Agency Benefits Coordinators
- Training Calendar - March
- eForms
- First Time Users/Password Reset for Edison
- Video Guide: How to Enroll Using ESS (active employees)
- Video Guide: Edison Password Reset (active employees)
- Video Guide: Retrieving Edison Access ID (active employees)
- Video Guide: Logging in to Edison the First Time (active employees)
- Video Guide: How to Enroll Using ESS (retirees)
- Video Guide: Edison Password Reset (retirees)
- Video Guide: Retrieving Edison Access ID (retirees)
- Video Guide: Logging in to Edison for the First Time (retirees)
- Edison Query List
- Edison Query Manual
- Video: Dependent Verification
- Instructions for Running Past Collection Applied Reports
- Instructions for Running Your PPACA Report
- Uploading Documents through Zendesk
- Step by Step Instructions on Data Entry
- 2019 January - June archive
- 2018 July - December archive
- 2018 January – June archive
- 2017 Nov 3 - December archive
- 2017 June 30 – October 27 archive
- 2017 January – June 23 archive
- 2016 January – June archive
- 2016 July – December archive
- 2015 January – September archive
- 2015 October – December archive
- Enrollment Change Application
- Edison Benefits User Security Authorization Form
- TennCare Notice
- Corrections and Clarifications Form
- Fax Document Separator
- Agency ACH Form
- Certificate of Incapacitation for Dependent Child
- Request for Claims/Enrollment Data
- To request large claims data for premium bids, email benefits.privacy@tn.gov
- Insurance Cancel Request Application
- Dependent Verification Fax Transmittal Sheet
- Securian (Minnesota Life) Order Form
- Securian (Minnesota Life) Dismemberment Form
- Notice of Death Form
- Notice of Claim for Accelerated Benefit Form
- Life Insurance Waiver of Premium Claim Form
- Life Insurance Beneficiary Statement
- Life Insurance Preference Beneficiary Statement
- Process — State
- Process — Higher Education
- Termination due to Death — Local Education and Local Government
- Response to Funeral Home
- Basic Life Beneficiary Designation
- State Required Federal Marketplace Notice
- Higher Education Required Federal Marketplace Notice (MS Word)
- Local Education Required Federal Marketplace Notice (MS Word)
- Local Government Required Federal Marketplace Notice (MS Word)
- Full to Part Time Changes (State only) (rev 1/18)
- Information Sheet (State only) (rev 2/18)
- Minimum Value Certification 2015
- Minimum Value Certification 2016
- Minimum Value Certification 2017
- Minimum Value Certification 2018
- PPACA Update — Local Education & Local Government
- Plan Document (2019)
- Order Form
- Employee Checklist
- 2019 New Hire PowerPoint Presentation
- 2019 New Hire Presentation with Notes
- Excluding coverage for spouses
Q&A
Declaration Document - Memorandum of Understanding (MOU) - 2019
- 25-hour Resolution
Amendment
Resolution Form - Board of Education
Resolution Form - Board of Commissioners
- Plan Document (2019)
- Order Form
- Employee Checklist
- 2019 New Hire PowerPoint Presentation
- 2019 New Hire Presentation with Notes
- Excluding coverage for spouses
Q&A
Declaration Document - Memorandum of Understanding (MOU) Responsibilities
- OPEB Liability/Retiree Health Documents
OPEB Liability and the Local Government Plan Webinar PowerPoint Presentation
OPEB Webinar Questions
December 17, 2018 Memo LG Insurance Committee Actions – Retiree Health/OPEB Update
January, 18, 2019 Memo OPEB: Local Government Agency – Retiree Coverage Election Form
Division of Benefits Administration Local Government Agency – Retiree Coverage Election Form