Vanderbilt University Human Resources

Improvements to this Web page have caused changes to links below. We're trying to get you where you want to go ... FASTER! Suggestions regarding the Benefits tab of the HR Web site can be emailed to benefits@vanderbilt.edu.

Health Care Plan

As a benefits-eligible employee, you may choose between three health options. Click on the links below for details of each options (have your VUnetID and e-password ready to view these secure pages), the online directories, evidence of coverage booklets and administrators' Web sites.

Standard	Details of this option
	Online Provider Directory
	Evidence of Coverage
	Aetna Web site

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Advantage P	Details of this option
	Online Provider Directory
	Evidence of Coverage
	BlueCross BlueShield of Tennessee Web site

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HealthFund	Details of this option
	Watch demo of how this plan works
	Online Provider Directory
	Evidence of Coverage
	Aetna Web site

Prescription Drug Benefit

All three health plan options include the same Prescription Drug Benefit. Through December 31, 2009, Caremark will administer the prescription drug program. On January 1, 2010, Navitus Health Solutions will begin administering this benefit for all Vanderbilt faculty and staff enrolled in one of the three health plan options.

Caremark Web site

Navitus Web site

For details of the Navitus drug program, go to https://hr.vanderbilt.edu/secure/Benefits/Navitus.htm.

Disease Management Program

All three health plan options include a Disease Management Program administered by ActiveHealth.

ActiveHealth Web site

Preventive Care Program

All three health plan options include a comprehensive Preventive Care Program that covers such things as annual well-checkups and well-baby visits for covered dependents.

Applied Behavior Analysis for Autism Spectrum Disorder

Each of the Vanderbilt Group Health Plan options (Standard, Advantage P and HealthFund) includes a limited provision for Applied Behavioral Analysis (ABA) therapy for autism spectrum disorder (ASD). Click here for more information.

Tobacco Cessation Benefit

Vanderbilt helps to pay for a tobacco cessation program for employees and their dependents covered on the health plan. Click here for more information.

Health Care Plan Eligibility

Coverage under the Vanderbilt Health Plan for Faculty and Staff is extended to full-time, regular faculty and staff, their spouses or certified domestic partners, and all unmarried eligible dependent children from birth to 25 years of age. Coverage beyond the age of 25 may be available if child is disabled. You must contact Vanderbilt Human Resources prior to the child’s 25th birthday for more information.

If you are a full-time, non-exempt staff member (paid weekly or every two weeks), your health insurance begins on the first of the month following 60 days of employment. If you are a full-time, exempt staff member (paid monthly), your health insurance begins on your hire date. Enrollment forms should be submitted as quickly as possible after your hire date.

Special Enrollment Rights under CHIPRA

The Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA) was enacted by the United States federal government on February 4, 2009. CHIPRA created new special enrollment rights effective April 1, 2009. CHIPRA extended the State Children’s Health Insurance Program (SCHIP) through 2013 and renamed it the Children’s Health Insurance Program (CHIP). The special enrollment rights under CHIPRA allow the following for qualified Vanderbilt Group Health Plan members:

If you or your dependent become eligible for state-granted premium assistance, or, you or your dependent’s coverage terminates due to a loss of eligibility (as opposed to termination due to failure to pay premiums) under Medicaid, Tennessee’s CoverKids program, or a State Children’s Health Insurance Plan, you may enroll in the Vanderbilt Group Health Plan. You must request coverage within 60 days of this special-enrollment qualifying event by completing a Notification of Family Status Change Form and providing supporting documentation to the Office of Benefits Administration.
If your dependent becomes eligible to receive a premium subsidy from the Child Health Insurance Program, you will be allowed under CHIPRA to disenroll (drop) your dependent from the Vanderbilt Group Health Plan. You must request this coverage change within 60 days of this special-enrollment qualifying event by completing a Notification of Family Status Change Form and providing supporting documentation to the Office of Benefits Administration.

Forms

Benefits Enrollment Form

The Benefits Enrollment Form (BEF) is the document that benefits-eligible employees must complete to choose insurance options for your health plan, dental coverage, and life and accidental death and dismemberment insurances. The BEF should be submitted as soon as possible after your hire date or you will be enrolled in the default coverage, which currently is Aetna Standard at the employee-only tier. You can find the BEF in the listing on the Forms and Documents page of this Web site.

Non-exempt staff: your BEF is due within 60 days of your hire date.

Non-exempt staff going from regular part-time to regular full-time position: your BEF is due within 30 days of your change in employment status.

Exempt staff and faculty: your BEF is due within 30 days of your hire date.

Health Care Waiver Form

Employees covered by health insurance elsewhere may waive Vanderbilt health insurance coverage. The Health Plan Waiver form must be completed within 60 days from hire date for non-exempt staff and 30 days from hire date for exempt staff. You can find the form in the listing on the Forms and Documents page of this Web site.

Note: If you are eligible for the FRA (Flexible Reimbursement Account), waiving the health plan will terminate your FRA. You have 30 days from FRA account termination to file FRA claims for reimbursement.

Coverage Tiers

Faculty and staff can choose one of four coverage tiers for health, dental and vision: 1) employee, 2) employee plus spouse or certified domestic partner, 3) employee plus child(ren), or 4) family coverage. You make your tier selection on the BEF form.