Eligible state, local education and local government employees may enroll in
health coverage through the state group insurance program. Available options
include the Preferred Provider Organization (PPO) which is available statewide,
a Point of Service (POS) also available statewide or a Health Maintenance Organization (HMO) if
available in your service area. There are specific guidelines regarding the time
frame in which you and your eligible dependents must enroll. Please see the Insurance Handbook for specific information regarding eligibility and enrollment. To review a comparison of some common benefit categories
for the healthcare options, please see the Medical Options Comparison. For specific information about
benefits, refer to the appropriate Member Handbook and Provider Directory. All
referenced materials are available on the Forms & Publications page or can
also be obtained through your agency benefits coordinator.
To enroll, you must complete an enrollment/change application. If selecting an HMO option, a
physician selection card must also be completed designating your primary care
physician. The only time of the year when your healthcare selection may be changed is
during the annual enrollment transfer period unless you move out of a designated
service area.
Preferred Provider Organization (PPO)
The PPO is available statewide with claims administered by BlueCross BlueShield
of Tennessee. Under the PPO, participants choose a network provider or a
non-network provider. A network provider accepts a pre-negotiated fee. The
participant is responsible for a percentage of the maximum allowable charge and
an annual deductible. When a participant utilizes a non-network provider, care
is paid at a percentage of the maximum allowable charge and charges above the
maximum allowable are the patient's responsibility. Annual out-of-pocket
maximums apply.
BlueCross BlueShield of Tennessee
Office Hours: 8:00-5:00 eastern time, Monday-Friday
1-800-558-6213
Point of Service (POS)
The POS is available statewide with claims administered by Cigna HealthCare. Under the POS, participants use in-network providers who have agreed to accept a fixed copayment. Use of out-of-network
providers is covered at a percentage of the maximum allowable charge. Charges
above the maximum allowable amount are the patient's responsibility. There are
no deductibles or out-of-pocket maximums if you use in-network providers.
Cigna HealthCare
Office Hours: 8:00-6:00, Monday-Friday
1-800-564-7642 (enrollment information line)
1-800-244-6224 (member services)
Health Maintenance Organization (HMO)
The HMO is available in many counties within the state. Under the HMO, all care
is coordinated through a primary care physician. No benefits, other than
approved emergency or urgent care, are paid apart from the HMO's network.
Copayments are paid each time services are received and there are no deductibles
or out-of-pocket maximums.
HMO Service Areas
(Please click on the service area map for customer service numbers)
