Agenda Annual Enrollment Period What’s Important for 2017

Annual Enrollment Period Enrollment ends at 4:30 p.m. Central
State of Tennessee Group Insurance Program State and Higher Education Annual Enrollment Period October 3 – October 14, 2016 Enrollment ends at 4:30 p.m. Central Please note, the annual enrollment dates for state and higher education employees have changed. Eligible employees will have two business weeks to enroll from October 3 through October 14. Enrollment will end at 4:30 p.m. on October 14.

Agenda Annual Enrollment Period What’s Important for 2017
Using ESS in Edison Health Benefits Overview 2017 Partnership Promise Dental, Vision and Additional Benefits Overview Thanks for attending our meeting today. I’m [presenter name] and today we’ll cover these topics: The annual enrollment period for 2017 insurance benefits What’s Important for 2017 Using ESS in Edison An overview of your health benefits The 2017 Partnership Promise An overview of dental, vision and other voluntary benefits We’ll also take some time to answer your questions.

Annual Enrollment Period
October 3 to October 14 - ends at 4:30 p.m. Central Annual Enrollment Period (AEP) is an open enrollment for most programs Shorter time period this year! Only two business weeks! You can make the following changes: Change, enroll or cancel health insurance for yourself or your eligible dependents Choose or change your health insurance network/carrier New network option this year – you have the choice of three networks Enroll in, cancel or transfer between dental options Enroll in, cancel or transfer between vision coverage options Enroll in or cancel voluntary accidental death & dismemberment coverage Apply for, cancel, increase or decrease voluntary term life coverage amounts (if eligible) Enroll in flexible spending accounts (flexible benefits) The annual enrollment dates are on the screen - October 3 to October 14, 2016, for most programs. This is when you can change your benefits. Please note, the enrollment will end at 4:30 p.m. Central time on October 14 – this is a much shorter time period than last year! First, you can enroll, change or cancel health insurance for yourself or your eligible dependents We’ll talk more about the health plan options and a very important change about the Partnership Promise in just a minute. You must use Employee Self Service (ESS) in Edison to make changes. Next, you can select or change your health insurance network. There is a new network option this year – this is a larger network, but it costs more. You will have the choice of three different networks. You can enroll in, cancel or transfer between dental options. Enroll in, cancel or transfer between vision coverage. For State and Higher Education employees: You can also enroll in or cancel voluntary accidental death & dismemberment coverage and voluntary term life insurance if eligible. Flexible benefits: State employees will enroll in ESS from October 3 to October 14 Higher education employees will enroll on the PayFlex website from Oct 1 to October 31

Very Important Changes
Premiums, copays, coinsurance and deductibles are changing. You should look closely at all costs in your plan options for 2017. Partnership Promise Change Due to federal rule changes, all members can enroll in any health option. If you and your spouse are currently in the Partnership PPO or the Wellness HealthSavings CDHP in 2016 and you do not complete the 2016 Partnership Promise, you can stay in your plan, but you do not qualify for the lower Partnership PPO premium or state health savings account (HSA) money. This means you will pay a higher premium if you stay in the Partnership PPO. Or, if you stay in the HealthSavings CDHP, the state will not put money in your HSA. Cost changes take place automatically – you could pay more if you don’t make a change You can choose a different plan option during annual enrollment Premiums, copays, coinsurance and deductibles are changing. You should look closely at all costs in your plan options for 2017. Partnership Promise Change Due to federal rule changes, all members can enroll in any health option. If you and your spouse are currently in the Partnership PPO or the HealthSavings CDHP in 2016 and you do not complete the 2016 Partnership Promise, you can stay in your plan, but you do not qualify for the lower Partnership PPO premium or state health savings account (HSA) money. This means you will pay a higher premium if you stay in the Partnership PPO. Or, if you stay in the HealthSavings CDHP, the state will not put money in your HSA. Cost changes take place automatically – you could pay more if you don’t make a change You can choose a different plan option during annual enrollment If you want to choose a different plan option – you must make this change during annual enrollment

What is ALEX? ALEX is a smart, funny benefits expert who explains benefits and may help members choose what’s best for them. Go to Coming September 1 - we also have ALEX! ALEX is an online tool that explains your benefits choices and may help you choose which plan is best for you. Alex will be available online 24/7. Go to and click on ALEX for State and Higher Education. This tool will walk you through your health plan options and estimated costs based on information you enter into the decision tool. ALEX also includes information about dental, vision, EAP services and tax savings information that is especially helpful for the CDHP/HSA options.

If you DO NOT want to make changes … You will keep your current benefits. This means you will stay in your current options (PPO or CDHP) with your current network (BCBS Network S or Cigna LocalPlus). Remember, if you are in the Partnership PPO or the Wellness HealthSavings CDHP and you do not complete the 2016 Partnership Promise, you will pay a higher premium in the Partnership PPO in Or, if in the HealthSavings CDHP, the state will not put funds in your HSA. Cost changes will take place automatically 2017 Partnership Promise Plan Members: Members and spouses who enroll in or stay in a plan with the Partnership Promise agree to fulfill the 2017 Partnership Promise. Three health insurance networks! You will have the choice between three different health insurance networks. Check the networks and provider directories carefully! If you want to change networks - you must make this change If you DO NOT want to make changes You will keep your current benefits. This means you will stay in your current options (PPO or CDHP) with your current network (BCBS Network S or Cigna LocalPlus). Remember, if you are in the Partnership PPO or the Wellness HealthSavings CDHP and did not complete the 2016 Partnership Promise, you will pay a higher premium in the Partnership PPO. Or, if in the HealthSavings CDHP, the state will not put funds in your HSA. If you do not make a change, cost changes will take place automatically – meaning you will pay higher premiums in the PPO or you will not receive state HSA funds 2017 Partnership Promise Plan Members: Members and spouses who enroll in the Partnership Promise PPO or the Promise HealthSavings CDHP automatically agree to fulfill the 2017 Partnership Promise. Health insurance networks: You will have the choice between three different health insurance networks. Check the networks and provider directories carefully! If you want to make a change to your network, you must do so in ESS.

If you DO want to make changes You must use Employee Self Service (ESS) in Edison Enroll early! The enrollment period is shorter - submit your changes as early as possible. Enrollment ends at 4:30 p.m. Central on October 14. All new dependent verification documents must be received by 4:30 p.m. Central on October 14. Life Insurance: Use the Minnesota Life website for voluntary term life insurance. Flexible benefits: State employees: October 3 to October 14 in ESS Higher education employees: October 1 – October 31 on PayFlex website If you do want to make changes this year, you must use Employee Self Service (ESS) in Edison. Enroll early! You only have two business weeks to make changes! Enrollment ends at 4:30 p.m. Central on October 14. If you are adding dependents, all dependent verification documents must be received by 4:30 p.m. on October 14 – or they WILL NOT be enrolled State and Higher Ed employees: Use the Minnesota Life website for voluntary term life insurance. Flexible benefits: Will no longer be managed by Treasury For medical, dependent care and limited purpose FSA, benefits will now be managed by PayFlex. State employees only: parking/transportation FSA managed by Benefits Administration Enrollment: State employees: October 3 to October 14 in ESS Higher education employees: October 1 – October 31 on PayFlex website

Changes take effect on January 1, 2017 Selections remain in effect through December 31, 2017, unless you lose eligibility or have a qualifying event A qualifying event or family status change is something that results in a person losing coverage under another plan or becoming newly eligible for coverage Examples include birth, a change in marital status or new employment Contact your Agency Benefits Coordinator (ABC) if you experience a qualifying event Changes made during the enrollment period take effect on January 1, 2017, and remain in effect through December 31, 2017, unless you lose eligibility or have a qualifying event or family status change during the year. A qualifying event or family status change (life event) is something that results in a person losing coverage under another plan or becoming newly eligible for coverage. Examples include birth, a change in marital status or new employment. If you or your covered dependent(s) experience one of these events and need to make changes to your coverage during the year, or you need more information about reasons to cancel coverage and who qualifies, contact your Agency Benefits Coordinator (ABC).

What’s Important for 2017 Health insurance premiums will increase for the Partnership PPO and the HealthSavings CDHP. Premiums will decrease in the Standard PPO plan, but other costs are higher than the Partnership PPO. Your Decision Guide has more information Change – Health insurance networks: There will be three different network options. You choose one: New - Cigna Open Access Plus (OAP): This is a large network. You will have a choice of more doctors and facilities including Baptist Memphis. But you will pay more each month. BlueCross BlueShield (BCBS) Network S: This network was offered last year. No additional cost for this network. Cigna LocalPlus: This network was offered last year. Baptist Physician Group has been added. No additional cost for this network. This network is different from Cigna Open Access Plus. You will stay in your current network (BCBS Network S or Cigna LocalPlus) if you do not make a change We have a lot that is new or changing this year, so we will tell you about this first Health insurance premiums will increase for the Partnership PPO and the HealthSavings CDHP. Premiums will decrease in the Standard PPO plan, but other costs are higher than the Partnership PPO. Your Decision Guide has more information. Change – Health insurance networks: There will be three different network options. You choose one: New - Cigna Open Access Plus (OAP): This is a large network. You will have a choice of more doctors and facilities including Baptist Memphis, but you will pay more each month. BlueCross BlueShield (BCBS) Network S: This network was offered last year. No additional cost for this network. Cigna LocalPlus: This network was offered last year. Baptist Physician Group has been added. No additional cost for this network. This network is different from Cigna Open Access Plus. If you do not change your network during annual enrollment, you will stay in your current network (BCBS Network S or Cigna LocalPlus). To see if your provider is in a network, go to partnersforhealthtn.gov for more information on the health carrier page

What’s Important for 2017 Member cost sharing is changing in all options Out-of-pocket maximums: (Partnership PPO and Standard PPO): The medical and pharmacy out-of-pocket maximums will be combined. The total out-of-pocket maximums for the PPOs will be less in 2017. Partnership PPO options: In 2017, the plan benefits (copays, deductible and coinsurance) will be the same for both options. Difference - you will pay lower premiums if you agree to the Partnership Promise. Standard PPO: The deductible is twice as much as the Partnership PPO, and the copays and coinsurance are higher. But the premiums are lower. HealthSavings CDHP options: In 2017, the plan benefits (deductibles and coinsurance) will be the same for both CDHP options. Difference - the state will put money in your HSA if you agree to the Partnership Promise. Member cost sharing is changing in all options Out-of-pocket maximums: (Partnership PPO and Standard PPO): The medical and pharmacy out-of-pocket maximums (OOPM) will be combined. The total out-of-pocket maximums for the PPOs will be less in 2017. Partnership PPO options: In 2017, the plan benefits (copays, deductible and coinsurance) will be the same for both options. The difference - you will pay lower premiums if you agree to the Partnership Promise. Standard PPO: The deductible is twice as much as the Partnership PPO, and the copays and coinsurance are much higher. But the premiums are lower. HealthSavings CDHP options: In 2017, the plan benefits (deductibles and coinsurance) will be the same for both CDHP options. The difference is the state will put money in your HSA if you agree to the Partnership Promise.

What’s Important for 2017 Coinsurance for labs, diagnostics and x-ray: Will have coinsurance for all plan options. Preventive services still covered at 100% Pharmacy copays and coinsurance: Copays in the PPOs will go up slightly (up $2-$15). For specialty drugs in the PPOs, coinsurance will apply with a member minimum ($50) and maximum ($150) out-of-pocket. Brand Obesity Medications Now Covered: Gives members a less costly, non-surgical option for losing weight. Members must meet certain criteria to qualify. Change - Partnership Promise - Coaching: Only members in disease management (diabetes, heart failure, coronary artery disease, asthma and COPD) and case management will have to coach. Lifestyle management coaching is not required in 2017 – members can voluntarily participate but will not be contacted Coinsurance for labs, diagnostics and x-ray: Will have coinsurance for all plan options. Preventive services still covered at 100% Pharmacy copays and coinsurance: Copays in the PPOs will go up slightly. For specialty drugs in the PPOs, coinsurance will apply with a member minimum ($50) and maximum ($150) out-of-pocket. Brand Obesity Medications Now Covered: Gives members a less costly, non-surgical option for losing weight. Members must meet certain criteria to qualify. Change - Partnership Promise - Coaching: Only members in disease management (diabetes, heart failure, coronary artery disease, asthma and COPD) and case management will have to coach. Lifestyle management coaching is not required in 2017 – members can voluntarily participate but will not be contacted

What’s Important for 2017 Change - Optum Health will be the new behavioral health, substance abuse and Employee Assistance Program (EAP) vendor replacing Magellan. Behavioral health and substance abuse doctors may change. Benefits will include a new TeleBehavioral Health service. Dental and Vision Premiums: Cigna dental premiums will increase by 3% MetLife dental premiums will increase by 4% Vision premiums will not change Change - Optum Health will be the new behavioral health, substance abuse and Employee Assistance Program (EAP) vendor replacing Magellan. Behavioral health and substance abuse doctors may change. Benefits will include a new TeleBehavioral Health service. Dental and Vision Premiums: Cigna dental premiums will increase by 3%; MetLife dental premiums will increase by 4%. Vision premiums will not change.

What’s Important for 2017 Change - Flexible Spending Accounts (FSA): PayFlex will manage flexible spending accounts (FSA) for state and higher education employees (except for parking/transportation, managed by Benefits Administration for state employees). You will have a debit card to pay for medical services (Healthcare FSA/limited purpose FSA) or you can submit receipts Telehealth: You can contact a doctor for minor illnesses such as cold and flu, infections, fever and more. Schedule a visit for you or your covered dependents from anywhere, at any time. Cost is only $15 for all PPOs. CDHP members pay $38 until the deductible is met. Change - Flexible Spending Accounts (FSA): PayFlex will manage flexible spending accounts (FSA) for state and higher education employees, except for parking/transportation – managed by Benefits Administration for state employees. You will have a debit card to pay for medical services (Healthcare FSA/limited purpose FSA) or you can submit receipts. Telehealth: You can contact a doctor for minor illnesses such as cold and flu, infections, fever and more. Schedule a visit for you or your covered dependents from anywhere, at any time. Cost is only $15 for all PPOs. CDHP members pay $38 until the deductible is met.

Using Edison ESS To make changes, you must use Employee Self Service (ESS) in Edison . To use ESS, log on to Edison at UEST Health Insurance option names in Edison: In Edison, the names of four health insurance options are shortened Check the chart below before making your choice Health insurance options Names as they appear in Edison Partnership Promise PPO Partners Promise PPO No Partnership Promise PPO No Partners Promise PPO Standard PPO Promise HealthSavings CDHP Promise CDHP No Promise HealthSavings CDHP No Promise CDHP If you want to make changes in your coverage you must do so online using ESS in Edison. You can find the Edison link on tn.gov – Government drop down – State Employees Health Insurance option names in Edison: In Edison, the names of four health insurance options are shortened. This information is also in your Decision Guide Partnership Promise PPO will be Partners Promise PPO in Edison No Partnership Promise PPO will be No Partners Promise PPO in Edison Standard PPO is the same in Edison Promise HealthSavings CDHP – which was called the Wellness HealthSavings CDHP last year, will be Promise CDHP in Edison. For Higher Ed employees, you will have an HE after the name No Promise HealthSavings CDHP will be called the No Promise CDHP in Edison. Again for Higher Ed employees, there will be an HE after the name

Using Edison ESS Designating Life Insurance Beneficiaries:
You can designate beneficiaries in Edison for Basic Term Life, AD&D and voluntary AD&D If submitting changes during annual enrollment, the beneficiary page will display after submitting changes Flexible Benefits State: You must also use ESS to enroll in flexible benefits from Oct. 3 - Oct. 14 Higher ed: Use the PayFlex website to enroll in flexible benefits from Oct. 1 – Oct. 31 More information about flexible benefits is in your Decision Guide State and Higher Education employees are able to designate beneficiaries for basic term life/AD&D and voluntary AD&D in Edison. If you are submitting changes to your coverage, the beneficiary page will display after you submit your enrollment changes and upload dependent verification documents if adding new dependents. If you have no changes to make, you can also designate beneficiaries in Edison. Directions are in your Decision Guide State employees: You must also use ESS to enroll in flexible benefits (FSA). This includes parking/transportation. Higher ed employees: You will use the PayFlex website to enroll in flexible benefits from October 1 through the 31st Flexible Benefits: There are also restrictions with having both a flexible benefits account and a CDHP/HSA plan. If you enroll in either HealthSavings CDHP plan, you can only have a limited purpose flexible spending account (LFSA) in The state will offer a limited purpose FSA in We have more information later. Any previous FSA balances must be spent down to $0 by December 31, 2016, to access funds in your HSA to pay for approved medical costs.

Recommended Browsers When you use ESS in Edison to add or make changes in your benefits, Internet Explorer 11 is your best choice. You may not be able to enroll in your benefits if you use the Chrome browser or any mobile devices. Although not recommended, other browsers might work. But all of your information may not be on the enrollment screens, which could mean that you are not enrolled in your choices. If these issues cannot be resolved, you will need to use a recommended browser. When you use ESS in Edison to add or make changes in your benefits, Internet Explorer 11 is your best choice. You may not be able to enroll in your benefits if you use the Chrome browser or any mobile devices. Although not recommended, other browsers might work. But all of your information may not be on the enrollment screens, which could mean that you are not enrolled in your choices. If these issues cannot be resolved, you will need to use a recommended browser.

Using Edison ESS Passwords
Higher education employees: Using the Edison system for the first time or having trouble logging in, go to the Edison homepage and click on 1st Time Login/Password Reset and follow the steps. Call Benefits Administration Service Center at if you need help after following the steps. State employees: Trouble logging in to Edison, go to the Edison homepage and click on 1st Time Login/Password Reset and follow the steps to reset your password or call the Edison help desk at Instructions on how to use ESS are in the Decision Guide Passwords – some of this information is different this year. For higher education employees, if you are using the Edison system for the first time or are having trouble logging in, go to the Edison homepage and click on 1st Time Login/Password Reset and follow the steps. If you are still unable to login call the Benefits Administration Service Center at Instructions on how to use ESS are available in the Decision Guide or from your Agency Benefits Coordinator. For state employees, if you have trouble logging in to Edison, go to the Edison homepage and click on 1st Time Login/Password Reset and follow the steps to reset your password or call the Edison help desk at

Health Benefits Your Enrollment Decision Steps Coverage Type
Partnership PPO Standard PPO HealthSavings CDHP Plan Employee Only Employee + Spouse Employee + Child(ren) Employee+ Spouse + Children Coverage Type BCBST Network S Cigna LocalPlus Cigna Open Access Plus (OAP) (new option) Network Voluntary Benefits Member Choice Very important! Member cost sharing is changing. You will need to review your choices carefully! This year, two Partnership Promise options can save you money. If you choose the Partnership Promise PPO, you will pay $50 to $100 less for your premiums than the No Partnership Promise PPO each month. Or, if you choose the Promise HealthSavings CDHP, the state will put money in your HSA. First, you’ll choose your health insurance option. We’ll give more details about the Partnership Promise and No Partnership Promise options on the next slide. Next, what type of coverage do you need? You’ll add your dependents. Employee only Employee + child(ren) Employee + spouse Employee + spouse + child(ren) Then, you can choose between three networks – but one has a surcharge and will cost more: BlueCross BlueShield of Tennessee with Network S Cigna with the LocalPlus network Cigna Open Access Plus or OAP: larger network and costs $40 more for premiums each month for employee only and employee + child(ren)tiers; it will cost $80 more for premiums each month for employee+spouse and employee+spouse+child(ren) tiers If you enrolled in the Partnership PPO or Wellness HealthSavings CDHP in 2016 and did not complete the 2016 Partnership Promise, you do not qualify for the lower premium Partnership PPO. Or if enrolled in the HealthSavings CDHP, you do not qualify for state HSA funds. COBRA participants and retirees are not eligible for state HSA funds.

Health Insurance Options
First, you choose your health insurance option Partnership PPO - Two options give you the same benefits, but the cost is different: Partnership Promise PPO – Agree to the 2017 Partnership Promise, and you will save money! Your premiums will be $50 or $100 dollars less than the No Partnership Promise PPO each month. No Partnership Promise PPO – This option does not include the Partnership Promise. Your premiums will be $50 to $100 more than the Partnership Promise PPO each month. Standard PPO - Current Standard PPO members can stay or move to any plan option, including Partnership Promise options. HealthSavings CDHP - Two options give you the same benefits and cost the same, but only one includes state HSA funds: Promise HealthSavings CDHP – Agree to the 2017 Partnership Promise, and the state will put $500 or $1,000 into your HSA! No Promise HealthSavings CDHP – This option does not include the Partnership Promise and the state will not put money into your HSA. Here are your plan options again. Some include the Partnership Promise and some do not. Partnership PPO - Two options give you the same benefits, but the cost is different: Partnership Promise PPO – Agree to the 2017 Partnership Promise, and you will save money! Your premiums will be $50 or $100 dollars less than the No Partnership Promise PPO each month. No Partnership Promise PPO – This option does not include the Partnership Promise. Your premiums will be $50 to $100 more than the Partnership Promise PPO each month. Standard PPO - Current Standard PPO members can move to any plan option, including Partnership Promise options. HealthSavings CDHP - Two options give you the same benefits and cost the same, but only one includes state HSA funds: Promise HealthSavings CDHP – Agree to the 2017 Partnership Promise, and the state will put $500 or $1,000 into your HSA! No Promise HealthSavings CDHP – This option does not include the Partnership Promise and the state will not put money into your HSA.

Health Insurance Options
All health options cover the same services and treatments: In-network preventive care at no cost But medical necessity decisions can vary by carrier (BCBS or Cigna) All health options include: Medical, behavioral health and pharmacy benefits Fixed copays or coinsurance for some services depending on plan Out-of-pocket maximums to limit costs Access to the wellness program All health options cover the same services and treatments: In-network preventive care at no cost But medical necessity decisions can vary by carrier (BCBS or Cigna) Free preventive health services include, but are not limited to: Flu vaccination and pneumococcal vaccinations Annual preventive visit (i.e., physical or annual exam) Annual well-woman visit Osteoporosis screening for women Screenings for colon, breast or cervical cancer It’s important to remember that you need to visit an in-network provider to receive preventive care services at no cost. All plans include: Medical, behavioral health and pharmacy benefits Fixed copays or coinsurance for some services depending on the plan Out-of-pocket maximums to limit your costs Access to the wellness program Carriers also offer discounts for certain value-added benefits not covered by traditional insurance. This could include programs for weight loss, fitness club membership or laser vision care. Refer to the BlueCross and Cigna member handbooks or websites for more information. Carriers may offer discounts for services not covered. Refer to the carrier’s member handbooks or websites for more information.

Health Insurance Networks
Next, you would choose your health insurance network BlueCross BlueShield of Tennessee Network S Cigna LocalPlus New - Cigna Open Access Plus (OAP) – this is a large network, includes Baptist Memphis and will cost you more each month. A surcharge applies: $40 more employee/employee+children coverage each month $80 more for employee+spouse/employee+spouse+children coverage each month BlueCross BlueShield of Tennessee Network S - this network was offered in 2016 Cigna LocalPlus - this network was offered in 2016 – different than new Cigna Open Access Plus network. Baptist Physician Group has been added to this network New - Cigna Open Access Plus (OAP) – this is a large network – includes Baptist Memphis. This network costs more each month! Many doctors and hospitals are in more than one network. On the other hand, some doctors and hospitals may be in one network, but not the other. You will want to choose your insurance carrier based on whether or not your doctor, hospital or facility participates in their network. Be sure to check the networks carefully when making your decision. Providers can be added or dropped out of a network during the year. Provider directories are available on the ParTNers for Health website (partnersforhealthtn.gov) – Health Carrier drop down Online directories have the most current provider information versus a printed directory. For Cigna networks – directories are only available on the Partners for Health website or at cigna.com/stateoftn or by calling Cigna 24/7. You cannot do an online search for all of your Cigna network providers from the Cigna website

Health Insurance Networks
Another look at your network options: BlueCross BlueShield Network S Cigna LocalPlus New Cigna Open Access Plus (OAP) Type of Network Offered last year. Smaller network than Cigna Open Access Plus Offered last year. Smaller network. NOT Open Access Plus network. Baptist Physician Group has been added. Large network with more doctors and hospitals. Includes Baptist Memphis Additional Cost (in addition to your monthly premium) $0 $40 more per month - Employee $40 more per month - Employee + Children $80 more per month - Employee + Spouse $80 more per month - Employee + Spouse + Children Here is a chart that shows your network options and costs Please note – if you enroll in the new option – Cigna Open Access Plus- you will pay an additional monthly cost. The cost would depend on your coverage tier: $40 more each month for employee only or employee+child(ren) coverage $80 more each month for employee+spouse or employee+spouse+child(ren)coverage

Voluntary Benefits Then, you choose your voluntary benefits Dental
Vision Life (voluntary term – not available in Edison) Flexible spending accounts (FSA) Long-term care (not available in Edison) AD&D Voluntary benefits are all employee paid premium After you choose your health plan option and network, you will choose your voluntary benefits Dental Vision Life (voluntary term – not available in Edison) Flexible spending accounts (FSA) Long-term care (not available in Edison) AD&D

Health Benefits HealthSavings CDHP Two different CDHP options:
Promise HealthSavings CDHP – includes the Partnership Promise and the state will put $500 or $1,000 into your HSA* No Promise HealthSavings CDHP - does not include the Partnership Promise and no funds from the state. Employees may fund the HSA CDHPs: Lower monthly premium - but a higher deductible Can help you save money Includes a tax-free health savings account (HSA), which you own Can be used to pay for qualified medical, behavioral health, dental and vision expenses Employees can make pre-tax payroll deduction contributions or post-tax contributions into the HAS *New enrollees with coverage effective dates Sept 2 through Dec 1, 2017, will not receive a state contribution in The Promise HealthSavings CDHP is only available to state and higher ed active employees. Since the HealthSavings CDHP plans are still relatively new options, we wanted to give you more information: There are two different options: Promise HealthSavings CDHP – if you choose this option, you agree to complete the 2017 Partnership Promise. In 2017, the state will put $500 or $1,000 (depending on your coverage tier) into your Health Savings Account (HSA) for you to use tax free for qualified medical expenses. HealthSavings CDHP - does not include the Partnership Promise and the state will not put funds into your account. You can choose to fund your HSA on your own, and the money will still be tax free if used for qualified medical expenses. CDHPs: Lower monthly premium - but a higher deductible Can help you save money Includes a tax-free health savings account (HSA), which you own Can be used to pay for qualified medical, behavioral health, dental and vision expenses Employees can make pre-tax payroll deduction contributions or post-tax contributions into the HSA *New enrollees with coverage effective dates Sept. 2 through Dec. 1, 2017, will not receive a state contribution to the HSA in The Promise HealthSavings CDHP is only available to active state and higher education employees.

Health Benefits How does a CDHP work?
You pay for services up to your deductible before the plan starts paying for anything — but you can use the money in your HSA to pay for your deductible and qualified medical costs After meeting the deductible, you pay coinsurance (a set percentage of the discounted network cost) instead of copays (a set amount), until your reach your out-of-pocket maximum How does a CDHP work? You pay for services up to your deductible before the plan starts paying for anything — but you can use the money your HSA to pay for your deductible and qualified medical costs After meeting the deductible, you pay coinsurance (a set percentage of the discounted network cost) instead of copays (a set amount), until your reach your out-of-pocket maximum

Health Benefits HealthSavings CDHP Pharmacy Benefits
You pay the full negotiated cost of prescription drugs up to annual deductible Then you pay coinsurance until the annual out- of-pocket maximum is reached Plan covers 100% of in-network costs after you reach the out-of-pocket maximum For 90-day chronic maintenance drugs (e.g., hypertension, high cholesterol, etc.) you pay coinsurance only – don’t have to meet the deductible first when filled through mail order or a Retail-90 network pharmacy. Important Note: Members pay medications at the time of purchase. Even at the negotiated or discounted rate, some drugs can be expensive, particularly specialty drugs, so CDHP members may need to know costs and plan for those costs until the deductible is met HealthSavings CDHP pharmacy benefits are different with the CDHP plans: You would pay the full negotiated cost of prescription drugs up to annual deductible (you can use your HSA to pay for your prescriptions). It is important to note, you would pay for the medication at the time of purchase. Even at the negotiated or discounted rate, some drugs can be expensive – particularly specialty drugs CDHP members may need to know costs and plan for those costs until the deductible is met After you meet your deductible, then you pay coinsurance until the annual out-of-pocket maximum is reached Then the plan covers 100% of in-network costs For certain 90-day supplies of chronic maintenance drugs (e.g., anti-hypertensives for coronary artery disease and congestive heart failure; statins used to treat high cholesterol; oral diabetic medications, insulin and diabetic supplies; medications for asthma; COPD; and depression, etc.) you do not have to meet your deductible first; you pay the coinsurance amount. To use this benefit, members must fill a 90-day supply through mail order or a Retail-90 pharmacy. If you are currently enrolled and buy your prescriptions by mail order, you will need to provide Caremark with your HSA debit card number before the prescription can be processed and shipped. Otherwise, Caremark will charge the order to the credit card they have on file. You can call your pharmacist or current members can log in to info.caremark.com.stateoftn, register, and see how much you are currently spending for prescriptions.

Health Benefits CDHP Enrollment Restrictions
You cannot enroll in a HealthSavings CDHP if you are enrolled in another plan, including the PPO, your spouse’s plan or any government plan (e.g., Medicare A and/or B, Medicaid, or Social Security benefits). Also, if your spouse has a FSA or HRA you cannot contribute to a HSA. Retirees and COBRA participants are not eligible for state funds contributed to your HSA. If you are eligible for VA, Tricare or Indian Health Service (IHS) medical benefits and did not get benefits during the past three months, you can enroll in and put money in your HSA. If you get VA benefits in the future, then you CANNOT put money in your account for another three months. Other restrictions may apply. Go to IRS.gov to learn more. CDHP Enrollment Restrictions You cannot enroll in a HealthSavings CDHP if you are enrolled in another plan, including the PPO, your spouse’s plan or any government plan (e.g., Medicare A and/or B, Medicaid, or Social Security benefits). Also, if you or your spouse has a FSA or HRA you are not eligible to contribute to a HSA. Retirees and COBRA participants are not eligible for state funds contributed to your HSA. If you are eligible for VA, Tricare or Indian Health Services (IHS) medical benefits and did not get benefits during the past three months, you can enroll in and put money in your HSA. If you get VA, Tricare or IHS benefits in the future, then you CANNOT put money in your account for another three months. Other restrictions may apply. Go to IRS.gov to learn more.

Health Benefits HSA Benefits:
Money in your HSA rolls over each year – you keep it when you leave or retire Your HSA earns interest You can invest your HSA money (when HSA is over $1,000) HSA offers tax advantages on money in your account: 1. Both employer and employee contributions are tax free 2. Withdrawals for qualified medical expenses are tax free You can use your HSA card to pay for your qualified medical expenses (from payroll deductions and other contributions) and your deductible Qualified expenses such as hearing aids, contact lenses, acupuncture, etc., that may not be covered by your plan HSA can also serve as a retirement savings account. Money in the account can be used tax free for health costs when you retire. And, when you turn 65, it can be used for non-medical expenses. Non-medical expenses are taxed prior to age 65 HSA Benefits: Money in your HSA rolls over each year, and you keep it when you leave or retire Your HSA earns interest You can invest your HSA money (when HSA is over $1,000) HSA offers tax advantages on money in your account: 1. Both employer and employee contributions are tax free 2. Withdrawals for qualified medical expenses are tax free You can use your HSA card to pay for your qualified medical expenses (from payroll deductions and other contributions) and your deductible Qualified expenses such as hearing aids, contact lenses, acupuncture, etc., that may not be covered by your plan HSA can also serve as a retirement savings account. Money in the account can be used tax free for health costs when you retire. And, when you turn 65, it can be used for non-medical expenses. Non-medical expenses are taxed prior to age 65

Health Benefits How does the Health Savings Account (HSA) work?
Once you enroll in a CDHP, a HSA is set up for you. You can put money in your HSA by taking money from your paycheck and/or putting money directly into your account. There is a maximum amount you can contribute each year. What is the maximum I contribute to a HSA each year? In 2017, IRS guidelines allow total annual tax-free contributions up to $3,400 for individuals and $6,750 for families. At age 55 and older, you can make an additional $1,000/year contribution ($4,400 for individuals or $7,750 for families). The maximum includes any employer contribution. How does the Health Savings Account (HSA) work? Once you enroll in a CDHP, a HSA is set up for you. You can put money in your HSA by taking money from your paycheck and/or putting money directly into your account. There is a maximum amount you can contribute each year. What is the maximum I contribute to a HSA each year? In 2017, IRS guidelines allow total annual tax-free contributions up to $3,400 for individuals and $6,750 for families. At age 55 and older, you can make an additional $1,000/year contribution ($4,400 for individuals or $7,750 for families). The maximum includes any employer contribution. Higher Ed employees: If you want to contribute to your HSA by payroll deduction, you will need to work with your ABC to submit your payroll deduction contribution.

Health Benefits HSA vs. FSA
If you enroll in a HealthSavings CDHP, you cannot use a flexible spending account (FSA) for medical costs. You can enroll in a limited purpose FSA (LPFSA) to use for dental and vision costs. Remember, HSA dollars are not “use-it-or-lose-it” like an FSA, so you may put the maximum amount allowed in your HSA without fear of losing those dollars. Very Important: If you have money in your FSA and choose a HealthSavings CDHP/HSA, you must spend all of your FSA money by Dec. 31, 2016, or your HSA will not open, and neither you nor your employer can put money in your account until April 1, 2017. HSA vs. FSA If you enroll in a HealthSavings CDHP, you cannot use a flexible spending account (FSA) for medical costs. You can enroll in a limited purpose FSA (LPFSA) to use for dental and vision costs. Remember, HSA dollars are not “use-it-or-lose-it” like an FSA, so you may put the maximum amount allowed in your HSA without fear of losing those dollars. Very Important: If you have money in your FSA and are thinking about choosing a HealthSavings CDHP/HSA, you must spend all of your FSA money by Dec. 31, 2016, or your HSA will not open, and neither you nor your employer can put money in your account until April 1, 2017.

Health Benefits Health Savings Account
After you enroll in a HealthSavings CDHP, you will need to activate your account with PayFlex You will register and access your PayFlex HSA online at stateoftn.payflexdirect.com PayFlex will send you additional information about the account after you enroll Go to their website for a Quick Reference guide and other information PayFlex will send you a debit card to pay for your eligible expenses Convenient way to pay for eligible expenses Expenses are paid automatically, as long as funds are available Keep your receipts for audit purposes Health Savings Account If you choose to enroll in a HealthSavings CDHP, you will need to activate your account with PayFlex. PayFlex is the vendor contracted to work with the state for your HSA. You will register and access your PayFlex HSA online at stateoftn.payflexdirect.com PayFlex will send you additional information about the account after you enroll in the CDHP. PayFlex will send you a debit card to pay for eligible expenses. Convenient way to pay for eligible expenses Expenses are paid automatically, as long as funds are available Keep your receipts for audit purposes

Health Benefits Health Savings Account Pay yourself back
Pay for your eligible medical expenses with cash, check or personal credit card Then withdraw funds for your HSA to pay yourself back Can have your payment deposited directly into your checking or savings account Pay your provider Use PayFlex’s online feature to pay your provider directly from your account Contribute post-tax dollars from your checking or savings account online Account fees: The state will pay the monthly maintenance fee for your HSA as long as you are enrolled in a HealthSavings CDHP. You are responsible for standard banking fees. However, if you leave your job, retire or choose a PPO option in the future, you will be responsible for paying any applicable HSA fees. Use the PayFlex Card It is a convenient way to pay for eligible expenses. Expenses are paid automatically, as long as funds are available. Keep your receipts for audit purposes. Pay yourself back Pay for your eligible medical expenses with cash, check or personal credit card. Then withdraw funds for your HSA to pay yourself back. Can have your payment deposited directly into your checking or savings account. Pay your provider Use PayFlex’s online feature to pay your provider directly from your account. You can also contribute post-tax dollars from your checking or savings account online and file for the deduction on your tax return.

Pharmacy Benefits CVS/caremark is the Pharmacy Benefits Manager
All state health insurance plans include pharmacy benefits The covered drug list is the same in each insurance plan but costs differ from plan to plan For each plan, how much you pay depends on the prescription tier: Lowest cost: Tier one/generic drug Higher cost: Tier two/preferred brand drug Highest cost: Tier three/non-preferred brand New specialty pharmacy tier Copays in the PPOs will go up slightly from $2 to $15 depending on the tier For specialty drugs in the PPOs, coinsurance will apply with a member minimum ($50) and maximum ($150) out-of-pocket A chart in the Decision Guide compares pharmacy costs by plan CVS/caremark is the pharmacy benefits manager for all plan members. The covered drug list is the same in each insurance plan but costs differ from plan to plan For each plan, 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 New specialty pharmacy tier Copays in the PPOs will go up slightly. For specialty drugs in the PPOs, coinsurance will apply with a member minimum ($50) and maximum ($150) out-of-pocket You can save money on certain maintenance medications when you have your doctor write a prescription for a 90-day supply and you fill it either through mail order or from a participating Retail-90 pharmacy. Tobacco Cessation: The State’s prescription drug coverage provides free tobacco quit aids to members who want to stop using tobacco products. For more information about quit aids, go to and click on the Pharmacy tab. You can refer to your Decision Guide for more information about pharmacy benefits.

Pharmacy Benefits New Copay Installment Program for Maintenance Medications You can spread the cost of your 90-day mail order prescriptions over a three- month period – at no additional cost to you Enroll online or by calling CVS/caremark customer care: Info.caremark.com/stateoftn > register and log in There is a new copay installment program for maintenance medications You can spread the cost of your 90-day mail order prescriptions over a three- month period – at no additional cost to you. Enroll online or by calling CVS/caremark customer care: Info.caremark.com/stateoftn > register and log in

Behavioral Health Benefits
Optum Health – Behavioral Health Vendor Optum Health is your new behavioral health and substance abuse vendor, replacing Magellan. This is a different network, and your doctor may or may not be in it. You will need to check the network carefully. Members enrolled in health coverage automatically have access to this benefit. Also, you now have the option of TeleBehavioral Health counseling services and can have a counseling session with a provider over the phone. To get maximum benefits, you should use an in-network provider and some services require prior authorization. Learn more by visiting HERE4TN.com or calling Optum Health is your new behavioral health and substance abuse vendor, replacing Magellan. This is a different network, and your doctor may or may not be in it. You will need to check the network carefully. Members enrolled in health coverage automatically have access to this benefit. You will also have the option of TeleBehavioral Health counseling services. You can have a counseling session with a provider over the phone. Optum Health can be reached toll-free at 855.HERE.4.TN ( ) any time, day or night, to speak confidentially with a trained professional for a referral. To get maximum benefits, you should use an in-network provider and some services require prior authorization. Participants may see an out-of-network mental health provider without calling for a referral; however, coinsurance and copayments will be higher. Participants are also subject to balance billing by the out-of-network provider, meaning that they will pay the difference between the maximum allowable charge and the actual charge. In addition, participants are at risk of having inpatient benefits totally denied.

Employee Assistance Program (EAP)
The Employee Assistance Program (EAP) provides you and your family with both workplace and personal resources. Benefits are administered by Optum Health. Services are confidential and available at no cost to eligible employees and their eligible dependents – even if they don’t have medical coverage. COBRA participants are also eligible. Services are available 24 hours a day, 365 days a year New -TeleBehavioral Health – talk to a provider over the phone You may use up to five counseling sessions per episode EAP has resources that can help you and your family with: Call Toll Free 24/7 at HERE4TN ( ) The Employee Assistance Program (EAP) provides you and your family with both workplace and personal resources. Benefits are administered by Optum Health. Services are confidential and available at no cost to eligible employees and their eligible dependents – even if they don’t have medical coverage COBRA participants are also eligible Services are available 24 hours a day, 365 days a year New -TeleBehavioral Health – talk to a provider over the phone You may use up to five counseling sessions per episode You can see a list of services EAP can help with: Family or relationship Child and elder care Feeling anxious or depressed Difficulties and conflicts at work Dealing with addiction Grief and loss Legal or financial Work/life balance The toll free number is 855.HERE4TN ( ) State and Higher Education employees: All benefits eligible employees and their dependents receive EAP benefits even if you do not participate in the State Group Insurance Program. Family or relationship issues Child and elder care Feeling anxious or depressed Difficulties and conflicts at work Dealing with addiction Grief and loss Legal or financial issues Work/life balance

ParTNers for Health Wellness Program
All health plan members have access to the ParTNers for Health Wellness Program, which gives you the tools, information and support you need to take charge of your health and feel your best. ParTNers for Health Wellness Program is provided at no additional cost to all members. Wellness Resources: Coaching – call and get support from a coach on your well-being goals Well-Being Assessment (WBA) – online well-being questionnaire Nurse advice line – medical information and support at no cost to you Wellness challenges - a fun way to develop a healthier lifestyle with group support Weight Watchers at Work and Fitness Center discounts Additional wellness and fitness discounts through the EAP program and our carriers BlueCross BlueShield and Cigna All health plan members have access to the ParTNers for Health Wellness Program, which gives you the tools, information and support you need to take charge of your health and feel your best. The ParTNers for Health Wellness Program is provided at no additional cost to all members. Wellness Resources: Coaching offers professional support to create and meet goals to improve your health. All members can voluntarily talk to a coach by calling An online questionnaire can help you learn more about your health and any potential health risks. Login to your Well-Being Account and complete the Well-Being Assessment (WBA). Partnership Promise PPO and Promise HealthSavings CDHP members must complete the WBA between January 1 and March 15, 2017 The nurse advice line gives you medical information and support 24/7 at no cost to you. Call and select Option 3 to reach the nurse advice line. Quarterly wellness challenges offer a fun way to help you develop a healthier lifestyle while providing group support. Login in to your Well-Being Account to join a challenge. Weight Watchers at Work and fitness center discounts offer affordable ways to improve your health. Go to partnersforhealthtn.gov for more information. Additional wellness and fitness discounts are available through the health insurance carriers. Go to partnersforhealthtn.gov and select the Wellness Program page.

Premiums for 2017: State and Higher Education
Employee Share of Monthly Premiums Premium Level Partnership Promise PPO No Partnership Promise PPO Standard PPO HealthSavings CDHP (promise and no promise) Employee Only $133 $183 $130 $84 Employee + Child(ren) $200 $250 $197 $127 Employee + Spouse $280 $380 $275 $177 Employee + Spouse + Child(ren) $346 $446 $340 $219 Here are the health insurance premiums for active state plan employees. A complete chart for all coverage tiers is available in the Decision Guide and on the ParTNers for Health website. Important to note – premiums do not include the cost for the Cigna Open Access Plus network which would add $40 to $80 more per month to your premium depending on your coverage tier Premiums shown are for the employee share for active employees. A complete chart is available in the Decision Guide and on the ParTNers for Health website. Premiums are for the BCBS Network S or Cigna LocalPlus network Premiums do NOT include the cost for the larger Cigna Open Access Plus network – which would add $40 to $80 more EACH MONTH depending on your tier

2017 Deductibles and Out-of-Pocket Co-insurance Maximums
Partnership PPO Standard PPO HealthSavings CDHP In-Network Deductibles Employee only $500 $1,000 $1,500 Employee + Child(ren) $750 $3,000 Employee + Spouse $2,000 Employee + Spouse + Child(ren) $1,250 $2,500 Out of Pocket Max (medical and pharmacy combined) $3,600 $4,000 $5,400 $6,000 $5,000 $7,200 $8,000 $9,000 $10,000 This chart shows the annual deductible and out-of-pocket maximums Note: The medical and pharmacy out-of-pocket maximums have been combined for all plans The annual deductible is the amount you must pay each year before your plan pays any hospital or other charges that are covered through co-insurance. Your annual deductible is lower for in-network services. For the Partnership and Standard PPOs, the deductible does not apply to primary care visits, prescription drugs or other services or products that require a copay. The PPOs also have out-of-pocket maximums for both in-network and out-of-network services. You will need to check the Decision Guide for information on the out-of-network costs These maximums limit how much co-insurance and copays you would have to pay in any given year if you or a covered family member had a serious illness or injury. After you reach your out-of-pocket maximum level for in-network services, the plan would pay 100% of in-network costs for the rest of the year The out-of-pocket maximums provide you and your covered dependents with peace of mind and financial protection against a catastrophic illness or injury. Refer to your Decision Guide for more information.

2017 Partnership Promise Take Action – Save Money – Improve Health
The goal of the Partnership Promise is to help you get and stay healthy – while saving you money. We can cut healthcare costs with our own personal choices. Members who agree to the 2017 Partnership Promise are not only taking steps toward better health, they can save money on premiums or get state HSA funds. If you choose the Partnership Promise PPO, you will pay $50 to $100 less in monthly premiums than if enrolled in the No Partnership Promise PPO. If you choose the Promise HealthSavings CDHP, the state will put money, either $500 or $1,000, into your health savings account (HSA). The goal of the Partnership Promise is to help you get and stay healthy – and save you money! Members who enroll in the Partnership PPO or the Wellness HealthSavings CDHP agree to take steps to improve health. These steps are called the Partnership Promise. If you choose the Partnership Promise PPO, you will be rewarded by paying $50 to $100 less in monthly premiums than if enrolled in the No Partnership Promise PPO. If you choose the Promise HealthSavings CDHP, the state will put money, either $500 or $1,000, into your HSA. If you or your covered spouse fails to fulfill any requirement of the 2016 Partnership Promise, you and all dependents in your plan will be transferred from the Partnership PPO to the Standard PPO or from the Wellness HealthSavings CDHP to the HealthSavings CDHP the following year.

2017 Partnership Promise In 2017, all Partnership Promise members and covered spouses must: Complete the online Healthways Well-Being Assessment™ (health questionnaire) between January 1 and March 15, 2017 Complete a biometric health screening by July 15, 2017 Actively participate in coaching if you are called Coaching only required for members in disease management and case management. Disease management is diabetes, COPD, asthma, coronary artery disease and heart failure. Lifestyle management coaching not required in 2017 Update your contact information with your employer if it changes Spouses must keep contact information current with Healthways In 2017, all Partnership Promise members and covered spouses must: Complete the online Healthways Well-Being Assessment™ (health questionnaire) between January 1 and March 15, 2017 Complete a biometric health screening by July 15, 2017. Actively participate in coaching if you are called Coaching only required for members in disease management and case management. Disease management: diabetes, COPD, asthma, coronary artery disease and heart failure. In 2017, lifestyle management coaching will not be required. This includes tobacco cessation Update your contact information with your employer if it changes Spouses must keep contact information current with Healthways By enrolling in a plan that includes the Partnership Promise you are agreeing to the terms of the Partnership Promise. Enrolled employees and covered spouses (if applicable) are required to complete the requirements. Children enrolled in your health plan are not required to complete Partnership Promise requirements.

Dental Benefits During annual enrollment, eligible employees can choose between two dental options: During the enrollment period, eligible employees can enroll in or transfer between the two options You will keep your current coverage if you don’t change your current dental carrier or cancel coverage Cigna Prepaid Plan Fixed copays Participating dentists only MetLife Dental Preferred Plan Coinsurance and deductibles Any dentist Pay less with network providers During annual enrollment, employees can enroll in or transfer between two dental options: •Cigna Prepaid Plan •MetLife Dental Preferred Provider Organization (DPPO) Enrolled employees may also drop coverage for self and/or family members. You will keep your current coverage if you don’t change your dental carrier or cancel coverage.

Dental Benefits Cigna Prepaid Plan
Provides services at fixed copay amounts. A limited network of participating dentists and specialists must be used to receive benefits. Must select a general dentist from the Cigna dental provider list and notify Cigna of your choice. You must use your selected dentist to receive benefits. The network is Dental Care (HMO). There may be some areas in the state where network dentists are limited or not available. Be sure to carefully review the provider directory for your location. With this plan, you can cancel coverage during the year if there are no network general dentists within a 40-mile radius of your home You pay predetermined member copay amounts (reduced fees) for dental treatments. No deductibles to meet, no claims to file, no waiting periods, no annual dollar maximum. Preexisting conditions are covered. Orthodontic treatment fee lifetime maximum. Referrals to specialists are not required. Premiums will increase by 3 percent in 2017. The Prepaid Plan is administered by Cigna and provides services at predetermined copay amounts from a limited network of participating dentists and specialists. You must select a general dentist from Prepaid dental list and notify Cigna of your choice. You can change your dentist at any time. You must use your selected dentist to receive benefits. The network is Dental Care (HMO). There may be some areas in the state where network dentists are limited or not available. Be sure to carefully review the provider directory for your location. With this plan, you can cancel coverage during the year if there are no network general dentists within a 40-mile radius of your home You pay predetermined member copay amounts (reduced fees) for dental treatments. No deductibles to meet, no claims to file, no waiting periods, no annual dollar maximum. Preexisting conditions are covered. Orthodontics available for employees and dependents and there is a treatment fee lifetime maximum. Referrals to specialists are not required. Premiums will increase by 3% in 2017

Dental Benefits MetLife Dental
Provides services with coinsurance. Any dentist may be used to receive benefits but you will pay less if an in-network provider is used. Can use any dentist — receive maximum benefits when visiting an in-network MetLife DPPO provider. Network is PDP. • Deductible applies for basic and major dental care. • You pay coinsurance for basic, major, orthodontic and out-of-network covered services. • You or your dentist will file claims for covered services. • Some services (e.g., crowns, dentures, implants and complete or partial dentures) require a 6-month waiting period from member’s effective date before benefits begin. • There is a 12-month waiting period from the member’s effective coverage date on replacement of a missing tooth and for orthodontics. • Referrals to specialists are not required. Pre-treatment estimates are recommended for services with significant expense. • Premiums will increase by 4 percent in 2017. The Dental Preferred Provider Organization plan is administered by MetLife and provides services with coinsurance. You can use any dentist but will receive maximum benefits when visiting an in-network MetLife DPPO provider. The network is PDP. Deductible applies for basic and major dental care. You pay coinsurance for basic, major, orthodontic and out-of-network covered services. You or your dentist will file claims for covered services. Some services (e.g., crowns, dentures, implants and complete or partial dentures) require a 6-month waiting period from member’s effective date before benefits begin. There is a 12-month waiting period from the member’s effective coverage date on replacement of a missing tooth and for orthodontics. Broken beyond repair crowns, fixed bridges, and partial dentures are covered with a pro-rated coinsurance based upon the number of years since appliance was installed Referrals to specialists are not required. Pre-treatment estimates are recommended for services with significant expense. Premiums will increase by 4% in 2017.

Dental Benefits Monthly Premiums for Active Members
Cigna Prepaid MetLife DPPO Employee Only $12.99 $22.37 Employee + Child(ren) $26.97 $51.44 Employee + Spouse $23.02 $42.32 Employee + Spouse + Child(ren) $31.65 $82.80 Dental services for both the Prepaid Plan and the DPPO Plan include: These are the dental premiums effective January 1, 2017. Dental services for both the Cigna Prepaid Plan (DHMO) and the MetLife Dental Preferred Provider Organization (DPPO) include: Periodic oral evaluations Routine Cleanings Amalgam fillings Endodontics – Root Canal X-rays Extractions Major restorations Orthodontics (children/dependents) Dentures A list of covered services and costs is included in the Decision Guide. You may also refer to the ParTNers for Health website at partnersforhealthtn.gov for more information about dental coverage. Periodic oral evaluations Routine Cleanings Amalgam fillings Endodontics-Root Canal X-rays Extractions Major restorations Orthodontics Dentures

Vision Benefits Vision Plan - Administered by EyeMed Vision Care
There are two plan options – both plans offer the same services: Premiums will not increase in 2017 Basic Plan Expanded Plan Discounted rates Copays Allowances The vision plan is administered by EyeMed Vision Care Vision coverage is available to all state and higher education employees and dependents. Higher Ed: Tennessee Board of Regents Vision Plans: the TBR will not offer the TBR-VSP plan in The VSP vision coverage for current 2016 participants will terminate effective December 31, All current TBR-VSP participants who want vision coverage effective Jan. 1, 2017, must enroll in the state’s EyeMed vision plan. To enroll in the state’s vision plan, you must use the state’s Edison ESS. Choose from two plans: With the basic plan, you pay a discounted rate or the plan pays a fixed-dollar allowance for services and materials. The expanded plan provides services with a combination of copays, allowances and discounted rates. Both plans offer the same services, including: Annual routine eye exam (once every calendar year) Frames (once every two calendar years) Eyeglass lenses (once every calendar year) Contact lenses (once every calendar year) Discount of Lasik/Refractive surgery In-network and out-of-network benefits are available. See partnersforhealthtn.gov for a list of limitations and exclusions. You will receive the maximum benefit when visiting a provider in EyeMed’s Select Network. Premiums will not increase in Members are responsible for the full premium. Basic Expanded 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

Additional Benefits Basic Term Life / Accidental Death Insurance
State and Higher Education Only The State provides $20,000 of basic term life and $40,000 of accidental death and dismemberment insurance If you are enrolled in health insurance as the head of contract, your coverage increases with your salary — to a maximum of $50,000 for basic term life insurance and $100,000 for accidental death insurance The State provides a basic level of term life insurance ($20,000) and accidental death and dismemberment insurance ($40,000) to all State and Higher Education employees through Minnesota Life. You are automatically enrolled for this coverage when you are hired. If you are enrolled in health insurance as the head of contract, your coverage increases with your salary — to a maximum of $50,000 for basic term life insurance and $100,000 for accidental death insurance. With coverage above $20,000/$40,000 the premiums are deducted from the employee’s paycheck. The amount of basic term and basic AD&D begins to decrease when the employee reaches age 65. If you enroll in family health coverage, your eligible dependents are also covered for $3,000 of basic dependent term life insurance and an amount for basic accidental death and dismemberment based on your salary and family composition. If you do not enroll in health coverage, your dependents are not eligible for this coverage. You can designate beneficiaries in Edison for basic term life/AD&D and voluntary AD&D. There are also Life Insurance Resources for employees: Travel assistance: Pre-trip resources as well as emergency assistance and transport services available 24/7 when 100+ miles from home. Beneficiary Financial Counseling: Independent financial counseling services for beneficiaries. Legacy Planning Resources: Assistance with resources designed to help families plan for end-of-life issues. You can go to partnersforhealthtn.gov for more information. Important: Keep your life insurance beneficiary information up to date You can make updates online More information is in your Decision Guide

Additional Benefits Voluntary Accidental Death & Dismemberment Insurance State and Higher Education Only Additional accident protection for yourself and your dependents Coverage is available at low group rates—no questions asked Premiums vary by salary The maximum benefit available to employees is $60,000 Members can enroll through ESS Available for State and Higher Education employees. If you would like additional accident protection, you may enroll in voluntary Accidental Death and Dismemberment insurance for yourself and your dependents. This coverage is available through Minnesota Life. Coverage is available at low group rates—no questions asked of employees. Premiums vary by salary. The maximum benefit available to employees is $60,000. Enroll in voluntary Accidental Death & Dismemberment Insurance (AD&D) through Edison (ESS). For more information you can also go to partnersforhealthtn.gov.

Additional Benefits Voluntary Term Life Insurance
State and Higher Education Only If you qualify, you may be able to purchase voluntary term coverage from Minnesota Life for yourself and your dependent spouse and children. If you are currently enrolled and are eligible for employee guaranteed issue increase, information will be mailed to you. If you and/or your dependent spouse are not presently enrolled, you will be required to present evidence of insurability through a health questionnaire. Enroll through the Minnesota Life website at lifebenefits.com/stateoftn If you qualify, you may be able to purchase voluntary term life coverage from Minnesota Life for yourself and your dependent spouse and children. Can apply for up to seven times your annual base salary (maximum of $500,000) for yourself. (Evidence of good health is required.) Up to a maximum of $30,000 for your spouse under 55 ($15,000 for ages 55 and older). Note: Your spouse must answer specific health questions to determine eligibility. Can apply for coverage for children equal to $5,000 or $10,000. Child term rider coverage is guaranteed issue. If you are currently enrolled and are eligible for employee guaranteed issue increase, information will be mailed to you. The guaranteed increase during the annual enrollment period is $5,000 for employees, up to five times base annual salary without proof of good health. If you and/or your dependent spouse are not presently enrolled, you will be required to present evidence of insurability through a health questionnaire. Enroll in Voluntary Term Life Insurance through the Minnesota Life website at lifebenefits.com/stateoftn

Apply for coverage at any time through medical underwriting.
Additional Benefits Long-Term Care Insurance Who is eligible? Qualified employees Eligible dependents Covers services for individuals who are no longer able to care for themselves Nursing home care Assisted living Home healthcare Retirees Parents and parents-in-law Home care Adult day care Qualified employees, their eligible dependents (spouse and children ages 18 through 25), retirees, parents and parents-in-law are eligible to enroll in long-term care coverage. This insurance covers certain services required by individuals who are no longer able to care for themselves without the assistance of others. Natural aging, a serious illness or an accident may bring on this need. Services covered include nursing home care, assisted living, home healthcare, home care and adult day care. New hires may enroll without medical underwriting within 90 days of first becoming eligible. You and your eligible family members may apply for long-term care coverage at any time, but will be subject to medical underwriting review for approval to enroll. Call MedAmerica or refer to their website to enroll. You can find contact information in your Decision Guide or at partnersforhealthtn.gov under “Other Benefits”. Apply for coverage at any time through medical underwriting.

Additional Benefits Long-Term Care Insurance
Benefits available for different daily benefit amounts ($100, $150 or $200) for either three- year or five-year coverage Available with or without inflation protection You pay 100% of the premium Premiums are based on age at the time of enrollment Choose to have the premium taken from your payroll check or opt for a direct bill arrangement Benefits are available through different options based on a daily benefit amount ($100, $150 or $200) for either a three-year or five-year coverage period. The benefits are also available with or without inflation protection. The inflation benefit protects the value of the coverage you buy today to offset future increases in the costs for long-term care. If purchased, your benefits will increase at 5% compounded annually. You must pay 100% of the premium if you choose this coverage. Premiums are based on age at the time of enrollment. So the younger you are when you apply, the lower your monthly premium will be. You may choose to have the premium taken from your payroll check, or may opt for a direct bill arrangement with MedAmerica. Direct billing or payment by bank draft can be set up on a quarterly, semi-annual or annual basis. Enroll by visiting or calling

Additional Benefits Flexible Benefits – State and Higher Ed
In 2017, PayFlex will manage medical, dependent care and limited purpose FSA programs State employees: Parking and transportation flexible benefits will be managed by Benefits Administration State employees will no longer send claims to Treasury PayFlex will send all medical FSA participants a debit card in December. You can use it at pharmacies, doctor’s offices and other healthcare facilities for instant payment from your medical FSA Important: State employees should file 2016 FSA claims with the Treasury as soon a as possible. Claims must be submitted before December 31, 2016 State employees must enroll during annual enrollment from Oct. 3 – Oct. 14 Higher ed employees enroll on PayFlex website from Oct 1. – Oct. 31 Flexible Benefits – State and Higher Ed In 2017, PayFlex will manage medical, dependent care and limited purpose FSA programs State employees: Parking and transportation flexible benefits will be managed by Benefits Administration State employees will no longer send claims to Treasury PayFlex will send all medical FSA participants a debit card in December. You can use it at pharmacies, doctor’s offices and other healthcare facilities for instant payment from your medical FSA Important: State employees should file 2016 FSA claims with the Treasury as soon a as possible. Claims must be submitted before December 31, 2016 State employees must enroll during annual enrollment from Oct. 3 – Oct. 14 Higher ed employees enroll on PayFlex website from Oct 1. – Oct. 31

Additional Benefits Flexible Benefits – State and Higher Ed
Medical FSA: For certain medical, dental, vision and prescription costs not covered by insurance. You do NOT qualify if enrolled in a CDHP. But you can put money in a limited purpose FSA for dental and vision Limited Purpose FSA: For certain dental and vision costs not covered by insurance. Dependent Care FSA: For certain dependent care costs such as after school care, baby-sitting fees, adult or child daycare and pre-school State employees only: Transportation and Parking FSA: For certain work-related commuting and/or parking expenses. Contribution limits: Set by the IRS. Go to IRS.gov for contribution limits If you were enrolled in a FSA in 2016, you need to re-enroll. The exception is parking and transportation – you do not have to re-enroll Currently have a HSA with a debit card and plan to enroll in a limited-purpose FSA – in 2017 you will use the same debit card for both Flexible Benefits – State and Higher Ed Medical FSA: For certain medical, dental, vision and prescription costs not covered by insurance. You do NOT qualify if enrolled in a CDHP. But you can put money in a limited purpose FSA for dental and vision Limited Purpose FSA: For certain dental and vision costs not covered by insurance. Dependent Care FSA: For certain dependent care costs such as after school care, baby-sitting fees, adult or child daycare and pre-school State employees only: Transportation and Parking FSA: For certain work-related commuting and/or parking expenses. Contribution limits: Set by the IRS. Go to IRS.gov for contribution limits If you were enrolled in a FSA in 2016, you need to re-enroll. The exception is parking and transportation If you currently have a HSA with a debit card and plan to enroll in a limited-purpose FSA – in 2017 you will use the same debit card for both

For more information or to enroll, visit the SLB website
Additional Benefits Employee Sick Leave Bank – State Only Administered by Tennessee Department of Human Resources Provides sick leave to qualifying members A member may receive a maximum of 90 days from the Bank Open enrollment is August 1 – October 31 each year Must be a full-time state employee for 12 consecutive months and have at least six days of sick leave by October 31 of your enrollment year Must contribute four sick leave days to enroll One day of sick leave thereafter assessed each Oct 1 to maintain membership If you are already enrolled you do not need to take any action The Tennessee Department of Human Resources administers the Employee Sick Leave Bank (SLB). Higher Ed employees: You have access to your own sick leave program. The SLB provides sick leave to qualifying members who are medically certified as unable to perform the duties of their jobs. A member may receive a maximum of 90 days from the Bank as a result of a personal illness, injury, accident, disability, medical condition, or quarantine or a condition related to, resulting from, or recurring from a previously diagnosed condition for which the Bank granted sick leave. Open enrollment is August 1 through October 31 each year. You must be a full-time State employee for 12 consecutive months and have at least six days of sick leave by October 31 of your enrollment year. New members must contribute four sick leave days to enroll. Thereafter, one day of sick leave per year will be assessed each October 1 to maintain membership in the Bank. Existing members contribute one day annually. See the SLB Guidelines, eligibility requirements, FAQs and enroll online on the SLB website listed above. You are not required to re-enroll every year if you are already a member of the Bank. You maintain your membership in the Bank as long as you meet the annual assessment requirement. For more information or to enroll, visit the SLB website

Additional Benefits Retire Ready Tennessee Deferred Compensation Program (401(k) and 457) – State Only State employees have a retirement plan comprised of the TCRS defined benefit pension and two tax-deferred retirement savings plans, 401(k) and State employees are eligible for an additional $50 monthly match from the State into their 401K accounts. Those hired after July 1, 2014, are automatically enrolled in the 401K plan at 2%, but have the option to increase their contribution as needed to help meet their retirement savings goals. More information is available on the Treasury’s website at treasury.tn.gov/dc trewww.treasury.tn.gov/dc. Retire Ready Tennessee Deferred Compensation Program (401(k) and 457) — State employees only State employees have a retirement plan comprised of the TCRS defined benefit pension and two tax-deferred retirement savings plans, 401(k) and 457. State employees are eligible for an additional $50 monthly match from the State into their 401K accounts. Those hired after July 1, 2014, are automatically enrolled in the 401K plan at 2%, but have the option to increase their contribution as needed to help meet their retirement savings goals. These plans are administered by the Department of Treasury along with Empower Retirement, providing record keeping and financial education to assist you in determining and taking action on your retirement goals. More information is available on the Treasury’s website at Plans are administered by the Department of Treasury and Empower Retirement providing record keeping and financial education

Take Note! If you do not make changes, you will stay in your current options (except for medical and dependent care FSA). If you do want to make changes or add coverage, you must use ESS and meet the enrollment deadline of October 14, 2016. Don’t Wait ─ Enroll early! Enrollment period is shorter this year. You must click “submit” in ESS to finalize your selections by 4:30 p.m. Central on October 14, 2016. Dependent verification documents must also be submitted by October 14 at 4:30 p.m. Central or the dependents WILL NOT be enrolled. You can’t make changes until the next Annual Enrollment Period – unless you have a qualifying event. If you do not want to make changes to your coverage, no action is required. You will keep your current plan options for another year (except for medical and dependent care FSA). If you do want to make changes or add coverage, you must use ESS by the October 14, 2016, deadline. Don’t wait – Enroll early! We anticipate more people will have changes this year so enroll as soon as possible. You must click “submit” in ESS to finalize your selections by 4:30 p.m. Central on October 14. Dependent verification documents must also be submitted by this date and time or the dependent WILL NOT be enrolled. Unless you have a qualifying event, you will not be able to make a change until the next Annual Enrollment period.

ID/Debit Card Information
All health insurance plan members will get new medical ID cards because of changes in deductibles, copays and coinsurance in December. New to health insurance or made a change to current coverage, you will get a new pharmacy ID card in December. New to dental coverage or made a change to current coverage, you will get a new dental ID card in December. New to vision coverage or made a change to current coverage, you will get a new vision ID card in December. HSA and FSA debit cards: Current HealthSavings CDHP/HSA plan member, you will get a new debit card this fall Note the new phone number New 2017 HealthSavings CDHP/HSA member, you will get a debit card in December All state and higher ed members who enroll in a medical or limited-purpose FSA will get new debit cards Enroll in the CDHP/HSA and choose a limited-purpose FSA for dental and vision expenses only, you will get one debit card from PayFlex in December will all of your information loaded. The limited-purpose funds, when applicable, will be used before your HSA funds. All health insurance plan members will get new medical ID cards because of changes in deductibles, copays and coinsurance in December. If you are new to health insurance or made a change to current coverage, you will get a new pharmacy ID card in December. If you are new to dental coverage or made a change to current coverage, you will get a new dental ID card in December. If you are new to vision coverage or made a change to current coverage, you will get a new vision ID card in December. HSA and FSA debit cards: If you are a current HealthSavings CDHP/HSA plan member, you will get a new debit card this fall. Please note the new phone number. If you are a new 2017 HealthSavings CDHP/HSA member, you will get a debit card in December. All state and higher education members who enroll in a medical or limited-purpose FSA will get new debit cards in December. If you enroll in the CDHP/HSA and choose a limited-purpose FSA for dental and vision expenses only, you will get one debit card from PayFlex in December will all of your information loaded. The limited-purpose funds, when applicable, will be used before any of your HSA funds.

Member Communications
Current eligible employees will receive a copy of the 2017 Decision Guide in early September. Eligible employees are mailed a copy of the 2017 Decision Guide in early September. Much like last year, this guide explains your benefits and what’s important for The guide as well as other related information is available on the ParTNers for Health website at

Employee Webinars Want to learn more about the HealthSavings CDHP ?
Benefits Administration will have employee webinars for state and higher ed employees: October 4 – 2:30 p.m. to 3:30 p.m. Central time October 5 – 10:30 a.m. to 11:30 a.m. Central time October 11 – 2:30 p.m. to 3:30 p.m. Central time October 12 – 2 p.m. to 3 p.m. Central time Go to partnersforhealthtn.gov for login instructions If you want to learn more about the HealthSavings CDHP- you can join an employee webinar Benefits Administration will have state and higher ed employee webinars: October 4 – 2:30 p.m. to 3:30 p.m. Central time October 5 – 10:30 a.m. to 11:30 a.m. Central time October 11 – 2:30 p.m. to 3:30 p.m. Central time October 12 – 2 p.m. to 3 p.m. Central time Go to partnersforhealthtn.gov for login instructions

Don’t forget Alex!! ALEX is a smart, funny benefits expert who explains benefits and may help members choose what’s best for them. Go to And don’t forget ALEX! ALEX is the online tool that explains your benefits choices and may help you choose which plan is best for you. Go to and click on ALEX for State and Higher Education. This tool will walk you through your options and estimated costs based on information you enter into the decision tool. It also includes information about dental and vision as well as EAP services and tax savings information that is especially helpful for the CDHP/HSA plan options.

Who to Contact Agency Benefits Coordinator (ABC)
Questions about a provider or claim – contact your insurance carrier Questions about eligibility and enrollment – call Benefits Administration Service Center at , Mon. – Fri., 8:00 a.m. to 4:30 p.m. Central ParTNers for Health website – Handbook publications and forms – ALEX – your decision support tool found on the ParTNers for Health website 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 Decision Guide 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 , Monday – Friday, 8:00 a.m. to 4:30 p.m. Central. Our ParTNers for Health website ( has information about all the benefits described in this presentation—plus definitions of insurance terms that may be unfamiliar and answers to common questions from members. ALEX, your decision support tool which can help you with your benefits decisions. He is found on the homepage of the ParTNers for Health website. All handbook publications and forms referenced in this presentation are located on the Benefits Administration website - the address is on the screen - or ask your ABC for a copy.

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Agenda Annual Enrollment Period What’s Important for 2017

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Agenda Annual Enrollment Period What’s Important for 2017

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