BCBST GROUP HEALTH INSURANCE FOR TDA MEMBER EMPLOYERS AND THEIR EMPLOYEES
Tennessee Dental Association (TDA) members have exclusive access to BlueCross BlueShield of Tennessee (BCBST) health plans designed with simplicity, savings, and support in mind. Open enrollment ends December 5th!
PLAN HIGHLIGHTS:
IMPORTANT LINKS:
FREQUENTLY ASKED QUESTIONS:
1. How can I view the 2026 rates?
You can view the 2026 Rate Sheet here.
2. How do I enroll?
Enrollment is completed through our user-friendly online portal, designed for a smooth and convenient experience.
3. What is the effective date of coverage and duration of the plan year?
Coverage will begin on January 1, 2026. The plan year runs from January 1, 2026 through December 31, 2026.
4. How can I confirm if my current providers are in-network?
Two ways, check the BCBST Provider Directory (Select Blue Network S) or contact your provider’s office directly to confirm their participation in BCBST Network S.
5. Can a solo dentist with one W-2 employee qualify for coverage under the plan?
Yes, provided the W-2 employee is working at least 30 hours per week. The plan requires that there be at least two eligible non-spousal employees to qualify as a group. Both employees do not need to enroll. One of the eligible employees can be the solo dentist.
6. Can a solo dentist enroll in the plan without a W-2 employee?
No. The plan requires that there be at least two eligible non-spousal employees to qualify as a group.
7. Is coverage available for office staff?
Yes, office staff are eligible if the dentists are members of the Tennessee Dental Association.
8. Do eligible employees need to enroll in coverage in order for their spouses and dependents to be covered?
Yes. Employees must enroll in the plan for their spouses and dependents to be eligible for coverage.
9. If my practice enrolls in the plan, are we required to offer coverage to all employees?
No, you can offer coverage based on employee class. However, all employees working 30 hours or more per week within an eligible class must be offered coverage. A minimum of two non-spousal employees must be eligible.
10. Are employers required to contribute toward employees’ premiums?
No, there is no required employer contribution. That said, many employers choose to contribute voluntarily. A common approach is covering 50% of the premium for the lowest-cost, employee-only plan. Ultimately, contribution amounts are at the employer’s discretion but must be applied equally across all eligible employees.
11. We have staff and dentists working remotely in and outside of Tennessee. Are they eligible for the health plan?
Yes. Eligible employees who live, work, or travel outside of Tennessee will have access to the BlueCross BlueShield National BlueCard PPO Network, providing coverage across the country.
12. Can 1099 independent contractors enroll in the health plan?
No. The plan is not available to 1099 independent contractors.
13. What happens to my coverage if I leave the practice or become ineligible?
If your coverage ends due to separation from the practice or a change in employment status, you may be eligible to continue coverage through COBRA.
14. Is vision insurance available?
Yes, a stand-alone vision plan is offered through BCBST. This plan is available to dentists, staff, and their eligible dependents, even if they are not enrolled in the health plan. Eligibility requirements mirror those of the health plan: the practice must be a two-person group to qualify.
15. Is life insurance included with the health plan?
Yes, each employee enrolled as the primary subscriber in the health plan receives a $15,000 guaranteed issue life insurance policy. This coverage is automatic and costs $3.00 per subscriber, per month. This benefit cannot be waived. In addition, a stand-alone voluntary guaranteed issue option is available to dentists, staff, and their eligible dependents, even if they are not enrolled in the health plan.
16. What are the eligibility requirements to become a participating employer?
To qualify as a participating employer, an organization must meet all of the following criteria:
- Qualifies as an entity which provides dental services or healing arts.
- Constitutes as an “Employer” as defined under section 3(5) of ERISA.
- Employs at least one common law employee in the State of Tennessee.
- Has executed the TD Consortium Benefits Trust Participation Agreement.
- Has elected to participate in the plan.
- Is a Tennessee duly organized and validly existing professional corporation, limited liability company, professional limited liability company, general partnership, limited partnership, limited liability partnership, sole proprietorship, or other entity that complies with the laws of the State of Tennessee.
- Is a member of the Tennessee Dental Association (TDA) and maintains individual memberships in the TDA for all of its dentists. Staff are not required to be members, only dentists.
17. What are qualifying life events?
A qualifying life event, such as marriage, the birth of a child, or loss of health coverage, may make an employee/subscriber eligible for a special enrollment period. This provides the opportunity to enroll in or modify health insurance coverage outside the standard annual open enrollment window. To take advantage of this provision, the request must be submitted by the employee within 31 days of the change in status. Examples of a qualifying life event includes the following:
- Marriage or divorce*
- Birth or adoption of a child of the employee*
- Death of the employee’s spouse or dependent
- Change in dependency status
- Medicare eligibility
- Coverage by another payor
- Termination of employment or commencement of employment
- Switching from part-time to full-time, or from full-time to part-time by the employee or the employee’s spouse
- Loss of previous health coverage when the employee was enrolled in another health coverage plan at the time he or she was initially eligible for group coverage through the employer group plan; and he or she stated in writing at that time why he or she chose not to enroll through the employer group plan.
*When an employee gets married or has a child (birth or adoption), this constitutes a special enrollment period for not only the employee; but for everyone covered under the employee’s plan. Similarly, if a dependent loses previous coverage, the employee and everyone covered under the employee’s plan may enroll for coverage outside the open enrollment period.
Additional special enrollment periods may apply. Please refer to the BlueCross BlueShield Evidence of Coverage (EOC) for complete information.
18. What are HIPAA special enrollment rights?
Under HIPAA regulations, insurance carriers must allow employees and their dependents to enroll in any benefit package offered by the group during a special enrollment period, regardless of the package in which the employee was previously enrolled. This applies when an employee or dependent loses coverage under another health plan and meets the following conditions:
- The employee and dependent are otherwise eligible to enroll in the benefit package, based on the plan’s eligibility rules.
- And, at the time the group coverage was initially offered, the employee had existing coverage under another group health plan or individual health insurance policy.
19. I’m already enrolled in the plan. Where can I access my plan documents?
You can view your plan documents by visiting the TDA TDCBT Document Center. If you need further assistance, contact your TDA Insurance representative, Mike Harmon, at michaelh@assoc-admin.com or 423.648.0247.
20. Who can I contact if I have questions?
Please reach out to your TDA Insurance health plan representative, Mike Harmon, at michaelh@assoc-admin.com or 423.648.0247. Or, utilize the webform below and we’ll get back to you shortly.