Already have outside insurance? Our supplement plans enhance your existing medical coverage at no additional cost.
Supplemental Coverage
What are the supplemental plans?
THT currently offers two supplemental plans for members who already have health coverage through their spouse or other means. These plans enhance your existing health coverage at no extra cost to you. The following supplemental plans are not full coverage health plans or replacements to a medical plan.
Members on these plans can select a dental and/or vision plan (additional premium may apply), or waive dental and/or vision.
Hospital Supplement Plan
You will be reimbursed $260 for each day of overnight hospitalization or every 24-hour observation period that incurs room and board charges, up to a lifetime maximum of 365 days.
Eligibility
- All active/suspended employees and COBRA participants are eligible
- Dependents are not eligible
- Retirees are not eligible
Benefits
- Reimbursement for eligible hospital stays
- $50,000 Life Insurance Benefit
- Optional Dental Coverage (HMO or PPO, additional premium may apply)
- Optional Vision Coverage (Standard or Plus, additional premium may apply)
Reimbursement process
- Send itemized hospital bill or EOB to THT within 12 months of discharge date via the Member Portal message center.
- THT will verify & send eligible reimbursements within 7-10 business days
Spousal Supplement
This plan reimburses in-network copays, deductibles, and coinsurances for eligible employees and their eligible dependents who receive medical and pharmacy benefits as a dependent on their partner’s plan. Members on this plan will no longer have to worry about the cost of copays, coinsurance, and deductibles when seeing an in-network provider under their primary medical plan.
Eligibility
- All active/suspended employees who are covered as a dependent on their partner’s insurance (must not be a THT or CCSD plan).
- Employees who are COBRA participants are eligible.
- Employees may enroll their eligible dependents who are also covered on the eligible employee’s partner’s insurance.
- Retirees are not eligible.
Benefits
- Reimbursement for in-network copays, coinsurances, and deductibles.
- $50,000 Life Insurance Benefit
- Optional Dental Coverage (HMO or PPO, additional premium may apply)
- Optional Vision Coverage (Standard or Plus, additional premium may apply)
How to Enroll
- Select the Spousal and Domestic Partner Supplement Plan during Open Enrollment or a special enrollment period following a life event. This will waive medical coverage with THT.
- Send the Certificate of Coverage (COC) received from THT to your partner’s Human Resources Department in order to be eligible to join their health plan.
- This step must be completed within 30 days of waiving your coverage with THT or you may become ineligible to be added onto your partner’s plan.
- Submit your EOBs to THT after you receive care to receive reimbursement for all copays, coinsurances, and deductibles.
Medical Reimbursement Process
- On your first reimbursement request, submit a copy of the primary’s medical ID card.
- Submit EOBs in the THT Member Portal message center. Documents must be uploaded within 180 days of the issued date on the EOB.
- THT will verify and send reimbursement for all in-network copays, coinsurances, and deductibles within 60 days.
Pharmacy Reimbursement Process
You received a coordination of benefits card from Teachers Health Trust. Please give this card to the pharmacy at the same time you give your primary insurance card to them. The pharmacy will run your claim through your primary, and then through the Teachers Health Trust card. You should not owe anything for prescriptions that are on the primary’s formulary.
If for any reason pharmacy benefit does not coordinate, please submit Pharmacy receipt with description, pharmacy name, and direct reimbursement form through your member portal for reimbursement. Documents must be uploaded within 180 days of date on receipt.
