Health Care Plan
June 2, 2015: The St. Thomas Medical Group has terminated its agreement with Aetna to participate as In-Network providers. Click here to see the list of providers that are no longer in the Aetna network. The Aetna network consists of qualified physicians that can serve your needs. Visit the Aetna website to locate an In-Network provider.
As a benefits-eligible employee, you may choose between three health options. Click on the links below for details of each options (VUnetID and ePassword are needed), provider directories, evidence of coverage booklets and administrators' Web sites. Also see the Health Care Plan Summary Plan Description.
- Aetna Select - 2015 Evidence of Coverage Booklet (most detailed information)
- 2015 Aetna Select Summary of Benefits and Coverage (SBC)
- Online Provider Directory
- Aetna Website
- Aetna HealthFund
Prescription Drug Benefit
All three health plan options include the same Prescription Drug Benefit. Navitus Health Solutions administers the prescription drug benefit for all Vanderbilt faculty and staff enrolled in one of the three health plan options.
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 (Plus, Select and HealthFund) includes coverage for Applied Behavioral Analysis (ABA) therapy for autism spectrum disorder (ASD). Refer to the Evidence of Coverage Booklet 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. Learn more.
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 same-sex domestic partners, and eligible children from birth to 26 years of age. Coverage beyond the age of 26 may be available if child is disabled. (You must contact Vanderbilt Human Resources prior to the child's 26th birthday for more information on continuing coverage for disabled children.) Refer to the Health Care Plan Summary Plan Description for full details of eligibility.
Health, dental and vision benefits for staff begin on the hire date. The monthly cost of the health plan is not pro-rated.
Aetna automatically mails insurance cards for the default health plan option (Aetna Plus at the 'employee-only' coverage tier) to new employees. To elect another health plan option and/or coverage tier, you must use the My VU Benefits Enrollment Tool within 30 days of your hire date (see "Benefits Enrollment Tool" below). If you elect another health plan option, you may disregard the Aetna Plus card. If you choose the Plus health plan option, keep the card for your use.
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). Learn more about 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 making a Family Status Change.
- 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 making a Family Status Change.
How to Enroll
To enroll, use the My VU Benefits Enrollment Tool within 30 days of your hire date:
- Go to My VU Benefits and log in with your VUnetID and ePassword
- Click on the link for Benefits Enrollment
- Make your benefits selections
- Print your benefits enrollment receipt and keep it for your records
Faculty and staff can choose one of four coverage tiers for health, dental and vision:
- employee plus spouse or same-sex domestic partner
- employee plus child(ren)
- family coverage
You make your tier selection on the My VU Benefits website.
- Health Care Plan Summary Plan Description
- Aetna Claim Form
- Uniform Glossary of Health Coverage and Medical Terms
- Traveling with Vanderbilt Health Care
- Community Pediatricians Approved for In-Network Vanderbilt Employee Co-pay (VUnetID required)
- Program for LGBTI Health
Links to Vendors
- Aetna online provider directory
- Phone: 800.743.0910
Navitus (prescription benefit)
- Phone: 866.333.2757
For complete details of the Health Care Plan, refer to the Summary Plan Description.