GROUP HEALTH INSURANCE

FOR FIRMS AND SOLO PRACTITIONERS WITH AT LEAST ONE W-2 EMPLOYEE

The TBA BlueCross BlueShield of Tennessee group health insurance plan provides guaranteed issue coverage, with no health questions and no pre-existing condition exclusions. Rates could be as much as 30% below what members are paying today. Open enrollment will be available Sept. 30, 2024 through Dec. 13, 2024.

1. How do I get a quote or enroll?

Open enrollment will be available Sept. 30, 2024 through Dec. 13, 2024. Sole proprietors are eligible to enroll if they have at least one W-2 employee working 30+ hours a week (one employee must enroll).

2. What is the name of the insurance carrier?

BlueCross BlueShield of Tennessee. See rate sheet to compare options.

3. Who is eligible to become a "Participating Employer"?

An employer who meets all of the following qualifications:

• 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.
• Qualifies as an entity which provides legal services.
• Constitutes an employer as defined under ERISA § 3(5).
• Employs in the state of Tennessee at least one common law employee.
• Executes the Tennessee Bar Benefit Trust Participation Agreement.
• Elects to participate in the plan.
• Is a law firm member of the Tennessee Bar Association: Maintains individual memberships in the TBA for all of its attorneys. Staff are not required to be members — only attorneys. Please contact Membership Director Mindy Thomas for verification.

4. What are my plan and network options?

There are four benefits options available (see rate sheet to compare options):

• Option 1: $5,000 High Deductible Plan (HSA Qualified).
• Option 2: Deductible + Copay Plan: $0 copay for virtual care visits. First dollar coverage with office visit copays of $40 for PCP, $65 for specialists and $100 for urgent care. The individual deductible is $5,000. RX benefit with $10/$10/$40/$70 copays. Lesser copays for home delivery network up to 90 day supply.
• Option 3: $0 Deductible Copay Plan: $0 copay for virtual care visits. $40 primary care copay. $80 specialist copay. RX benefit with $10/$10/$40/$70 copays. Lesser copays for home delivery network up to 90-day supply.
• Option 4: Deductible Plan + RX Copay Plan: $0 copay for virtual care visits with a $7,900 deductible and max out of pocket. RX Benefit with $5/$5/$15/$70 copays. Lesser copays for home delivery network up to 90-day supply.

Stand Alone Dental and Vision Plans are available through BlueCross BlueShield of Tennessee for your firm, employees, and family members even if not covered by the health plan. See your 2025 BCBS Welcome Kit for more details. Large BlueCross BlueShield of Tennessee network “S” with access to the National BlueCard PPO network. See Network S for more details.

5. What are the eligibility requirements for dental coverage under the plan?

Same as medical, 2+ groups are eligible for coverage.

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

Yes.

7. Are there limitations on pre-existing conditions in the group health coverage plan? 

No.

8. Are 1099 independent contractors allowed on the group health coverage plan?

No.

9. What is a TBA "law firm member"?

A law firm that maintains individual memberships in the TBA for all of its attorneys (please contact Membership Director Mindy Thomas for verification).

10. Are non-attorneys (office staff) eligible to be covered under the plan? 

Yes, as long as the attorneys are members of the TBA. Full time employees/staff (working 30+ hours a week) of law firms do not have to be members.

11. Is a solo attorney covered under the plan?

Not currently. However, if you have a W2 full time employee, you are eligible for coverage as a two-person group.

12. If a solo attorney has one W2 employee, can the attorney and the employee qualify for insurance under the plan?

Yes.

13. If I am a licensed attorney, not engaged in the practice of law, can I qualify for the plan?

Yes, as long as you and your firm are a member and in good standing with the TBA.

14. If I am a licensed attorney engaged in another business with other licensed attorneys, can we qualify for the plan?

Yes, as long as you are and/or the other attorneys are members in good standing with the TBA.

15. Is it possible for non-attorney staff who are in the legal services industry to be covered under this plan?

Yes, as long as the attorneys in the firm are members of the TBA.

16. What is the plan year?

Jan. 1 through Dec. 31 each year.

17. 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) and/or with your physician’s office to confirm they are a provider in the above networks.

18. Who is the point of contact for any issues with open enrollment or plan administration?

Please contact your TBA Member Insurance Solutions representative, Autumn Chandler, at 423-629-2400, ext. 264 or email us at TBAMS@tnbar.org.

19. What happens to my coverage if I leave my firm or move to a status not otherwise covered under the plan?

You will have the option to elect COBRA coverage.

20. When do I need to renew my membership so I can participate in the program?

Please contact Membership Director Mindy Thomas for verification.

21. What is the membership and health plan coverage timeline?

Open enrollment begins fall 2024 for an effective date of Jan. 1, 2025.

22. Will law firm staff and attorneys who work remotely in and outside of Tennessee qualify?

Yes, they will have access to the BlueCross BlueShield BlueCard PPO national network if they live, work or vacation across the country. The law firm must be domiciled in the state of Tennessee.

23. Are family of staff and attorneys covered?

Yes, provided they elect to enroll in the plan.

24. Can I meet with someone about this?

Yes. Contact Buck Orrison of TBA Member Insurance Solutions for a 15-minute Consultation to review your current plan and the options available for your firm.

 

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ADDITIONAL COVERAGE OPTIONS

FOR ALL INDIVIDUAL PARTICIPANTS OR FIRMS

1. Are there any additional coverage plans that could benefit me or my firm?

Yes, we have negotiated with Gulf Guaranty to offer our members a guaranteed issue portable and payroll deducted group plan that can greatly offset the costs of many of the higher deductible plans should you or a covered dependent have an unfortunate hospital stay. These plans are available to any member firm regardless of who you or your spouse might have coverage through. Please review: Deductible Guard.

2. Does TBA offer disability coverage? 

Yes, TBA offers up to $10,000 a month of added personal disability income insurance to help strengthen your personal disability income protection and up to $15,000 a month of business overhead expense (BOE) insurance to help keep your practice healthy while you’re away. See more on individual disability options.

3. Are there group disability options?

Yes, many lawyers have discovered the value of adding group disability coverage to supplement their individual disability policy. By adding an additional $5,000, 10,000 or even up to $15,000 a month in disability benefits, these lawyers are able to bridge some or all of the ‘protection gap” they have between their current income and their individual disability insurance coverage. Furthermore, this is an added benefit for your staff. See more on group disability plans.