2023 Tennessee Code › Title 8 - PUBLIC OFFICERS AND EMPLOYEES (§§ 8-1-101 — 65-168) › Chapter 27 - GROUP INSURANCE FOR PUBLIC OFFICERS AND EMPLOYEES (§§ 8-27-NEW — 8-27-910) › Part 3 - GROUP INSURANCE FOR LOCAL EDUCATION EMPLOYEES (§§ 8-27-301 — 8-27-307) › Section 8-27-304 - Eligibility for enrollment in plans - Withdrawal of local education agency from basic health plan - Participation of surviving spouse and eligible dependents of local education employee killed in line of duty as national guard member

(a)
During a period established by the local education insurance committee after the implementation in each local education agency of the basic health plan provided for in §
8-27-302
, enrollment shall be open to all eligible employees regardless of preexisting conditions. Thereafter, the local education insurance committee may permit supplemental enrollments and shall provide for the entrance of newly employed eligible employees into the plan.
(b)
Enrollment in any insurance plan for local education employees under this part shall be open to any teacher as defined in §
49-5-501
, who transitions from part-time to full-time employment, notwithstanding the teacher's failure to participate in the plan as a part-time employee.
(c)
(1)
A local education agency seeking to enroll in any plan offered by the local education insurance committee shall provide in its request for enrollment:
(A)
Verification that a majority of eligible employees of the LEA have agreed to enrollment in the plan. The local education insurance committee may waive the majority requirement if, in its discretion, there is good cause to do so; and
(B)
Information necessary for processing the enrollment including names and required identifying information, financial information necessary to process payments, and signed memoranda of understanding.
(2)
The local education insurance committee reserves the right to audit participation and to terminate agencies whose participation falls below a majority of eligible employees.
(d)
An educational cooperative shall comply with the Educational Cooperation Act, compiled in title 49, chapter 2, part 13, for five (5) years before the educational cooperative is eligible to have its employees participate in the health insurance plan authorized in this section.
(e)
Any local education agency may withdraw from the basic health plan authorized in §
8-27-302
following at least twenty-four (24) months of participation in that plan. The local education agency shall comply with the equivalency provisions of §
8-27-303(a)(2)
and the requirements in subsection (c) prior to withdrawal from the basic health plan with the exception that the local education insurance committee shall not waive the verification requirement in subdivision (c)(1)(A). Upon withdrawal, the local education agency shall be responsible for coverage for all retirees and other former employees eligible to continue healthcare coverage who were covered at the time of the termination of employment with the local education agency. The local education insurance committee may establish conditions for local education agencies that withdraw to resume coverage through the basic plan.
(f)
(1)
The surviving spouse and eligible dependent children of a local education employee maintaining family coverage through the local education group insurance plan and who is a member of the Tennessee army national guard or the Tennessee air national guard and who has been activated for federal duty or who has been called up on state active duty, and who is subsequently killed in the performance of that duty, may participate in the group health insurance plan for local education employees established pursuant to §
8-27-302(a)(1)
.
(2)
The cost of the coverage provided in this section to the surviving spouse and dependent children shall be equal to twenty percent (20%) of the monthly premium for active employee coverage. The military department shall pay the balance of the monthly premium.
(3)
The criteria for determination of eligibility of dependent children shall be the same as the criteria established by the local education insurance committee for participating employees and their families.
(4)
In the event that the surviving spouse is or becomes eligible for insurance coverage through a subsequent marriage or employment, the extension of coverage authorized in this section shall be terminated on the first day of the following month. The local education insurance committee may establish specific conditions for extensions in instances where preexisting conditions may apply during the transfer of coverage.
(5)
In the event that insurance coverage under the local education plan is terminated for the surviving spouse pursuant to subdivision (f)(4), but the surviving spouse is unable to secure, through the new coverage, insurance coverage for the eligible dependent children, the dependent children may continue coverage under this section; provided, that the dependent children continue to meet all dependent eligibility requirements.
(6)
This section shall be retroactive to September 11, 2001. As individuals who are qualified for such extension are identified, elect coverage, and pay the appropriate contribution, the coverage shall be provided on a prospective basis.
Amended by 2015 Tenn. Acts, ch. 426, s 3, eff. 5/18/2015.
Acts 1985, ch. 455, § 4; 2007 , ch. 163, § 1.