8-27-302 - Basic, optional and supplemental plans Extensions of coverage.
8-27-302. Basic, optional and supplemental plans Extensions of coverage.
(a) The committee established in § 8-27-301 shall approve a group insurance plan for eligible local education employees which shall consist of:
(1) A plan, hereinafter referred to as the basic plan, providing accident and medical expense insurance as it deems necessary and reasonable, and a dental insurance plan which, at the discretion of the committee, may be a part of the basic plan or an optional plan;
(2) (A) Such optional plans as may be necessary and reasonable, in the discretion of the committee, to provide the same levels of insurance coverage existing in local education agencies having superior medical benefits within the meaning of § 8-27-303;
(B) Such optional plans as may, in the discretion of the committee, be necessary and reasonable to provide a superior level of benefits as a supplement to those available in the basic plan.
(3) At the discretion of the committee, a supplemental disability insurance plan which may be part of the basic plan or an optional plan. Administration of such plan, if implemented, may be contracted to an agency of state government as determined by the committee. Any benefits paid under such plan shall be coordinated with any benefits paid by employer funded programs, including social security, retirement and workers' compensation; provided, that the committee may include in the plan a minimum guaranteed benefit for all claimants;
(4) The committee may, at its discretion, and with the approval of the state insurance committee created under § 8-27-101, develop the plan in such a way that the eligible local education employees are covered under the same group plan for general state employees authorized under § 8-27-201, or the committee may provide for the separate operation of a plan exclusively for eligible local education employees.
(b) The basic plan shall be available in all local education agencies. The optional plan, provided for by subdivision (a)(3), if available, shall be offered in all local education agencies. The optional plan provided for by subdivision (a)(2) shall be available only in local education agencies in which the local board votes to be responsible for the coverage costs provided for in § 8-27-303. Any plan offered to the local education agency must be accepted by a majority of eligible employees prior to adoption by the local education agency.
(c) (1) Any retired local education agency employee who is participating in the insurance plan authorized by this section and who is in receipt of a disability retirement allowance pursuant to chapter 36, part 5 of this title, shall not be required to discontinue coverage in the basic medical plan authorized by subdivision (a)(1) upon eligibility for Part A of Medicare and may continue in the plan as a retired employee to the point at which Medicare eligibility would have been attained had the disability not occurred; provided, that such retired employee remains eligible for the disability retirement allowance and that Part B of Medicare is retained. The insurance premium shall be the same as that charged to non-disability retirees who are not yet eligible for Medicare. Any retired teacher who is granted a service retirement under the provisions of title 8, chapter 36, shall also qualify for a continuation of insurance coverage if the teacher meets the conditions set forth in this subsection (c) and the eligibility criteria established by the local education insurance committee.
(2) Any additional cost incurred by the medical insurance coverage authorized by this section which is attributable to the extension offered pursuant to this subsection (c) shall be funded through an increase in the employee portion of the premium paid by retired local education agency employees.
(d) (1) The local education insurance committee shall establish a schedule of premium payments for retired teachers participating in the basic plan authorized under subdivision (a)(1). The schedule shall be based upon the total monthly plan premiums for all participants and the retiree's contribution shall be graduated to reflect the retiree's length of service. For retirees with less than twenty (20) years of service, the retiree shall pay seventy-five percent (75%) of the total premium under the plan. For retirees with twenty (20) but less than thirty (30) years of service, the retiree shall pay sixty-five percent (65%) of the total premium under the plan. For retirees with thirty (30) or more years of service, the retiree shall pay fifty-five percent (55%) of the total premium under the plan.
(2) The local education insurance committee is authorized to establish the eligibility criteria for retired teachers and the administrative requirements for the collection of premiums.
(3) Years of service, as used in this subsection (d), means only those years of service rendered by the retiree as a teacher, as is defined in § 8-34-101, or as a state employee, as is defined in § 8-27-201(g), and upon which the retiree's monthly retirement allowance is based.
(4) To the extent that retirees pay less than the total monthly premium and to the extent that the benefit payments exceed the anticipated premium for eligible retirees who were not retired during the prior calendar year, that expense shall be reimbursed by the state through a direct appropriation to the local education insurance plan.
(e) As used in this part:
(1) Committee means the local education insurance committee created in § 8-27-301;
(2) Eligible local education employee or eligible employee means those persons included within the definition in § 8-34-101, and who are not eligible for insurance coverage under § 8-27-201; and
(3) (A) Local education agency has the same definition as used in § 49-3-302 and includes educational cooperatives created pursuant to title 49, chapter 2, part 13.
(B) An educational cooperative must exist under the provisions of title 49, chapter 2, part 13, for five (5) years before it is eligible to have its employees participate in the health insurance plan authorized in this section.
[Acts 1976, ch. 804, § 5; T.C.A., § 8-4505; Acts 1982, ch. 914, § 2; 1985, ch. 455, § 2; 1986, ch. 574, § 1; 1991, ch. 279, § 1; 1994, ch. 966, § 1; 1997, ch. 513, § 12; 1998, ch. 1109, § 1; 2001, ch. 58, § 2.]