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State of Tennessee Group Insurance Program Open Enrollment/Annual Enrollment Transfer Period October 1 – November 1, 2

State of Tennessee Group Insurance Program Open Enrollment/Annual Enrollment Transfer Period October 1 – November 1, 2013. Open Enrollment: October 1 – November 1, 2013 Annual Enrollment Period (AETP) is now an Open Enrollment Late applicant fee will no longer apply in 2014

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State of Tennessee Group Insurance Program Open Enrollment/Annual Enrollment Transfer Period October 1 – November 1, 2

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  1. State of Tennessee Group Insurance ProgramOpen Enrollment/Annual Enrollment Transfer Period October 1 – November 1, 2013

  2. Open Enrollment: October 1 – November 1, 2013 Annual Enrollment Period (AETP) is now an Open Enrollment Late applicant fee will no longer apply in 2014 Employees can make the following changes: Switch PPOs (subject to eligibility) Enroll in Cigna LocalPlus PPO (Middle TN only) Change health insurance carriers Enroll, cancel or make changes to health insurance Enroll in, cancel or transfer between dental options Open Enrollment/Annual Enrollment Transfer Period www.partnersforhealthtn.gov

  3. If you DO NOT want to make changes No action is required this year If you stay in the Partnership PPO, you (and your covered spouse) are agreeing to fulfill the 2014 Partnership Promise If you DO want to make changes You must use Employee Self Service (ESS) in Edison Benefits Administration will not accept paper forms (exception for Local Gov with fewer than 100 employees) Use the Minnesota Life website for the optional term life insurance Open Enrollment/Annual Enrollment Transfer Period www.partnersforhealthtn.gov

  4. Changes take effect on January 1, 2014 Selections remain in effect through December 31, 2014, unless you lose eligibility or have a qualifying event A qualifying event or family status change is something that results in a covered person losing coverage under another plan or becoming newly eligible for coverage Contact your agency benefits coordinator if you experience a qualifying event Open Enrollment/Annual Enrollment Transfer Period www.partnersforhealthtn.gov

  5. Using Edison ESS • To make changes to your health coverage or add dental insurance, you must use Employee Self Service (ESS) in Edison • To use ESS, log on to Edison at www.edison.tn.gov • Instructions on how to use ESS are available in the Decision Guide or from your Agency Benefits Coordinator www.partnersforhealthtn.gov

  6. Health and Dental Premiums Health insurance premiums will increase by the following percentages: State and Higher Ed Plan = 5.5% Local Education Plan = 5.6% Local Government Plan = 5.3% Dental insurance premiums will increase by 3% for both plans What’s Changing for 2014 www.partnersforhealthtn.gov

  7. What’s Changing for 2014 • Late applicant fee • Beginning in January 2014, the late applicant fee will no longer apply • For those currently paying the monthly late applicant fee, the last payroll deduction will occur at the end of November 2013 www.partnersforhealthtn.gov

  8. What’s Changing for 2014 • 2014 Partnership Promise Requirement Changes • In 2014 everyPartnership PPO plan member must complete two things as a part of the Partnership Promise: • Complete the online Well-Being Assessment(WBA) by March 15, 2014 • Get a biometric screening at your doctor’s officeor at a worksite location betweenJuly 16, 2013 and July 15, 2014 www.partnersforhealthtn.gov

  9. Limited PPO available to Local Education Now available to both Local Government and Local Education What you should know about the Limited PPO Monthly premiums are low, but the deductibles and out-of-pocket maximums have changed Be sure to look at out-of-pocket costs carefully What’s Changing for 2014 www.partnersforhealthtn.gov

  10. What’s Changing for 2014 • Additional services apply to out-of-pocket copay maximum • Addition of three services: • Emergency room • In-network chiropractic • In-network urgent care visits • To provide additional financial protection for members, copays for these three services will now count towards the in-network out-of-pocket copay maximum for the Partnership and Standard PPOs and the overall maximum out-of-pocket for the Limited PPO www.partnersforhealthtn.gov

  11. What’s Changing for 2014 • Pharmacy Benefits • $3,750 in-network pharmacy out-of-pocket copay maximum • New benefit this year: Once maximum is reached members will pay $0 in copayments for remainder of year • Increase for Limited PPO copays – Local Gov and Local Ed • Copays in bold have changed • Human Growth Hormone • Will implement step therapy; must try • preferred drug first • Currently two preferred specialty drugs • Impacts very few members • No grandfathering www.partnersforhealthtn.gov

  12. Health Benefits Your Health Insurance Options You have these health insurance options    Preferred Provider Organization (PPO) Options • Partnership PPO • Standard PPO • Limited PPO (Local Education and Local Government) Two Insurance Carriers • BlueCross BlueShield of Tennessee • Cigna Four Premium Levels • Employee • Employee + child(ren) • Employee + spouse • Employee + spouse + child(ren) www.partnersforhealthtn.gov

  13. BlueCross BlueShield (BCBST) and Cigna each have their own network Both carriers have made significant changes to their networks for 2014 Be sure to check the networks carefully when making your decision Provider directories are available on the ParTNers for Health website, by calling the carrier or from your ABC Available Networks: BlueCross BlueShield offers Network S CIGNA offers Open Access Plus Health Benefits www.partnersforhealthtn.gov

  14. Employee Assistance Program (EAP) All services are confidential and available at no cost to members 24/7 You and your eligible dependents may get up to five, no cost counseling sessions per problem episode, per year Your EAP also offers work-life services, financial and legal services, assistance finding eldercare and dependent care services and much more Contact ParTNers EAP: Toll Free 24/7 at 1.855.HERE4TN (1.855.437.3486) Or at www.Here4TN.com Employee Assistance Program (EAP) www.partnersforhealthtn.gov

  15. 2014 Deductibles and Out-of-Pocket Co-insurance Maximums www.partnersforhealthtn.gov

  16. Healthways administers the Partnership Promise Partnership PPO members pay much lower premiums Members and enrolled spouses must complete the Partnership Promise each year 2014 Partnership Promise If you or your spouse fail to fulfill any requirement of the 2014 Partnership Promise, you will both be transferred to the Standard PPO in 2015. www.partnersforhealthtn.gov

  17. 2014 Partnership PPO members and covered spouses must: 1. Complete the online Healthways Well-Being Assessment™ (health questionnaire) between January 1 and March 15, 2014 2. Complete a biometric health screening between July 16, 2013, and July 15, 2014 Members and covered spouses may have to do the following if applicable: Participate in health coaching and/or case management if identified Engage in the Healthways tobacco cessation program if you are a tobacco user Update your contact information with your employer if it changes 2014 Partnership Promise www.partnersforhealthtn.gov

  18. Required Online Well-Being Assessment (WBA) Summarizes your overall health and offers steps you can take to improve The Well-Being Assessment must be completed between January 1 and March 15, 2014 To complete the assessment, visit partnersforhealthtn.govand click on the “My Wellness Tab” 2014 Partnership Promise www.partnersforhealthtn.gov

  19. Required Biometric Health Screening You must get a biometric health screening by July 15, 2014 There are two ways to get a biometric screening: At a worksite screening At your doctor’s office: You may use screening results from a doctor’s visit between July 16, 2013, and July 15, 2014 2014 Partnership Promise www.partnersforhealthtn.gov

  20. 2014 Partnership Promise • Health Coaching • Members and spouses who are identified by Healthways must participate • Health coaching programs include: • Lifestyle management • Disease management • Case Management is managed by BlueCross BlueShield, Cigna and Magellan Healthways’ hours of operation: Monday – Friday 7:30 a.m. to 9:30 p.m. CT Saturday – 8:00 a.m. – 6:30 p.m. CT The Partnership Promise is managed by Healthways www.partnersforhealthtn.gov

  21. Tobacco Cessation Partnership PPO members who use tobacco must participate in Healthways tobacco cessation program andwork toward becoming tobacco free Partnership PPO members who use tobacco products must answer “Yes” to the question “are you a tobacco user” when completing the required online Well-Being Assessment Healthways will reach out to tobacco users to enroll You are not required to quit by the end of 2014 – but must make an effort to quit 2014 Partnership Promise www.partnersforhealthtn.gov

  22. Updating Contact Information Phone number, mailing address and email address, if you have one, must be current with your employer If your information changes during the year, you must notify your employer to update your record 2014 Partnership Promise www.partnersforhealthtn.gov

  23. Dental Benefits Eligible employees can choose between two dental options: • During the enrollment period, eligible employees can enroll in or transfer between the two options • If you don’t change your current dental carrier or cancel coverage, you will keep your current coverage AssurantPrepaid Plan • Fixed copays • Participating dentists only Delta Dental PDO Plan • Coinsurance and deductibles • Any dentist • Pay less with network providers www.partnersforhealthtn.gov

  24. Prepaid Plan Administered by Assurant Employee Benefits The network is DentiCare Predetermined copay amounts (reduced fees) for dental treatments There are no deductibles to meet, no claims to file, no waiting periods for covered members, no annual dollar maximum and pre-existing conditions are covered Referrals are not required To receive benefits, you must select a dentist from the Prepaid Plan list Premiums will increase by 3% in 2014 Note: There are some areas in the state where Assurant network dentists are not available Dental Benefits No Carriers in West TN www.partnersforhealthtn.gov

  25. Dental Benefits Monthly Premiums for Active Members Dental services for both the Prepaid Plan and the Dental PDO include: www.partnersforhealthtn.gov

  26. Optional Vision Plan Administered by EyeMed Vision Care Available to employees at participating agencies Both plans offer the same services There are no premium changes for the Basic Plan or Expanded Plans Vision Benefits Henry County School System does NOT participate in the State Vision Plan. We offer vision through Superior Vision which will be offered by an USAble Rep. www.partnersforhealthtn.gov

  27. If you do not want to make changes, no action is required If you do want to make changes or add coverage, you must use ESS and meet the enrollment deadline of November 1, 2013 Don’t Wait ─ Enroll early! You must click “submit” in ESS to finalize your selections by 11:59 p.m. CT on November 1, 2013 No changes until the next Open Enrollment/Annual Enrollment Transfer Period Take Note! www.partnersforhealthtn.gov

  28. Member Communications Current members will receive a copy of the 2014 Decision Guide at their homes in mid-September. www.partnersforhealthtn.gov

  29. HENRY COUNTYSCHOOL SYSTEM HEALTHINSURANCE PLAN RATES EFFECTIVEJANUARY 1,2014

  30. Primary point of contact - Agency Benefits Coordinator Tiffany Latta, 642-9733 Questions about a provider or claim – contact your insurance carrier Questions about eligibility and enrollment – call Benefits Administration service center at 1-800-253-9981 Our ParTNers for Health website – www.partnersforhealthtn.gov Handbook publications and forms – www.tn.gov/finance/ins Who to Contact www.partnersforhealthtn.gov

  31. Questions?

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