Tennessee § 8-27-204 - Eligibility for plans — Temporarily disabled employees — Dependents.

§ 8-27-204. Eligibility for plans — Temporarily disabled employees — Dependents.

State employees shall be eligible for the plans authorized under § 8-27-202. The state insurance committee shall establish procedures for enrolling state employees and collecting required premiums. For purposes of eligibility, “state employee” means: Any person who is a state official, including members of the general assembly and legislative officials elected by the general assembly; Any person who is employed in the service of, and whose compensation is payable by, the state; Any person who is employed by the state whose compensation is paid, in whole or in part, from federal or other funds; or Any commissioner of the Tennessee public utility commission. The following persons are not eligible for the state group insurance plan: Any person performing services on a contractual or percentage basis; or Any part-time or seasonal employee who works less than an average of thirty (30) hours per week. The average shall be calculated on an annual basis. The group insurance plan for state employees shall include as eligible employees, each officer and employee of the several departments and agencies of state government who, having been employed by the state for at least twenty-four (24) months, will work one thousand four hundred fifty (1,450) hours or more in a fiscal year, whether compensated on an hourly, daily, monthly, or piecework basis. The various departments, agencies, boards, and commissions of state government shall pay, on behalf of each participating employee within the respective departments, agencies, boards, and commissions, the same rate of the cost of the participating employee's participation in the group insurance plan as is paid for other employees pursuant to subsection (b) while the participating employee is on active status. The participating employee may maintain such insurance coverage during the time the employee is not on active status for a period not to exceed three (3) months in any one (1) fiscal year and shall be responsible for paying one hundred percent (100%) of the cost of such insurance during such time. This subdivision (a)(3) shall not apply to employees hired on or after July 1, 2015. The state insurance committee may determine criteria to extend eligibility to additional employees, subject to the availability of funds as certified by the commissioner of finance and administration. The state insurance committee shall develop procedures for special enrollment of employees consistent with applicable state and federal laws. Any employee who leaves the state payroll because of a work-related injury and who qualifies for temporary benefits after application to the board of claims shall be considered an eligible employee for the purpose of participating in the state group insurance plan during the period of temporary disability; provided, that the employee was participating in the state group insurance plan at the time the work-related injury occurred. The various departments, agencies, boards, and commissions shall pay all of the cost of the insurance premium for employees described in this subsection (c). Nothing in this subsection (c) shall permit payment by the group insurance plan for medical expenses incurred because of any work-related injury qualifying the employee for benefits from the board of claims. The state insurance committee shall extend eligibility to the dependents of state employees who are eligible for the state group insurance plan. The state insurance committee may determine which dependents are eligible, and what documentation is required to establish eligibility, subject to the requirements of state and federal law. Eligibility standards for dependents shall be approved at public meetings of the state insurance committee and published in the plan documents. The state may deny coverage to the spouses of state employees who are eligible for similar group health insurance through the spouses' employers. Any denial of coverage made pursuant to this subsection (d) and based on an employee's spouse's eligibility for similar group health insurance through the spouse's employer shall apply only to employees whose employment commenced on or after July 1, 2015. Acts 2015, ch. 426, § 2; 2017, ch. 94, § 27. Compiler's Notes. Former part 2, §§ 8-27-201 — 8-27-211 (Acts 1976, ch. 804, §§ 2, 3; Acts 1978, ch. 782, § 1; 1979, ch. 337, § 1; T.C.A., § 8-4502; T.C.A., § 8-4503; T.C.A., § 8-4507; T.C.A. § 8-27-209 ; T.C.A., § 8-27-304 ; Acts 1981, ch. 407, § 1; 1982, ch. 643, §§ 1, 3; 1983, ch. 375, §§ 1, 2; 1984, ch. 543, § 1; 1984, ch. 881, § 1; 1985, ch. 426, §§ 1, 2; 1985, ch. 455, § 4; 1986, ch. 509, § 1; 1986, ch. 647, § 1; 1989, ch. 343, § 2; 1989, ch. 532, § 1; 1989, ch. 544, § 1; 1990, ch. 827, § 1; 1990, ch. 1004, § 1; 1991, ch. 128, § 3; 1991, ch. 159, § 1; 1992, ch. 841, § 1; 1992, ch. 904, § 1; 1993, ch. 503, § 1; 1996, ch. 936, § 7; 1997, ch. 159, § 1; 1997, ch. 498, § 1; 1997, ch. 513, §§ 3,5, 8, 10; 1998, ch. 883, § 1; 1998, ch. 905, §§ 1, 2; 1999, ch. 116, § 2; 1999, ch. 396, § 1; 2001, ch. 58, § 1; 2002, ch. 853, §§ 1-3; 2002, ch. 863, § 19; 2002, ch. 870, § 1; 2004, ch. 629, § 1; 2005, ch. 376, §§ 1, 3; 2007, ch. 497, § 1; 2009, ch. 258, § 1; 2009, ch. 502, § 2; 2010, ch. 914, § 1; 2010, ch. 919, § 2; 2012, ch. 1069, § 1; 2013, ch. 245, § 1), concerning group insurance for state officials and employees, was repealed and reenacted by Acts 2015, ch. 426, § 2, effective May 18, 2015. Amendments. The 2017 amendment substituted “commissioner of the Tennessee public utility commission” for “director of the Tennessee regulatory authority” in (a)(1)(D). Effective Dates. Acts 2017, ch. 94, § 83. April 4, 2017.