Purpose:
It is the policy of Dyersburg State Community College (DSCC) to offer various insurance programs to its employees.
Scope:
The following policy shall be applicable to all full time and part-time (80%) regular employees.
Policy:
Eligible DSCC employees may enroll in health coverage through the state group insurance program. Available options include the Partnership PPO and the Standard PPO. Participation is optional. Coverage starts on the first day of the month after you complete one full calendar month of employment, except for voluntary term life insurance. Voluntary term life insurance will become effective after you have completed three full calendar months of employment. Employees must sign up within 30 days of hire. Open enrollment is the only time health coverage changes can be made unless there is a special qualifying event. Health coverage premiums are paid with pre-tax dollars. If you enroll in a CDHP/HSA, the state will deposit $250 for employee only coverage or $500 for family coverage into your health savings account (HSA). If your coverage effective date is September 2 through the end of the year, you will not receive the state contribution towards your HSA. If you enroll in the CDHP, a health savings account (HSA) will be set up for you. You cannot enroll in the CDHP/HSA if you are enrolled in another plan.
CVS Caremark is the pharmacy benefits manager for all plan members regardless of which healthcare option is selected. The state’s prescription drug plans require a copay or coinsurance. Benefits depend on the level of prescription drug (generic, preferred, or non-preferred).
DSCC provides, at no cost to employees, $20,000 of basic term life and $40,000 of basic special accident coverage. For employees who elect health coverage, the amount of coverage increases as the employee’s salary increases, with premiums for coverage above $20,000/$40,000 deducted from the employee’s paycheck. The maximum amount of coverage is $50,000 for term life and $100,000 for accidental death and dismemberment. The face amount of coverage declines at ages above 65. Eligible dependents (spouse and children) of employees enrolled in health coverage are covered for $3,000 of basic dependent term life coverage. Dependents (spouse and children) are eligible for basic special accident insurance, with the amounts of coverage based on salary and family composition.
Optional dental insurance is available to all state plan members. Employees can choose between two optional dental plans: Cigna Dental Care Prepaid Plan and MetLife Dental Preferred Provider Dental Plan. Participation is optional, and the employee pays premiums. Dental premiums are paid with pre-tax dollars.
The Tennessee Board of Regents offers one vision plan – Basic and Expanded through Davis Vision. Participation is optional, and the employee pays premiums. The State of Tennessee vision plan is paid with pre-tax dollars. Additional accidental death and dismemberment is available on a contributory basis for employees and dependents (spouse and children) and is in addition to the basic special accident death coverage.
Minnesota Life Insurance Company offers optional term and universal life insurance. This insurance is available on a contributory basis for employees and dependents (spouse and children) whether or not they participate in health coverage. For guaranteed-issued coverage, the employee must enroll during the first full month of employment with the state. If optional life coverage is not elected at that time, an employee may only enroll during the annual enrollment transfer period by presenting evidence of insurability through a health questionnaire. Premiums are based on age and the amount of coverage requested.
Prudential offers long‑term disability insurance for exempt and non-exempt employees who work a minimum of 30 hours per week, excluding temporary employees. Participation is optional and the employee pays premiums (based on salary). Acceptance is guaranteed if enrolled during first 30 days. MetLife offers short-term disability insurance for exempt and non-exempt employees. Employees must sign up within 30 days of hire.
Here4TN provides confidential financial, legal and emotional counseling at no cost to members and their dependents. Employee assistance program (EAP) services are offered to all full-time DSCC employees and their eligible family members, regardless of whether they participate in the State’s Group Insurance Program. Employees and their dependents enrolled in health coverage are eligible for mental health and substance abuse benefits, which are administered by Optum.
Compliance:
All Dyersburg State Community College employees are expected to adhere to this policy.
Definitions:
Employee:
(A) Any person employed by the employer, who is regularly scheduled to work not less than 30 hours per week;
(B) Any person who has received a seasonal appointment and who meets the requirements set forth in TCA 8-27-201(h); and
(C) All other individuals cited in state statute or approved as an exception by the State Insurance Committee. Individuals in positions classified as temporary appointments, or performing services on a contractual basis, shall not be considered employees.
Dependent:
(A) A legally married spouse; Article XI, Section 18 of the Tennessee Constitution provides that a marriage from another state that does not constitute the marriage of one man and one woman is “void and unenforceable in this state,” or
(B) A child under the age of 26 who meets at least one of the following criteria without consideration of factors such as financial dependency, marital status, enrollment in school, or residency:
(1) An employee’s natural (biological) child; or
(2) An employee’s adopted child (including a child placed for adoption in anticipation of adoption); or
(3) A stepchild of the employee or spouse; or
(4) A child for whom the employee is the legal guardian; or
(5) An employee’s child for whom the plan has received a qualified medical child support order requiring the child to be enrolled in a health insurance plan pursuant to State or Federal statutes.
(C) Dependents over the age of 26 who meet at least one of the criteria in 1.13(B) of this section and who are incapacitated (mentally or physically incapable of earning a living regardless of age, provided the dependent is incapable of self-sustaining employment). This provision applies only when the incapacity existed before the dependent’s 26th birthday and they were already insured by a state sponsored plan. The child must meet the requirements for dependent eligibility listed in this section. A request to continue coverage due to incapacity must be provided to Benefits Administration within the 90 days prior to the dependent’s 26th birthday. Annual proof may also be required. Approval is subject to review of the claims administrator. Coverage will not continue and will not be reinstated once the dependent is no longer incapacitated.
(D) Dependents not eligible for coverage include:
(1) Foster children;
(2) Dependents not listed in the above definitions;
(3) Parents of the employee or spouse;
(4) Ex-spouse; and
(5) Live in companions who are not legally married to the employee.
An employee may not be enrolled as both head of contract and dependent within the state plan.
Qualifying Event:
A) Death of Spouse or ex-spouse
B) Divorce
C) Legal Separation
D) Loss of eligibility (does not include a loss due to failure to pay premiums or termination of coverage for cause).
E) Loss of coverage due to exhausting lifetime benefit maximum.
F) Loss of TennCare (does not include a loss due to failure to pay premiums).
G) Termination of spouse’s or ex-spouse’s employment (voluntary or non-voluntary).
H) Employer eliminated contribution to spouse’s, ex-spouse’s or dependent’s insurance coverage (total contribution, not partial).
I) Spouse’s or ex-spouse’s work hours reduced causing loss of eligibility for insurance coverage.
J) Acquire a new spouse.
K) Acquire a new dependent (newborn or adoption/legal custody).
Revision History:
Created January 2005; Revised October 2012. Approved by Admin Council May 30, 2014. Revised July Approved by Administrative Council July 31, 2019.