Health Insurance Carrier Network Information

BlueCross BlueShield of Tennessee and Cigna, our health insurance carriers, administer our network options. Both carriers offer expansive networks of doctor, hospital and facility providers. For additional information about participating hospitals, please carefully review all information provided below, including the hospital list and other network information.

You can choose from the following four carrier networks for your medical care.

Narrow Networks:

BlueCross BlueShield Network S

Cigna LocalPlus

Narrow Networks include many providers, hospitals and facilities throughout Tennessee and across the country. Not all providers and hospitals are in narrow networks, which helps keep premiums and claims costs low. No premium surcharge is applied to the narrow networks.

Broad Networks:

BlueCross BlueShield Network P

Cigna Open Access Plus

Broad Networks cost an additional $65 per month for the employee only and employee + child(ren) tiers and an additional $130 per month for the employee + spouse and employee + spouse + child(ren) tiers. This cost is added to your monthly premium. In a broad network, you may also pay more per claim because the costs for services in these networks are generally higher than the narrow networks.

Network providers and facilities can and do change. Benefits Administration cannot guarantee all providers and hospitals in a network at the beginning of the year will stay in that network for the entire year. A provider or hospital leaving a network is not a qualifying event and does not allow you to make changes to your insurance choices.

If you use providers outside of the network, you will be charged out-of-network rates unless certain rights and protections apply. Your insurance ID card shows your carrier and network.

Information in provider directories is accurate at the time of publication. Providers and hospitals in the carriers' networks can change after documents are published. You can verify the network status of your preferred providers before receiving care by calling BCBST or Cigna member services or by using the online provider search on the carrier websites.

Covered services

The carriers' covered services are generally the same whether you choose BCBST or Cigna. For some procedures, different medical criteria may apply based on the carrier you select. For detailed information on covered services, exclusions and how the plans work, view the BCBST or Cigna member handbooks and your Plan Document, available on the Publications page. If you have questions about your benefits or medical criteria for a specific service, contact the carriers’ member services

Coordination of Benefits

Coordination of benefits rules decide which insurance plan pays your claims first, how much each plan will pay, and how much you will pay.

Double coverage means you have insurance under two medical plans. For example:
·         you might be enrolled in the State Group Insurance Program* plus another employer plan; or (for example, as an employee in the state plan and as a dependent, spouse or child in the local education plan)
·         you might be enrolled in two State Group Insurance Program* plans; or
·         you might be enrolled in Medicare as your primary coverage and in a State Group Insurance Program* plan as your secondary coverage

Coordination of benefits will be applied to your claims so that:
·         if you have other primary medical coverage and secondary medical coverage with this plan, you will pay any cost share required by this plan.
·         if you have primary and secondary coverage with this plan, you will pay the cost share required by this plan’s secondary coverage.

See examples.

*The State Group Insurance Program, also referenced as “this plan”, includes three separate plans: State/Higher Education, Local Education and Local Government.