Retirement Guide for Agency Benefits Coordinators

This page outlines the general requirements for group health insurance eligibility for retirees, differentiating between various employment sectors and service durations, with a critical initial hire date of prior to July 1, 2015, for most plans.

Eligibility Requirements

Hire Date

  • State, higher education and local education retirees must have a date of hire on or before July 1, 2015. 
  • The July 1, 2015, date of hire does not apply to local government agencies.

Retiree or Dependent Age

  • Retiree or spouse must be under 65 years old. 
  • Dependent child(ren) must be under 26 years old. 
  • Higher education optional retirement plan members, non-Tennessee Consolidated Retirement System local education retirees and all local government (both TCRS and non-TCRS) retirees must be at least 55 years old. 

Date of Retirement

  • Date of retirement for the TCRS pension and Benefits Administration retirement application must be on or before the active insurance end date.  

Timely Submission

  • The Application to Continue Insurance at Retirement must be submitted within one full calendar month of the active insurance end date. 

Years of Service and Continuous Insurance Leading to Retirement

Retirees must have at least 10 years of service to qualify for retirement.

Must be enrolled in state employee insurance leading up to retirement. Your years of service determine how much continuous insurance coverage you must have to qualify for retiree group health insurance. 

  • 10-19 years of service:
    • Three years of continuous insurance leading up to retirement. 
  • 20 or more years of service: 
    • One year of continuous insurance leading up to retirement. 
Graphic titled “Understanding Service Crediting” with a large stylized dollar sign on the left. On the right, four rules explain how service is counted: (1) Local Government Service – cannot be combined with other service; (2) Military Time – only counts if it interrupted employment; (3) Local Education Service – only counts if the LEA participates in the program; (4) Tennessee Consolidated Retirement System (TCRS) Service – only counts if it was not cashed out.

Combining Years of Service

  • Creditable service with state, higher education or local education agencies that participate in the State Group Health Insurance Program may be combined to obtain the required 10 years of service for retirement. 

Ineligible to Combine Years of Service

  • Local government service cannot be combined with any other service, including other local government agencies. 
  • Any military time that did not interrupt employment will not count towards creditable service. 
  • Any service with a local education agency that does not participate in the State Group Health Insurance Program will not count towards creditable service. 
  • Any TCRS service previously cashed out and not paid back will not count towards creditable service. 
    • Cashed out service may impact a retiree's eligibility to meet the hire date prior to July 1, 2015, even if it was purchased back. 

Application to Continue Insurance at Retirement 

  • This application is used for all employees who are going directly from active to retirement coverage – even if the employee is applying to enroll in The Tennessee Plan. 
  • Retirees will continue coverage in the same group health plan upon retirement. 
  • Changes can be made during Annual Enrollment or if a special qualifying event occurs. 

Dependent Coverage

  • Continuation of dependent-only group health is allowed if the retiree was covering dependents when they became Medicare eligible. 
  • A retiree who is no longer eligible for group health coverage is not eligible to add a dependent to the retiree group health insurance via the special enrollment provision, or during Annual Enrollment. 

The Tennessee Plan

The Tennessee Plan is supplemental medical insurance for retirees with Medicare.

Infographic titled “The Tennessee Plan Eligibility.” Four eligibility requirements are displayed in horizontal sections. Medicare Enrollment: The retiree must be enrolled in Medicare. TCRS Pension: The retiree must receive a TCRS pension based on their own service, with a hire date on or before July 1, 2015. Higher Education Retirees: ORP participants must have a hire date on or before July 1, 2015. Application Window: Members have 60 days from the date of initial eligibility to apply for guaranteed approval. Additional note: Members may apply after 60 days; however, approval is not guaranteed for the member or their spouse.

Covering a Spouse

  • A retiree must be enrolled in The Tennessee Plan in order to cover a spouse eligible for Medicare. 

Service and Premium Support

  • State, higher education and local education certified teacher retirees are eligible for a premium reduction based on their combined years of service. 
  • Local education support staff and local government retirees do not receive a reduction on premiums unless the agency has passed a Medigap resolution. 

Prescriptions

The Tennessee Plan is a supplemental plan for Medicare Parts A and B, and does not cover prescription drugs. 

Medicare Advantage

The Tennessee Plan will not pay claims if the retiree is enrolled in a Medicare Advantage plan. 

Retiree Dental and Vision

New Dental and Vision Eligibility Updates for 2026

Retirees who want to sign up for dental or vision insurance on or after Jan. 1, 2026, can only enroll if their agency has opted in to the State Group Insurance Program's dental or vision coverage.

  • If a retiree signs up for dental or vision insurance on or after Jan. 1, 2026, and their agency leaves the program, the retiree will no longer be eligible for dental or vision insurance.

Retirees are no longer required to be on retiree group health insurance for vision coverage and can retain retiree vision insurance beyond the age of 65.

Important: Retirees who already had dental or vision insurance before Jan. 1, 2026, can keep it, even if their agency does not opt in for dental or vision insurance.

  • If their agency opts out of dental or vision insurance later, they can keep their dental or vision insurance.
  • If the retiree cancels their dental or vision insurance and wants it back after Jan. 1, 2026, they will be subject to the new retiree dental or vision insurance rules.

Retiree Dental

  • The retiree's agency must have opted in for dental insurance.
  • If a retiree signs up for dental insurance on or after Jan. 1, 2026, and their agency leaves the program, the retiree will no longer be eligible for dental insurance.
  • Must receive TCRS pension or be a higher education ORP retiree. 
  • Must have a date of hire on or before July 1, 2015. 
  • Retiree is not required to be on retiree group health insurance and can keep retiree dental insurance past the age of 65. 

If a retiree had dental insurance as an active employee, they have the option to continue their dental coverage under the COBRA provision at a lower premium for 18 months before transitioning to retiree dental. 

COBRA Dental

  • COBRA dental premiums are cheaper than retiree dental and can be processed on a TCRS pension. 
  • The retiree must complete the COBRA dental application and return it to Benefits Administration. 
  • Benefits Administration will notify the retiree of enrollment and when the 18-month period will end. 

Retiree Vision

  • The retiree's agency must have opted in for vision insurance.
  • If a retiree signs up for vision insurance on or after Jan. 1, 2026, and their agency leaves the program, the retiree will no longer be eligible for vision insurance.
  • Must have a date of hire on or before July 1, 2015. 
  • If a retiree does not meet the eligibility requirements for retiree vision, they may continue coverage under COBRA vision if they had coverage as an employee. 

COBRA retiree vision premiums cannot be processed on the retirement pension with TCRS. 

Retiree Eligibility for 2026

Retirees may be eligible for dental insurance if they meet the eligibility rules. See below for rules effective Jan. 1, 2026.

Diagram of retirement insurance eligibility factors: hire date, age, service, timing.

Effective Jan. 1, 2026, a state retiree is an individual who:

  1. Was hired before July 1, 2015, has left active employment as a state employee, and is drawing retirement benefits through TCRS based on their own service or is a participant in a higher education optional retirement plan, as permitted by TCA 8-27-205. Employees whose employment with the state commenced on or after July 1, 2015, are not eligible for coverage as a retiree unless they were employed by the state or a participating local education agency, as defined in TCA § 8-27-301, before July 1, 2015, and did not accept a lump sum payment from the TCRS before July 1, 2015; or
  2. Is enrolled in the state’s dental insurance program and is a former governor or retired state of Tennessee senator or representative first elected to office prior to July 1, 2015, and meets the requirements set forth in TCA 8-27-208.

Effective Jan. 1, 2026, a local education retiree is an individual who:

  1. Was hired before July 1, 2015, has left active employment as a local education employee, and:
    1. If vested in TCRS, is drawing retirement benefits through TCRS based on their own service, as permitted by TCA 8-27-305; or
    2. If not vested in TCRS, is at least age 55 at the time of termination with 10 or more years of service with a participating local education agency or 10 or more years of combined service with a participating local education agency and the state.
  2. Was an employee whose employment with the local education agency commenced on or after July 1, 2015, are not eligible for coverage as a retiree unless they were employed by the state or a participating local education agency, as defined in TCA § 8-27-301, before July 1, 2015, and did not accept a lump sum payment from the TCRS before July 1, 2015.

Effective Jan. 1, 2026, and thereafter, eligibility to participate in the state retiree dental plan is only open to retirees of an LEA that is participating in the state dental plan at the time of retirement. If the LEA subsequently terminates participation in the state dental plan, its retirees are no longer eligible to continue retiree dental coverage.

Effective Jan. 1, 2026, a local government retiree is an individual who:

  1. Has retired from the participating employer, and:
    1. If vested in TCRS, receives a monthly benefit through TCRS based on their own service, as permitted by TCA 8-27-705; or
    2. If not vested in TCRS, is at least age 55 at the time of termination with 10 or more years of employment with the participating local government agency from which they retired.
  2. Has retired as a utility district commissioner with 20 or more years of service with the same utility district and is at least age 55 at the time of termination.       
  3. Has retired as a member of the chief legislative body of the county or municipal government (defined as only those elected officials who have the authority to pass local legislation) and is at least age 55 at the time of termination with 10 or more years of service with the participating local government agency from which they retired. 
  4. Has retired as a county official as defined in 8-34-101(9)(A) and (B) and is at least age 55 at the time of termination with 10 or more years of service with the local government agency from which they retired.

Effective Jan. 1, 2026, and thereafter, eligibility to participate in the state retiree dental plan is only open to retirees of an LGA that is participating in the state dental plan at the time of retirement. If the LGA subsequently terminates participation in the state dental plan, its retirees are no longer eligible to continue retiree dental coverage. This restriction does not apply to county officials as defined in 8-34-101(9)(A) and (B).

ABC Retirement Action Items

When an active employee is ready to retire, advise the employee to contact: 

  1. TCRS to verify eligibility and the application process for the pension. Note: This is a separate application from retirement insurance. If the agency does not participate in TCRS, please disregard this step. 
  2. Benefits Administration Retirement Department to verify eligibility and the application process for retirement insurance. 

Important: It is recommended that active employees initiate the pension and retirement insurance application process approximately three months prior to their anticipated retirement date. 

If the retiree or spouse are over age 65, they do not qualify for retiree group health insurance. The retiree or spouse may qualify for dental, vision and The Tennessee Plan, provided all eligibility requirements are met. 

A spouse cannot be on The Tennessee Plan until the retiree becomes eligible. 

If the spouse is under 65 and the retiree is over 65, the spouse may continue on the dependent-only group health and vision insurance coverage if they were on the retiree's insurance at the time the retiree turned 65. 

It is important for ABCs to terminate an employee in Edison in a timely manner. Failure to terminate an active employee's insurance coverage in a timely manner can result in it being extended into the next month, potentially leading to billing issues for the agency.  

ABCs will utilize the RET code for retirement terminations. 

Active employees who are looking to retire will fill out the application and return it to the ABC. This application is used for active employees who are under or over the age of 65. 

Application Explainer

Several acronyms are listed on the application to continue insurance at retirement. You can use this page to follow along when completing the form.

  • Active CVG Term Date: The date when active insurance coverage is expected to end. 
  • BIL: If the retiree insurance premiums will be billed to the retiree. 
  • FRM LEGIS: If your employee is a former member of the state legislature. 
  • INS: If the retiree insurance premiums will be billed to the agency. 
  • LE: Local education.
  • LE-SS: Local education support staff.
  • LG: Local government.
  • ORP/TIAA: Optional Retirement Plan managed by Teachers Insurance and Annuity Association of America that was previously offered to higher education employees. 
  • RET: If the retiree will have retiree insurance premiums billed to their TCRS pension. Note: If RET is selected and the member’s pension is not enough to cover retiree insurance premiums in full, BA will change the member’s payment status to BIL. The retiree will pay the retiree insurance premiums directly to BA. 
  • RET CVG Effect Date: The date when retiree insurance coverage should begin. 
  • ST: State.
  • Years of Creditable SVC: How many years the employee has for creditable service. 

Application Tips

Please verify the number of years the employee has been on state insurance prior to their retirement. 

Important: If the application to continue insurance at retirement is not certified by the ABC, the application will be sent back by Benefits Administration for the ABC to certify. This may cause delays in processing the employee's retirement insurance. 

Make sure to fill in your agency’s name along with your signature, date and phone number. 

Additional Retirement Resources for ABCs

  • Benefits Administration Service Center is open Monday–Friday from 8 a.m. to 4:30 p.m. CT.
  • The Benefits Administration Service Center phone number: 615-741-3590 or 800-253-9981 (select option 2 for the retirement department).
  • The Benefits Administration Service Center email address: retirement.insurance@tn.gov.
  • Watch The Tennessee Plan video.
  • Obtain additional information for employees continuing insurance at retirement.
  • TCRS phone number: 800-922-7772. 
  • Link to the TCRS website.
  • Social Security office phone number: 800-772-1213. 
  • The Tennessee State Health Insurance Assistance Program is a free, unbiased service that helps compare Medicare plans. It can also assist with general Medicare questions. The TN SHIP phone number: 877-801-0044.