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For Retirement

Retiree  Annual Enrollment is September 30 - October 25

for State, Higher Education, Local Education and Local Government Retirees

This is your chance to make benefit changes that will be effective Jan. 1, 2020. This year for Annual Enrollment, if you want to make changes, you can submit a paper application or make changes online in Edison ESS.

If eligible, during Annual Enrollment you can:

  • Change your health insurance option*
  • Change your health insurance carrier and network
  • Enroll in or cancel health insurance for your eligible dependents (retiree must be enrolled in the health insurance plan to add a dependent to coverage)
  • Enroll in, cancel or transfer between retiree dental options (if you are a TCRS retiree based on your own service or higher education ORP retiree)
  • Enroll in, cancel or transfer between retiree vision options (if you are enrolled in the retiree group health plan and you are a TCRS retiree based on your own service or higher education ORP retiree)

*Limited Preferred Provider Organization (PPO) is available to local education and local government retirees only. If enrolled in a consumer-driven health plan/health savings account (CDHP/HSA), as a retiree or a COBRA participant, you do not qualify for state HSA funds.

Networks and benefits may change and impact you. Even if you don’t make changes during Annual Enrollment, it’s good to review your enrollment each year. If you don’t want to make any changes in enrollment, NO ACTION is needed on your part.

Important for 2020

  • Health premiums are changing for state and higher education retirees. There are no premium changes for local education and local government retirees.
    • State and higher education retirees - 3.2% premium increase
    • Local education retirees – 0% premium increase
    • Local government retirees – 0% premium increase
  • Health options and network options are not changing.
  • Copays, coinsurance and deductibles are staying the same for all health plans.
  • Voluntary products premiums are staying the same. There are no premium increases for dental or vision coverage.

Benefit Improvements

  • Acupuncture will be an added benefit. It will be the same as the chiropractic benefit. Find plan comparison charts on the health webpage.
  • Costs are waived for members who use certain preferred substance use treatment facilities. PPO members who use these high-quality facilities won’t pay a deductible or coinsurance for facility-based substance use treatment; CDHP/HSA members’ coinsurance is waived after they meet their deductible. Copays for PPO members and deductible/coinsurance for CDHP/HSA members will still apply for standard outpatient treatment services. Find preferred Optum providers at HERE4TN.com or by calling 855-HERE4TN.

Want to Learn More?

  • Find your Annual Enrollment newsletter and more on the Enrollment Materials page.
  • On the Videos page, you can learn more about PPOs, CDHP/HSA, dental, vision, Telehealth and preventive care. A new video about The Tennessee Plan, the supplemental medical insurance for retirees with Medicare, is available. If you need help with Edison, scroll down this page to see step-by-step instructional videos made specifically for retirees. You will find help with logging in to Edison for the first time, resetting your Edison password, getting your Access ID and how to enroll in your benefits.
  • You can ask our help desk Questions? Click the blue button on the home page.
  • Call our Benefits Administration service center at 800.253.9981 and press option “2” for a retirement representative.

How to Make Changes

To make changes, fill out the annual enrollment application and submit it to Benefits Administration.

  • Mailed applications must be postmarked no later than Oct. 25, 2019.
  • Submit by fax at 615.741.8196 by Oct. 25, 2019, at 11:59 p.m. Central time.  OR …

You  may also make changes online in ESS in Edison at www.edison.tn.gov instead of using the paper Annual Enrollment application. And enrolling on your smart phone or mobile device is now possible. This is our first year; we will make improvements based on your experience.

Enrolling new Dependents (if eligible)

We need documents to prove their relationship to you. A list of required documents is found on the Enrollment Materials page.

  • You can upload your documents in Edison or fax to 615.741.8196.
  • The dependent documents deadline is Oct. 25 at 4:30 p.m. Central.
Prescription card

ID Cards

  • Members who change or transfer medical, dental or vision plans will receive new ID cards.
  • Because there are no changes to medical, dental and vision coverage, current members who continue their coverage can use the same ID cards.
  • New! Optum will send behavioral health ID cards to all members.
  • CDHP/HSA members who continue coverage will use the same debit card. If you are a new CDHP/HSA enrollee, you will receive a new debit card from PayFlex.
  • Members can always request additional cards by contacting their carrier network or vendor(s), or by using a vendor’s mobile app.

All eligible retirees who have some level of group health coverage for either themselves or covered dependents are sent general information on available healthcare options, premiums, a listing of benefit changes and service areas for the upcoming year.

The options you choose during the enrollment period take effect the following January 1. After annual enrollment, in most cases you can only add or cancel coverage if you lose eligibility or have a qualifying event or family status change during the year.

A qualifying event or family status change is something that results in a covered person becoming newly eligible for other coverage. Examples include birth, marriage, divorce and new employment. If you or your covered dependent(s) experience one of these events and need to make changes to your coverage, or you need more information about reasons to cancel coverage and who qualifies, contact Benefits Administration.