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Covering most health services that most Tennesseans need. 2nd Quarter 2012


In this issue

Understanding CoverTN's Benefit Limits

It's important that your enrolled employees remember the rules and limits of their CoverTN health plan. The chart below highlights some of them. For a complete listing, members should review their Schedule of Benefits which is Attachment C of their Member Handbook. They can also find this information at bcbst.com. Just go to the Plan Options tab at the top of the page. Then choose Cover Tennessee from the drop-down menu. Or, they may call Member Services toll-free at 1-888-877-3224 (TDD/TTY 1-866-591-2908) for details.

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Helping your employees
understand benefit limits

CoverTN has a $25,000 annual plan payment maximum, as well as limits on particular kinds of services. There are also quarterly prescription drug payment limits.

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Know your employees’ rights and responsibilities

CoverTN knows it’s important for your employees to understand how their health plan works. As a plan member they have the right to:

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Finding In-Network Providers

While most providers will notify their patients if they leave our networks, members should always make sure their doctor is in Network V before they make their next visit.

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Pregnant Covered Employee?

CoverTN members who become pregnant are eligible to enroll in TennCare or CoverKids HealthyTNBabies for maternity coverage.

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Reminder: Non-Sufficient Funds (NSF) Notices

As a participating CoverTN employer, you are required to fund both your third and your employee's third of the required premium through the bank draft process. The State pays the final third. You must withhold your employee's third through payroll deduction.

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BlueCross BlueShield of Tennessee, Inc., an Independent Licensee of the BlueCross BlueShield Association.

Call 1-888-887-3224, toll free, Monday-Friday, 8 a.m. to 6 p.m., ET, if you need help or need to speak with someone in another language. TDD/TTY users should call 1-866-591-2908. These services are free to enrollees. We do not allow unfair treatment in CoverTN. No one is treated in a different way because of race, color, birthplace, religion, language, sex, age, or disability. Do you think you've been treated unfairly? Do you have more questions or need more help? If you think you've been treated unfairly, call the Office of Non-Discrimination for free at 1-855-286-9085.

The information in this newsletter is not meant to take the place of a doctor's advice.

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