Call Monday-Friday, 8:30am ET to 4:30pm ET: 1.800.347.1109

Home » For Your Practice » BCBST Group Health Insurance for TDA Members

Group Health InsuranceBCBST GROUP HEALTH INSURANCE FOR TDA MEMBERS

We’re proud to offer BlueCross BlueShield of Tennessee (BCBST) group health plans specially developed for TDA members.

  • Guaranteed Issue for Full-Time Employees & Dentists of Participating Employers
  • No Health Questions
  • No Pre-Existing Condition Exclusions
  • 4 Health Benefit Plan Options Available — Stand-Alone Vision Plan is Also Available
  • Rates Could Provide Substantial Savings Compared to What You Are Paying Today

Open enrollment runs October 2023 through December 15, 2023 for a January 1, 2024 effective date.

For more plan details, see the 2024 BCBST Benefit Guide.

Sole proprietors are eligible to enroll if they have at least one W-2 employee working 30+ hours a week.
 

GET A FREE GROUP HEALTH INSURANCE QUOTE!
 

1. How do I get a quote or enroll?
Use the online quoting and enrollment tool. You can also view the rates on the TDA BCBST Rate Sheet.
 

2. Who is eligible to become a Participating Employer?
An employer who meets all of the following qualifications:

  • Qualifies as an entity which provides Dental Services or Healing Arts
  • Constitutes an employer as defined under ERISA § 3(5)
  • Employs in the State of Tennessee at least one common law employee
  • Executes the TD Consortium Benefits Trust Participation Agreement
  • Elects 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: Maintains individual memberships in the TDA for all of its dentists. Staff are not required to be members — only dentists. For membership verification, please contact TDA Membership Services Coordinator, Grace Czosek, at Grace@TNDentalAssociation.org or 615.628.0208.

 

3. What are my plan and network options?
All plans utilize BCBST’s Network “S” and the National BlueCard PPO Network nationwide.

  • Option 1 This is the lowest cost option. $6,550 deductible and out-of-pocket max. All copays, coinsurance and deductible go towards your total out-of-pocket max of $6,550. HSA-qualified plan.
  • Option 2 $5,000 deductible with a $6,550 out-of-pocket max. All copays, coinsurance and deductible go towards your total out-of-pocket max of $6,550. HSA-qualified plan.
  • Option 3 $7,350 deductible and out-of-pocket max. $0 copay for virtual care. Generous pharmacy benefit of $10/$10/$45/$85. All copays, coinsurance and deductible go towards your total out-of-pocket max of $7,350.
  • Option 4 $5,000 deductible/copay plan with a $7,350 out-of-pocket max. Primary care visits are $45, specialist visits are $90, and urgent care visits are $90. $0 copay for virtual care visits. Generous pharmacy benefit of $10/$10/$45/$85. All copays, coinsurance and deductible go towards your total out-of-pocket max of $7,350.

All plans are ACA-compliant and include annual well visits covered at 100%. See the 2024 BCBST Benefit Guide for more details.

A stand-alone vision plan is available through BCBST for your practice, employees, and family members — even if not covered by the health plan.

The 2024 health plans will now include an added benefit of a $15,000 life insurance policy for each employee subscribed to the health plan. The coverage is automatic and will cost $3.00 per subscriber, per month. Furthermore, there is a voluntary guaranteed issue option to purchase additional coverage for yourself and your dependents. 

4. What are the eligibility requirements for vision coverage under the plan?
Same as the health plan, 2+ groups are eligible for coverage.
 

5. Does the plan require eligible employees to enroll in coverage in order for their dependents and spouses to obtain coverage?
Yes.
 

6. Are there limitations on pre-existing conditions in the group health plan?
No.
 

7. Are 1099 independent contractors allowed on the group health plan?
No.
 

8. What is a “TDA member”?
A practice that maintains individual memberships in the Tennessee Dental Association for all of its dentists. For verification and membership questions, please contact TDA Membership Services Coordinator, Grace Czosek, at Grace@TNDentalAssociation.org or 615.628.0208.
 

9. Are non-dentists (office staff) covered under the plan?
Yes, as long as the dentists are members of the Tennessee Dental Association.
 

10. Is a solo dentist covered under the plan?
Not currently. However, if you have a W-2 full time employee, you are eligible for coverage as a two-person group.
 

11. If a solo dentist has one W-2 employee, can the dentist and the employee qualify for insurance under the plan?
Yes.
 

12. If I am a licensed dentist, not engaged in the practice of dentistry, can I qualify for the plan?
Yes, as long as all dentists in the practice are TDA members and in good standing with the TDA.
 

13. If I am a licensed dentist engaged in another business with other licensed dentists, can we qualify for the plan?
Yes, as long as all dentists in the business are TDA members in good standing with the TDA.
 

14. Is it possible for non-dentist staff who are in the dental services industry to be covered under this plan?
Yes, as long as all dentists in the practice are members of the TDA.
 

15. What is the plan year?
January 1st through December 31st each year.
 

16. How do I determine if I can remain with my current physicians if I use this plan?
Two ways, by checking the BCBST network provider finder (Network S) or by contacting your physician’s office to confirm they are a provider in BCBST Network S.
 

17. Who is the point of contact for any issues with open enrollment or plan administration?
Please contact your TDA Insurance Agency Representative, Mike Harmon at MichaelH@assoc-admin.com or 423.648.0247.
 

18. What happens to my coverage if I leave my practice or move to a status not otherwise covered under the plan?
You will have the option to elect COBRA coverage.
 

19. When do I need to renew my TDA membership so I can participate in the health plan?
For membership information, please contact TDA Membership Services Coordinator, Grace Czosek, at Grace@TNDentalAssociation.org or 615.628.0208.
 

20. What is the membership and health plan coverage timeline?
Open enrollment runs through December 15, 2023 for an effective date of January 1, 2024.
 

21. Our practice has staff and dentists working remotely in and outside of Tennessee, do they qualify for the health plan?
Yes, they will have access to the BlueCross BlueShield BlueCard PPO national network if they live, work or vacation across the country.
 

22. Are the families of staff and dentists covered?
Yes, provided they elect to enroll in the plan.
 

23. How can we pay less out-of-pocket for healthcare?
Deductible Guard is a hospital indemnity plan that you can add to your existing health insurance. This supplemental insurance pays a covered member up to $4,000 for inpatient charges. The plan is guaranteed issue, portable, and payroll deducted. You can view the rates and additional information here. For the application, click here.
 

If you have any questions, please contact us utilizing the webform below. Or, contact Mike Harmon at MichaelH@assoc-admin.com or 423.648.0247.

 
REQUEST MORE INFO: