Health Care Plan
Last Modified: 2017-01-13
Benefits-eligible employees can choose between three health options, which are administered by Aetna : Plus, Select and HealthFund. Health benefits begin on your hire date, or the first date you become eligible. Monthly premiums are not prorated. Click here to view the evidence of coverage booklets (most detailed information), summaries of benefits and coverage (SBCs), and other documentation for each option. Click on the links below for the provider directory and administrators' Web sites. Also see the Health Care Plan Summary Plan Description.
While we try to provide accurate information, this is summary information and as such, certain details and qualifying information is not included. If any information provided here varies from the official plan documents, the plan document prevails.
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 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
Fully benefits-eligible employees
A fully benefits-eligible employee is a regular or term employee (not temporary) who is regularly scheduled to work 30 hours or more per week.
Fully benefits-eligible employees may also cover the following:
- natural, step-, or adopted children up to age 26, and other qualified dependents, such as disabled children over age 26, with required documentation. 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 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 My VU Benefits 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.
Benefits while on leave
Your benefit deductions will continue while on a paid leave of absence. In some instances and depending on the nature of your role, you may be placed on an unpaid leave of absence for a limited period of time. If you are placed on an unpaid leave of absence, you will receive instructions to pay your health plan premiums directly to Vanderbilt’s benefit administration vendor, Benefit Express. Your premium will remain the same during this time. If your employment later ends, you will be able to continue your coverage through COBRA, but will be charged the full premium (employee plus employer portions), plus a two percent administrative fee.
In 2017, partially benefits-eligible employees will comprise:
- Regular and term exempt faculty and staff working part-time schedules (less than 30 hours per week / less than 75 percent of full time).
- Regular and term non-exempt employees who are regularly scheduled to work at least 20, but less than 30 hours per week (at least 50 percent time, but less than 75 percent time).
- Temporary employees, such as VTS, and flex employees who work 30 hours per week or more on average, for any 3 months within a 12 month period.
- Student workers , including graduate teaching and research assistants; professional students, and undergraduate student workers, who work 30 hours per week or more on average for any three months within a 12-month period. [IMPORTANT NOTES: Graduate and professional students must have prior approval in order to work more than 29 hours per week -- and undergrads must have prior approval to work more than 19 hours per week -- from the Dean of the school in which they are enrolled and the Office of the Provost. As a condition of student enrollment, all students (whether also working on campus or not) must provide evidence of healthcare coverage, such as through the Student Health Insurance Plan (SHIP) offered by Vanderbilt, their parents’ insurance, or other appropriate coverage. The University pays the cost of SHIP coverage for Ph.D. students who receive graduate teaching or research assistantships.]
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 My VU Benefits within 30 days of your hire date:
- Go to My VU Benefits and log in with your VUnetID and ePassword
- Make your benefits selections
- Print your benefits enrollment receipt and keep it for your records
- Decision-making tools: choosing a health plan, spousal coverage fee
- Vanderbilt Health Affiliated Network (VHAN)
- Aetna Claim Form
- Uniform Glossary of Health Coverage and Medical Terms
- Traveling with Vanderbilt Health Care
- Program for LGBTI Health
- Form 1095-C Information
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.