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975 East Third Street
Chattanooga, TN 37403
423-778-7000
Children's Hospital at Erlanger Erlanger Baroness Campus Erlanger Bledsoe Campus Erlanger East Campus Erlanger North Campus UT Erlanger Physicians Group





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Health Benefit Plan

Erlanger Health System understands the need to offer health insurance coverage to employees and their family. The health insurance premiums are deducted from an employee's paycheck on a pre-taxed basis. BlueCross BlueShield of Tennessee provides the current health insurance plan, which is BlueCross BlueShield PPO.

Eligibility
To be eligible for Health Insurance Coverage, an employee must be classified as a regular employee and at least a .52 FTE or greater. An employee may elect individual or family coverage.

Enrollment
Eligible employees may enroll in individual or family health insurance coverage within 31 days of hire or within 31 days of a change in status. Events that cause a change in status includes, but not limited to marriage, divorce or the birth of a child. Eligible employees may also enroll for coverage during the Open Enrollment Period.

Effective Date of Coverage
New Hires

The Effective Date of Coverage will be the first of the month following the initial one-month waiting period.

Status Changes
Qualifying events that allow an employee to enroll , terminate or make changes outside of the annual enrollment period are: birth/adoption, marriage, divorce, or spouse/children loosing their coverage through no fault of their own. Enrollments, terminations or changes due to qualifying events must be designated by completing a form and attaching appropriate documentation of the event (i.e. birth certificate, divorce decree, etc.). The form and documentation must be submitted to the Benefits Department within 31 days of the event. If completed form and documentation are not submitted to the Benefits Department within 31 days from the qualifying event, the employee must wait until the next annual open enrollment period to enroll, terminate or make changes to the coverage.

Birth/Adoption
Coverage become effective the date of the birth
marriage: Coverage become effective the date of the marriage
Divorce: Coverage becomes effective the first day of the month following the event
Loss of coverage: Coverage becomes effective the first day of the month following the event


Summary of Benefits

NOTE: Please note that this is a Summary of Benefits. Changes may be made at any time. Please refer to your BlueCross BlueShield of Tennessee Evidence of Coverage book or contact BlueCross BlueShield for specific coverage questions. Erlanger Health System will write-off a portion of the co-pay after receiving payment from all applicable insurance carriers for charges incurred at an Erlanger facility.

Office Visit Copay
  • Office Visit $35 PCP /$50 specialist
    (if treating physician is in network)
  • Emergency Room Services $150.00
  • Other Outpatient services no charge

Note: All co-pays due at the time of service

Deductible
  • Inpatient Services - $1,000 deductible
  • Outpatient Services - $1,000 deductible
  • Non-routine diagnostic services $1,000 deductible
  • Durable Medical Equipment (DME) $1,000 deductible
  • Discount offered through Erlanger Facilities:
  • Inpatient Services $500
  • Outpatient Surgery $250
  • Emergency Room Services $25
Prescription Drug Co-pay
  • Generic Drugs $10.00
  • Brand Name Drugs $35.00
    (Drugs in BCBS's Preferred Drug List)
  • Brand Name Drugs $50.00
    (Drugs Not in BCBS's Preferred Drug List)
  • Discount offered through Erlanger Pharmacy
  • Brand Name Drugs $30.00
  • (Drugs in BCBS's Preferred Drug List)
  • Brand Name Drugs $45.00
    (Drugs Not in BCBS's Preferred Drug List)

Note: All co-pays due at the time of service

If you are using a maintenance drug that is on the BCBS's Maintenance Drug List, you may obtain a 100-day supply at the pharmacy for two co-pays (all prescription medications must be purchased from a network pharmacy). For limitations and exclusion, you may contact BlueCross Blue Shield or refer to the Pharmacy section of your Evidence of Coverage book.

Employee Premiums
 
PLAN P
EMPLOYEE STATUS
Monthly
Bi-Weekly
Full-time (0.85 FTE) Individual
$40
$20

Family
$135
$67.50
Part-time (0.52_0.84 FTE) Individual
$76
$38

Family
$180
$90
Part-time (0.52 FTE) Not eligible

 

How to Contact BlueCross BlueShield of Tennessee

You may contact BlueCross BlueShield of Tennessee by telephone at 1-800-565-9140 or through their website at www.bcbst.com. Please have your health insurance card ready with account information.