Local Government Retirement Guide

The Local Government Plan Document and the certificates of coverage for voluntary programs like vision and dental are the official legal publications that define eligibility, enrollment, covered and excluded services, benefits and administrative rules of the State Group Insurance Program. You can find the Plan Document and the certificates on the Partners for Health Publications page  If any information in this guide conflicts with provisions in the Plan Document or the certificates of coverage, those documents control.  Likewise, if there is any conflict with applicable law, the law shall control.

INTRODUCTION

 

Notice

You may only apply to continue coverage as a pre-65 retiree in the state-sponsored local government insurance plan if your local government agency has opted into retiree coverage.

 

Overview

This guide explains the insurance options available to you at retirement and the rules for each type of coverage. There are two eligibility and enrollment sections. It is important that you refer to the section that applies to you. If you are a Tennessee Consolidated Retirement System participant, see the requirements on page two. If you are a non-TCRS participant, see page four. 

 

For More Information

Your agency benefits coordinator is your primary contact. He or she can provide you with forms and handbooks you need. For questions about eligibility, contact Benefits Administration. Our service center is your main point of contact regarding insurance once you retire.

All forms and handbooks referenced in this guide are on the Partners for Health website. You can also get copies by calling our office at 615-741-3590 or 800-253-9981 or emailing retirement.insurance@tn.gov. You need to include your Edison ID (found on your Caremark card), date of birth and your address in your email.  If you do not have your Edison ID then please include the last four digits of your Social Security number.

If you have questions about health coverage (e.g., prior authorization, claims processing or payment, bills, benefit statements or letters from your health care provider or insurance company) contact the insurance company’s member service number on your insurance card. See also, information at the end of this guide about your appeal rights.

 

Definitions

Continuous Coverage is participation in the state’s local government plan without any break in Coverage. 

Employment with the Employer is employment with the local government agency from which the employee is retiring.  For TCRS vested members, this is employment upon which contributions to TCRS are made by the employee or by the local government agency from which the employee is retiring.  For non-TCRS participants, this is employment in a position with the local government agency from which the employee is retiring, where the employee qualified for insurance coverage with the state’s local government plan.  Accumulated unused sick leave counts as Employment with the employer.  You may hear or see the things that count toward employment with the employer referred to as “creditable service”. 

Retirement Date is, with respect to vested TCRS participants, the date retirement benefits commence as determined by TCRS.

Termination Date is an employee’s last paid day or last day of leave from the employer, whichever is later.  A final termination date is an employee’s last paid day or last day of leave from an agency participating in one of the state health plans, whichever is later.