatment services.

Wellness Incentives

  • Maintain your cash incentive to receive up to $250 per employee and spouse ($500 annual maximum).
  • For preventative services and biometric screenings, add a lookback period (12/1/2019 – 11/30/2020).
  • Your preventative screenings and tests during December will count toward your 2020 cash incentives.
  • Add an annual physical (well visit) and receive a $50 incentive.
  • Add a well woman exam and receive a $50 incentive.
  • You can remove prostate screening as an incentive option. This screening has been downgraded to a C or D rating grade from the U.S. Prevention Services Task Force.
  • All other cash incentives currently in place remain unchanged.

State Retiree Health Insurance

  • There will be a 3.2 percent premium increase for state and higher education retirees only.

Dental Insurance

• Same carriers and no premium increases for either option

Cigna Prepaid Dental Plan

– Employee Only: $13.44
– Employee + Child(ren): $27.91
– Employee + Spouse: $23.83
– Employee + Spouse + Child(ren): $32.76

MetLife DPPO Plan

– Employee Only: $23.64
– Employee + Child(ren): $54.36
– Employee + Spouse: $44.72
– Employee + Spouse + Child(ren): $87.50

Davis Vision Plan

• No premium increases for this plan

Basic Plan
– Employee Only: $3.07
– Employee + Children: $6.13
– Employee + Spouse: $5.82
– Employee + Spouse + Child(ren): $9.01

Expanded Plan
– Employee Only: $5.56
– Employee + Children: $11.12
– Employee + Spouse: $10.57
– Employee + Spouse + Child(ren): $16.35

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