Appendix_7_5_Enrollment_by_Plan.xlsx

This file is an enrollment data spreadsheet for the State of Tennessee's three insurance plans (State, Local Education, and Local Government) that support the Employee Assistance Program and Behavioral Health Organization services procurement. The spreadsheet provides a detailed breakdown of 299,066 total covered lives across the three plans, segmented by plan type (Limited PPO, CDHP, Premier PPO, and Standard PPO), categorized by dependent or employee status, gender, and age bracket. The State Plan represents the largest population with 146,281 covered lives, followed by the Local Education Plan with 126,115 covered lives, and the Local Government Plan with 26,670 covered lives. The enrollment data demonstrates significant representation across all age groups, with the 19-to-39 and 40-to-64 age brackets representing the largest segments of the employee population. The Premier PPO plan is the most popular option across all three plans, accounting for approximately 161,511 covered lives (54% of total enrollment), while the Standard PPO and CDHP options collectively serve the remaining covered lives.

This enrollment data directly informs the scope and scale of the behavioral health services contract, which requires the selected vendor to manage claims adjudication, network administration, and utilization management for the entire population represented in this spreadsheet. The vendor must be capable of supporting approximately 300,000 covered lives across three financially independent self-funded plans with varying plan designs and enrollment distributions. The breadth of the enrolled population—spanning multiple age groups, plan types, and employment statuses (dependents and employees)—necessitates a vendor with robust infrastructure, comprehensive provider networks, and sophisticated claims processing systems capable of handling the administrative demands of a large, complex public sector health plan population.