1. State of Tennessee Group Insurance Program New Employee Benefits Orientation Local Government Employees July 1 – December 31, 2015

2. 1 Importance of Your Decisions The decisions you make now as a new employee will have lasting effects on your benefits Please note: Some of your decisions can only be made during the new hire period Please make sure that you are aware of all the options available to you and that you make an informed decision Submit any questions to your Agency Benefits Coordinator (ABC) or Benefits Administration (BA) www.partnersforhealthtn.govwww.partnersforhealthtn.gov 1-800-253-9981

3. 2 Resource Materials You will also be provided with an Employee Checklist to confirm that you have been informed of important benefits information For more detailed information, refer to the Eligibility and Enrollment Guide provided by your ABC. www.partnersforhealthtn.govwww.partnersforhealthtn.gov 1-800-253-9981

4. 3 Resource Materials The Summary of Benefits Coverage (SBC) describes your health coverage options. You can print a copy on the Benefits Administration website, or ask your ABC for a copy. www.partnersforhealthtn.govwww.partnersforhealthtn.gov 1-800-253-9981

5. 4 About the Plan The State Group Insurance Program (also called the Plan) covers three different populations: State and Higher Education Employees Local Education Employees Local Government Employees We spend about $1.3 billion annually and cover nearly 300,000 members The health plan is self-insured, meaning that the State, not an insurance company, pays claims from premiums collected from members and their employers The Division of Benefits Administration manages the State Group Insurance Program and works with your Agency Benefits Coordinator (ABC) to serve our Plan members www.partnersforhealthtn.govwww.partnersforhealthtn.gov 1-800-253-9981

6. 5 Who is Eligible for Coverage? Full-time employees are eligible for health insurance coverage as well as their dependents, who may include: Legally married spouses Children up to age 26, including natural, adopted or step-children or children for whom the employee is the legal guardian There are special circumstances for employees with disabled dependents that may allow for coverage of these dependents after age 26 For more information about disabled dependents, refer to the Eligibility and Enrollment Guide or consult your ABC www.partnersforhealthtn.govwww.partnersforhealthtn.gov 1-800-253-9981

7. 6 Notice to TennCare Enrollees You must contact your caseworker at TennCare within 10 days of your date of employment Report to TennCare your new job, salary and that you have access to medical insurance with your new employer Employees cannot be enrolled in both TennCare and a State Group Health Insurance plan www.partnersforhealthtn.govwww.partnersforhealthtn.gov 1-800-253-9981

8. 7 Adding Coverage There are only three times you may add health coverage: 1. As a new employee 2. During Annual Enrollment in the fall 3. If you experience a special qualifying event  A specific life change, such as marriage, the birth of a baby or something that results in loss of other coverage  Must submit paperwork within 60 days of the event or loss of other coverage  A complete list is provided on page three of the enrollment application www.partnersforhealthtn.govwww.partnersforhealthtn.gov 1-800-253-9981

9. 8 Annual Enrollment During Annual Enrollment you may: Enroll, cancel or make changes to health insurance Select or change your health insurance carrier Choose or switch PPOs (subject to eligibility) Enroll in, cancel or transfer between dental options (if offered by your agency) Enroll in, cancel or transfer between vision coverage (if offered by your agency) Changes are effective January 1 of the following year Annual Enrollment occurs each year during the fall. www.partnersforhealthtn.govwww.partnersforhealthtn.gov 1-800-253-9981

10. 9 Canceling Coverage You may only cancel health, dental or vision coverage for yourself or your dependents: 1.During Annual Enrollment 2.If you become ineligible to continue coverage 3.If you experience a qualifying event listed on the Insurance Cancel Request Application You cannot cancel coverage during the plan year, outside of Annual Enrollment, unless you have a qualifying event or lose eligibility under the plan www.partnersforhealthtn.govwww.partnersforhealthtn.gov 1-800-253-9981

11. 10 Definitions Premiums are the amount you pay each month for your coverage regardless of whether or not you receive health services A copay is a flat dollar amount you pay for services and products, like office visits and prescriptions A deductible is a set dollar amount that you pay out-of-pocket each year for services Co-insurance is a form of payment where you pay a percentage of the cost for a service, after meeting your deductible www.partnersforhealthtn.govwww.partnersforhealthtn.gov 1-800-253-9981

12. 11 Definitions The out-of-pocket maximum is the limit on the amount of money you will have to pay each year in deductibles, co-insurance and copays and limits how much you pay for certain in-network services and out-of-network services A network is a group of doctors, hospitals and other health care providers contracted with a health insurance plan to provide services to members at pre-negotiated (and usually discounted) fees The maximum allowable charge (MAC) is the most a plan will pay for a service For a complete list of definitions, see the Eligibility and Enrollment Guide or visit our website. www.partnersforhealthtn.govwww.partnersforhealthtn.gov 1-800-253-9981

13. 12 Choosing Your Health Insurance Options Three Preferred Provider Organization (PPO) Options  Partnership PPO  Standard PPO  Limited PPO Four Premium Levels (tiers) Employee Employee + child(ren) Employee + spouse Employee + spouse + child(ren) After the initial new hire period, changes can only be made if you experience a special qualifying event or during Annual Enrollment in the fall. Two Insurance Carriers BlueCross BlueShield of Tennessee Cigna  www.partnersforhealthtn.govwww.partnersforhealthtn.gov 1-800-253-9981

14. 13 Plan Options (PPOs) There are three health insurance plan options available to you: Partnership PPO Standard PPO Limited PPO All of these plan options are Preferred Provider Organizations (PPOs) How a PPO Works: Visit any doctor or hospital you want However, the PPO has a list of in-network doctors, hospitals and other providers that you are encouraged to use These in-network providers have agreed to take lower fees so you pay less for services You will pay more for services from out-of-network providers www.partnersforhealthtn.govwww.partnersforhealthtn.gov 1-800-253-9981

15. 14 Step One: Comparing Your PPO Options All options cover the same services and treatments. However, you will always pay less for services if you are enrolled in the Partnership PPO. www.partnersforhealthtn.govwww.partnersforhealthtn.gov 1-800-253-9981  Partnership PPOStandard PPOLimited PPO Rewards members for taking an active role in their health No incentives for healthy behaviors High deductible and out-of-pocket costs Commitment to Partnership Promise is required Members pay a greater share of costs Lower monthly premiums

16. 15 Partnership PPO www.partnersforhealthtn.govwww.partnersforhealthtn.gov 1-800-253-9981 The State Group Insurance Program determines the Partnership Promise requirements and Healthways administers the Partnership Promise Partnership PPO members save money on premiums and out-of-pocket costs versus the Standard PPO The Partnership Promise is an annual commitment and in order to remain in the Partnership PPO, members and covered spouses must complete the Partnership Promise each year The Partnership Promise requirements may change from one year to the next On average, an employee with no dependents can save $506 on premiums and out-of-pocket costs through the Partnership PPO instead of the Standard PPO. An employee with a covered spouse and dependents can save $1,041 on average. Estimated savings are based on a full year of health insurance premiums and average out-of-pocket costs.

17. 16 Partnership PPO Goal of the Partnership Promise Goal of the Partnership Promise: To help you get and stay healthy Why is this important? Poor health costs all of us: > We pay more in doctor’s visits and hospitalizations > All members pay higher health insurance premiums > Impacts our quality of life Now the good news: We can reduce healthcare costs with our own personal choices. Most members want to lose weight, eat healthy, increase exercise and quit tobacco. The Partnership PPO can help The Partnership PPO rewards members with lower costs because they have agreed to take steps to improve their health. These steps are called the Partnership Promise. Partnership PPO members promise to take these steps in exchange for lower health insurance rates and lower costs for services www.partnersforhealthtn.govwww.partnersforhealthtn.gov 1-800-253-9981

18. Partnership Promise – 2015 New Members 17 2015 new members and covered spouses must: Complete the online Well-Being Assessment (WBA) Get a biometric health screening * Both requirements must be completed within 120 days of your insurance coverage effective date www.partnersforhealthtn.govwww.partnersforhealthtn.gov 1-800-253-9981

19. 18 Partnership Promise You (and your covered spouse) will have 120 days from your coverage effective date to complete the Well-Being Assessment (WBA). www.partnersforhealthtn.govwww.partnersforhealthtn.gov 1-800-253-9981 Online Well-Being Assessment (WBA) Summarizes your overall health and offers steps you can take to improve To complete the assessment, visit partnersforhealthtn.gov and click on the “My Wellness Tab” to create an online Well-Being Account to access the assessment

20. 19 Partnership Promise www.partnersforhealthtn.govwww.partnersforhealthtn.gov 1-800-253-9981 Biometric Health Screening A biometric health screening is required within 120 days of your insurance coverage effective date  Biometric screenings include height, weight, blood pressure and waist circumference. A sample of your blood is collected to determine blood sugar and cholesterol levels  Members can get this screening from their healthcare provider  Visit the Quick Links box on the ParTNers for Health website (partnersforhealthtn.gov) to print a Physician Screening Form (PSF)  Take the form with you when you visit the doctor. You and your doctor will need to complete and sign the form  Send it by fax, mail to the address on the form or upload to the OHD website

21. 20 If You Cover Your Spouse Same PPO option Your spouse must also commit to the 2015 Partnership Promise and complete the requirements within 120 days Complete the Well-Being Assessment Complete a biometric health screening Exception: If you and your spouse both work for a participating employer you can choose different PPO options www.partnersforhealthtn.govwww.partnersforhealthtn.gov 1-800-253-9981

22. 21 Standard and Limited PPOs The Standard and Limited PPOs offer the same services as the Partnership PPO With the Standard PPO, you will pay more for monthly premiums, annual deductibles, copays, medical care co-insurance and out-of- pocket maximums With the Limited PPO, you will pay less for monthly premiums but have higher out-of-pocket costs Members enrolled in the Standard and Limited PPOs are not required to fulfill the Partnership Promise – but do have access to the ParTNers for Health Wellness Program and other tools, information and resources www.partnersforhealthtn.govwww.partnersforhealthtn.gov 1-800-253-9981

23. 22 Step 2: Choosing an Insurance Carrier You have a choice of two carriers: BlueCross BlueShield of Tennessee, which offers Network S Cigna, which offers Open Access Plus (statewide) or LocalPlus Network (Middle Tennessee eligible individuals only) Cigna LocalPlus has a narrower (smaller) network than Cigna Open Access Plus You may choose between these two carriers, regardless of the PPO option you select Check the networks carefully to make sure your preferred doctors and hospitals are in the network you choose www.partnersforhealthtn.govwww.partnersforhealthtn.gov 1-800-253-9981 

24. 23 Choosing an Insurance Carrier Each carrier offers statewide and national networks, regardless of the region where you live. www.partnersforhealthtn.govwww.partnersforhealthtn.gov 1-800-253-9981 Carrier costs vary by your region In East and Middle Tennessee: Cigna Open Access Plus costs $20 more per month for employee only coverage and $40 more per month for all other tiers (coverage levels) In Middle Tennessee (only): Cigna LocalPlus costs the same as BCBST. Cigna Open Access Plus costs more than BCBST and Cigna LocalPlus In West Tennessee: BlueCross BlueShield costs $20 more per month for employee only coverage and $40 more per month for all other premium tiers

25. 24 Choosing an Insurance Carrier If you select Cigna as your insurance carrier, you can choose between two different Cigna options: Cigna Open Access Plus Cigna LocalPlus Cigna Open Access Plus costs more in Middle Tennessee than Cigna LocalPlus, but Cigna LocalPlus has a narrower (or smaller) network With Cigna LocalPlus, certain hospital systems are not included. Check the network carefully before making this choice Cigna LocalPlus premiums are the same as BlueCross BlueShield of Tennessee in Middle Tennessee www.partnersforhealthtn.govwww.partnersforhealthtn.gov 1-800-253-9981 Note: In Middle Tennessee Only

26. 25 Step Three: Choosing Your Premium Level The amount you pay in premiums depends on the PPO you choose and the number of people you cover under the plan There are four premium levels (tiers) available: Employee Only Employee + Child(ren) Employee + Spouse Employee + Spouse + Child(ren) Remember: The Partnership PPO premiums are lower than the premiums for the Standard PPO. www.partnersforhealthtn.govwww.partnersforhealthtn.gov 1-800-253-9981 

27. 26 Choosing Your Premium Level If your spouse works for a participating employer, you have another option: Choose premium level (dependent on your situation either employee-only or employee + child or children), PPO and insurance carrier separately www.partnersforhealthtn.govwww.partnersforhealthtn.gov 1-800-253-9981

28. 27 Premiums: Local Government Total Monthly Premiums* *Premiums shown are for the least expensive carrier in the region and are for Premium Level 1. A complete chart is available in the Eligibility and Enrollment Guide and the ParTNers for Health website. www.partnersforhealthtn.govwww.partnersforhealthtn.gov 1-800-253-9981 The State does not pay any premiums for Local Government Plan employees. However, some Local Government employers may pay a portion. Premium Level Partnership PPO Standard PPO Limited PPO Employee Only$611.55$636.55$391.61 Employee + Child(ren)$947.90$972.90$606.99 Employee + Spouse$1,314.81$1,364.81$841.96 Employee + Spouse + Child(ren)$1,651.18$1,701.18$1,057.35

29. 28 Covered Services The PPOs cover the same services, treatments and products, including the following: In-network preventive care, x-rays, lab and diagnostics at no additional cost Free preventive health services (must visit an in-network provider) Fixed copays for some services Different medical criteria may apply based on carriers PPOs offer: Deductibles and co-insurance for certain services Out-of-pocket maximums to limit costs A comparison chart that lists covered services and their costs is available in the Eligibility and Enrollment guide and on the ParTNers for Health websiteParTNers for Health website www.partnersforhealthtn.govwww.partnersforhealthtn.gov 1-800-253-9981 Carriers may offer discounts for services not covered. Refer to the carrier’s member handbooks or websites for more information.

30. 29 Copays www.partnersforhealthtn.govwww.partnersforhealthtn.gov 1-800-253-9981 Partnership PPOStandard PPOLimited PPO In-NetworkOut-of- Network* In-NetworkOut-of- Network* In-NetworkOut-of- Network* Preventive CareNo charge$45 copayNo charge$50 copayNo charge$50 copay Well-baby or Well-child Visits No charge$45 copayNo charge$50 copayNo charge$50 copay Primary Care$25 copay$45 copay$30 copay$50 copay$35 copay$55 copay Specialty Care$45 copay$70 copay$50 copay$75 copay$55 copay$80 copay Prescription Drugs (30-day supply at Retail Pharmacy) $5 copay generic $35 copay preferred brand $85 copay non-preferred brand Copay for applicable tier plus amount over MAC $10 copay generic $45 copay preferred brand $95 copay non-preferred brand Copay for applicable tier plus amount over MAC $10 copay generic $55 copay preferred brand $105 copay non-preferred brand Copay for applicable tier plus amount over MAC

31. 30 Free In-Network Preventive Care Annual preventive care check-up offered to members at no cost Lab work related to the preventive care visit covered at 100 percent You need to visit an in-network provider to receive preventive care services at no cost Regular preventive care is one of the most important things you can do to stay healthy. www.partnersforhealthtn.govwww.partnersforhealthtn.gov 1-800-253-9981

32. 31 Co-Insurance www.partnersforhealthtn.govwww.partnersforhealthtn.gov 1-800-253-9981 Prior authorization is required for inpatient care, advanced x-ray, scans and imaging, inpatient therapy and certain medical equipment. Partnership PPOStandard PPOLimited PPO In-Network Out-of- Network* In-Network Out-of- Network* In-Network Out-of- Network* Inpatient Care (Including Mental Health and Substance Abuse) You pay 10%You pay 40%You pay 20%You pay 40%You pay 30%You pay 50% Advanced X-ray, Scans and Imaging You pay 10%You pay 40%You pay 20%You pay 40%You pay 30%You pay 50% Occupational Therapy, Physical Therapy, Speech Therapy You pay 10%You pay 40%You pay 20%You pay 40%You pay 30%You pay 50% Durable Medical Equipment You pay 10%You pay 40%You pay 20%You pay 40%You pay 30%You pay 50%

33. 32 Annual Deductibles You pay the annual deductible before co-insurance benefits kick in. But, any costs you pay toward your deductible will apply to your out-of-pocket maximum. www.partnersforhealthtn.govwww.partnersforhealthtn.gov 1-800-253-9981 Partnership PPOStandard PPOLimited PPO Annual DeductibleIn-Network Out-of- Network In-Network Out-of- Network In-Network Out-of- Network Employee only$450$800 $1,500$1,200$2,300 Employee + Child(ren)$700$1,250 $2,350$1,800$3,350 Employee + Spouse$900$1,600 $3,000$2,100$3,900 Employee + Spouse + Child(ren)$1,150$2,050 $3,850$2,600$4,950

34. 33 Out-of-Pocket Maximums *Members are responsible for 100% of non-emergency out-of-network provider charges above the maximum allowable charge (MAC). www.partnersforhealthtn.govwww.partnersforhealthtn.gov 1-800-253-9981 Partnership PPOStandard PPOLimited PPO Out-of-Pocket Co-insurance Maximum In-Network Out-of- Network* In-Network Out-of- Network* In-Network Out-of- Network* Employee Only$2,300$3,500$2,600$3,900$6,600$12,700 Employee + Child(ren)$3,200$4,600$3,800$5,900$13,200$25,400 Employee + Spouse$3,700$5,800$4,500$7,200$13,200$25,400 Employee + Spouse + Child(ren)$4,600$7,500$5,200$9,500$13,200$25,400

35. 34 Take Note! Deductibles and out-of-pocket maximums for in-network and out-of-network services add up separately Services received in-network count toward your in-network deductible and out-of-pocket maximum Services received out-of-network count toward your out-of-network deductible and out-of-pocket maximum Ineligible expenses, including non-covered services and expenses over the MAC don’t count toward deductibles and out-of-pocket maximums. DeductibleOut-of-Pocket Max In-Network$450$2,300 DeductibleOut-of-Pocket Max Out-of-Network$800$3,500 www.partnersforhealthtn.govwww.partnersforhealthtn.gov 1-800-253-9981

36. 35 Pharmacy Benefits www.partnersforhealthtn.govwww.partnersforhealthtn.gov 1-800-253-9981 CVS/caremark is the pharmacy benefits manager for all plan members  The covered drug list is the same for the Partnership, Standard and Limited PPOs  How much you pay depends on the prescription tier Lowest cost: Tier one/generic drug Higher cost: Tier two/preferred drug Highest cost: Tier three/non-preferred brand  More than 67,000 independent and chain pharmacies throughout the U.S. About 916 Tennessee pharmacies fill 90-day prescriptions in the Retail 90 Network Tobacco Cessation: The state’s prescription drug coverage provides free tobacco quit aids to members who want to stop using tobacco products.

37. 36 Prescription Drug Copays www.partnersforhealthtn.govwww.partnersforhealthtn.gov 1-800-253-9981 Partnership PPOStandard PPOLimited PPO In-NetworkOut-of-NetworkIn-NetworkOut-of- Network In-NetworkOut-of- Network Annual Deductible N/A $100 per member 30-Day Supply (only from pharmacies in the 30-day network) $5 copay generic $35 copay preferred brand $85 copay non- preferred brand copay, plus any amount exceeding MAC $10 copay for generic $45 copay for preferred brand $95 copay for non- preferred brand copay, plus any amount exceeding MAC $10 copay for generic $55 copay for preferred brand $105 copay for non- preferred brand copay, plus any amount exceeding MAC 90-Day Supply (90-day network pharmacy or mail order) $10 copay generic $65 copay preferred brand $165 copay non- preferred brand copay, plus any amount exceeding MAC $20 copay for generic $85 copay for preferred brand $185 copay for non- preferred brand copay, plus any amount exceeding MAC $20 copay for generic $105 copay for preferred brand $205 copay for non- preferred brand copay, plus any amount exceeding MAC 90-Day Supply (certain maintenance medications from 90-day pharmacy or mail order) $5 copay generic $30 copay preferred brand $160 copay non- preferred brand copay, plus any amount exceeding MAC $10 copay generic $40 copay preferred brand $180 copay non- preferred brand copay, plus any amount exceeding MAC $10 copay generic $50 copay preferred brand $200 copay non- preferred brand copay, plus any amount exceeding MAC

38. 37 Behavioral Health Benefits and Employee Assistance Program www.partnersforhealthtn.govwww.partnersforhealthtn.gov 1-800-253-9981 Behavioral Health and Employee Assistance Program (EAP) Both are included for everyone with medical benefits in all plans Not an optional or added benefit – provided for all with medical benefits You and your dependents receive EAP benefits

39. 38 Employee Assistance Program (EAP) – Free www.partnersforhealthtn.govwww.partnersforhealthtn.gov 1-800-253-9981 All services are free, confidential and available to members 24/7 You and your eligible dependents may get up to five, free counseling sessions per problem episode, per year Just a few issues EAP can help with: Contact ParTNers EAP: Toll Free 24/7 at 1.855.HERE4TN (1.855.437.3486) Or at www.Here4TN.com Family or relationship issuesChild and elder care Feeling anxious or depressedDifficulties and conflicts at work Dealing with addictionGrief and loss Legal or financial issuesWork/life balance

40. 39 Behavioral Health and Substance Abuse Treatment www.partnersforhealthtn.govwww.partnersforhealthtn.gov 1-800-253-9981 Members of the State Group Health Insurance Program and their dependents enrolled in health coverage have behavioral health and substance abuse treatment benefits through Magellan Health Call 1.855.HERE.4.TN (1.855.437.3486) or www.HERE4TN.comwww.HERE4TN.com Services generally include: Outpatient assessment and treatment Inpatient assessment and treatment Alternative care such as partial hospitalization, residential treatment and intensive outpatient treatment Treatment follow-up and aftercare Costs are based on your health plan (PPO) Prior authorization is required for some services

41. 40 Dental Benefits www.partnersforhealthtn.govwww.partnersforhealthtn.gov 1-800-253-9981 Eligible employees can choose between two dental options (if offered by your agency): Eligible employees can enroll in one of two options Unlike health insurance where a portion of the premium is paid by the employer, dental insurance is paid 100 percent by the employee Assurant Prepaid PlanDelta Dental PDO Plan Fixed CopaysCoinsurance and deductibles Participating dentists onlyAny dentist Pay less with network providers

42. 41 Prepaid Plan www.partnersforhealthtn.govwww.partnersforhealthtn.gov 1-800-253-9981 Prepaid Plan Administered by Assurant Employee Benefits The Prepaid Plan provides services at predetermined copay amounts from a limited network of participating dentists and specialists You must select a dentist from the Prepaid Plan list and notify Assurant There are some areas in the state where network dentists are not available You must use your selected dentist to receive benefits Services are provided at predetermined member copay amounts No deductible, no claims and no waiting period Referrals are not required

43. 42 Preferred Dental Organization www.partnersforhealthtn.govwww.partnersforhealthtn.gov 1-800-253-9981 Preferred Dental Organization (PDO) Plan administered by Delta Dental The PDO plan provides services with member coinsurance rates Choose any dentist (maximum benefits when visiting an in-network Delta Dental PPO provider) You pay co-insurance for covered services A deductible applies for out-of-network dental care only You or your dentist will file claims for covered services Referrals are not required, but are recommended in some instances Some services require waiting a 12-month waiting period There are some limitation and exclusions

44. 43 Dental Premiums Dental services for both the Prepaid Plan and the Dental PDO include: Periodic oral evaluations Routine Cleanings Amalgam fillings Endodontic – Root Canal X-rays Extractions Major restorations Orthodontics Dentures PremiumsPrepaid PlanPDO Plan Employee Only$10.13$21.51 Employee + Child(ren)$21.03$49.46 Employee + Spouse$17.95$40.69 Employee + Spouse + Child(ren)$24.68$79.62 www.partnersforhealthtn.govwww.partnersforhealthtn.gov 1-800-253-9981

45. 44 Optional Vision Benefits 44 www.partnersforhealthtn.govwww.partnersforhealthtn.gov 1-800-253-9981 Administered by EyeMed Vision Care There are two plan options (if offered by your agency): Both plans offer the same services Basic PlanExpanded Plan Discounted ratesCo-pays Allowances Discounted rates

46. 45 Vision Premiums PremiumsBasic PlanExpanded Plan Employee Only $3.35$5.86 Employee + Child(ren) $6.69$11.72 Employee + Spouse $6.35$11.14 Employee + Spouse + Child(ren) $9.83$17.23 Each year during Annual Enrollment, eligible employees can enroll in or transfer between vision options. www.partnersforhealthtn.govwww.partnersforhealthtn.gov 1-800-253-9981 Monthly premiums for Active Members: EyeMed offers some additional discounts

47. 46 Additional Benefits Local Government employees are also eligible for: ParTNers for Health Wellness Program Long-Term Care Insurance ParTNers for Health Employee Assistance Program (EAP) Did You Know? All health plan members have access to the ParTNers for Health Wellness Program even if enrolled in the Standard or Limited PPOs. www.partnersforhealthtn.govwww.partnersforhealthtn.gov 1-800-253-9981

48. 47 ParTNers for Health Wellness Program www.partnersforhealthtn.govwww.partnersforhealthtn.gov 1-800-253-9981 The ParTNers for Health Wellness Program is FREE to all health insurance plan members, eligible spouses and dependents Wellness Resources: Health Coaching – call Healthways and get support from a health coach Well-Being Assessment (WBA) – online questionnaire Nurse Advice Line – medical information and support at no cost to you Wellness Challenges – a fun way to help develop a healthier lifestyle with group support Weight Watchers at Work discounts and Fitness Center discounts Additional wellness and fitness discounts through the EAP program and our carriers BCBST and Cigna To access any of the services listed here, visit the wellness webpage on the ParTNers for Health websitewellness webpage

49. 48 Working for a Healthier Tennessee  The Working for a Healthier Tennessee program builds on the foundation of the existing ParTNers for Health Wellness Program by expanding certain wellness resourced to employees, regardless of whether or not they are enrolled in health coverage  The goal of Working for a Healthier Tennessee is to encourage and enable employees to lead healthier lives by focusing on three key areas: 1. Physical Activity 2. Healthy Eating 3. Tobacco Cessation  Some of our agencies have a Site Champion who provides ideas and activities to help employees improve in the three key areas www.partnersforhealthtn.govwww.partnersforhealthtn.gov 1-800-253-9981

50. 49 Long-Term Care Insurance www.partnersforhealthtn.govwww.partnersforhealthtn.gov 1-800-253-9981 Long-Term Care Insurance is administered by MedAmerica Covers services for individuals who are no longer able to care for themselves: Nursing home care Assisted living Home healthcare You have 90 days to enroll with guaranteed-issue coverage Your spouse, dependent children, parents and parents-in-law may also apply through medical underwriting Premiums are based on the age of the insured at the time of enrollment Home care Adult Day Care

51. 50 Enrolling in Benefits Two ways to enroll: Edison Employee Self -Service (ESS) Enrollment Change Application Enrollment must be completed within 31 days of your eligibility date Any required dependent verification must also be submitted during this timeframe Ask your ABC if a probationary period applies for insurance coverage since this can determine when you are able to enroll.

52. 51 Online Enrollment through ESS To select your health insurance and other benefit options online Log on to Edison »www.edison.tn.govwww.edison.tn.gov »Use username and temporary password provided by your ABC »Navigate to bottom left hand side of the main page »Click on BENEFITS ENROLLMENT »Click the SELECT button »Follow the prompts to enroll If you are covering dependents, you can submit dependent verification by: »Uploading electronic documentation »Faxing documentation to Benefits Administration service center www.partnersforhealthtn.govwww.partnersforhealthtn.gov 1-800-253-9981

53. 52 When Will Coverage Begin? Health, dental and vision coverage begin on the first day of the month following your eligibility date For example, if you are eligible on September 15, your coverage would begin on October 1 Ask your ABC if you have questions about when your coverage begins www.partnersforhealthtn.govwww.partnersforhealthtn.gov 1-800-253-9981

54. 53 When Are Premiums Paid? Your ABC will tell you when your premiums will be deducted from your paycheck To avoid a large deduction from your first paycheck, submit your benefit selections in ESS or your enrollment forms to your ABC as soon as possible www.partnersforhealthtn.govwww.partnersforhealthtn.gov 1-800-253-9981

55. 54 When Will My ID Cards Arrive? Within three weeks of the date your application is processed CVS/caremark will send separate ID cards for your pharmacy benefits (Note: Each family member’s card may arrive in a separate envelope) If you enroll in dental or vision benefits, you will also receive your ID cards within three weeks www.partnersforhealthtn.govwww.partnersforhealthtn.gov 1-800-253-9981 BlueCross BlueShieldCigna Will send up to two ID cards automatically, both with the member’s name Will send separate ID cards for each insured family member with each participant’s name These may be used by any covered dependent There may be up to four ID cards in each envelope

56. 55 Retiree Insurance www.partnersforhealthtn.govwww.partnersforhealthtn.gov 1-800-253-9981 As of July 1, 2015, retiree health insurance coverage (pre-65 retirees) will not be available to any employee whose employment first began on or after July 1, 2015. Medicare supplement insurance will not be available to any employee whose first employment began on or after July 1, 2015. Any employee whose first employment with the participating local government agency from which the employee is retiring began before July 1, 2015, and who returns to employment with that same agency after July 1, 2015, may participate in retiree coverage if the employee meets all other eligibility requirements for retirement insurance. If you have questions about the above or your insurance options, we encourage you to talk to your Agency Benefits Coordinator (ABC).

57. 56 Your Privacy www.partnersforhealthtn.govwww.partnersforhealthtn.gov 1-800-253-9981 Your personal health information is strictly confidential Your health privacy rights are protected through a federal law called “HIPAA” Benefits Administration can only discuss benefits information with the head of contract (HOC) The Authorization for Release of Protected Health Information form must be completed before Benefits Administration can discuss benefits information with your spouse or other authorized representative To print and complete a release form, visit http://www.tn.gov/finance/ins/forms.html.

58. 57 Insurance Carrier Websites BlueCross BlueShield, Cigna and CVS/caremark each offer member websites that allow you to: View detailed information about your claims Print temporary ID cards Access other helpful member services  BlueCross BlueShield  Cigna www.bcbst.com/members/tn_state/ www.cigna.com/site/stateoftn www.partnersforhealthtn.govwww.partnersforhealthtn.gov 1-800-253-9981  CVS/caremark www.info.caremark.com/stateoftn

59. 58 Who to Contact Your primary point of contact is your Agency Benefits Coordinator (ABC) If you have questions about a provider or insurance claim, contact your insurance carrier directly at the number listed on the inside cover of the Eligibility and Enrollment Guide, visit your carrier’s member website or use the number on the back of your ID card If you have questions about eligibility and enrollment, call the Benefits Administration service center at 1-800-253-9981 Benefits Administration www.tn.gov/finance/ins ParTNers for Health www.partnersforhealthtn.gov www.partnersforhealthtn.gov 1-800-253-9981

60. 59 Thank you for your attention during this presentation. More information is available at www.TN.gov/finance/ins.www.TN.gov/finance/ins If you have questions, please ask your Agency Benefits Coordinator at this time.