Tenn. Code Ann. § 56-16-204 — TN Code / Title 56 / Chapter 16 / Section 56-16-204
Subscriber's agreement and power of attorney - Power to modify - Contents
Status: in_force

(a) Every subscriber of a domestic reciprocal may execute a subscriber's agreement and power of attorney setting forth the rights, privileges and obligations of the subscriber as an underwriter and as a policyholder, and the powers and duties of the attorney. If the reciprocal does not require execution of a subscriber's agreement and power of attorney, the reciprocal shall include on its policies a statement that the subscriber shall be bound by the terms and conditions of the then current subscriber's agreement and power of attorney on file with the attorney and the department, and each subscriber shall by operation of law be bound by the subscriber's agreement and power of attorney as if individually executed. Without additional execution, notice or acceptance, every subscriber of a domestic reciprocal agrees to be bound by any modification of the terms of the power of attorney and subscriber's agreement that is jointly made by the attorney and the board of directors pursuant to § 56-16-205 . The subscriber's agreement and power of attorney shall contain in substance the following: (1) A designation and appointment of the attorney to act for and bind the subscriber in all transactions relating to or arising out of the operations of the reciprocal; (2) A provision empowering the attorney to: (A) Accept service of process on behalf of the reciprocal; and (B) Appoint the commissioner agent of the reciprocal upon whom may be served all lawful process against or notice to the reciprocal; (3) Except for nonassessable policies, a provision for a contingent assessment liability of each subscriber in a specified amount in accordance with § 56-16-112 ; and (4) The maximum amount to be deducted from advance premiums or deposits to be paid the attorney, and the items of expense, in addition to losses, to be paid by the reciprocal. (b) The subscriber's agreement may: (1) Provide for the right of substitution of the attorney and revocation of the power of attorney; (2) Impose any restrictions upon the exercise of the power agreed upon by the subscribers; (3) Provide for the exercise of any right reserved to the subscribers directly or through the board of directors; or (4) Contain other lawful provisions considered advisable. Acts 1990, ch. 728, § 2; T.C.A. § 56-16-304.
(a) Every subscriber of a domestic reciprocal may execute a subscriber's agreement and power of attorney setting forth the rights, privileges and obligations of the subscriber as an underwriter and as a policyholder, and the powers and duties of the attorney. If the reciprocal does not require execution of a subscriber's agreement and power of attorney, the reciprocal shall include on its policies a statement that the subscriber shall be bound by the terms and conditions of the then current subscriber's agreement and power of attorney on file with the attorney and the department, and each subscriber shall by operation of law be bound by the subscriber's agreement and power of attorney as if individually executed. Without additional execution, notice or acceptance, every subscriber of a domestic reciprocal agrees to be bound by any modification of the terms of the power of attorney and subscriber's agreement that is jointly made by the attorney and the board of directors pursuant to § 56-16-205 . The subscriber's agreement and power of attorney shall contain in substance the following: (1) A designation and appointment of the attorney to act for and bind the subscriber in all transactions relating to or arising out of the operations of the reciprocal; (2) A provision empowering the attorney to: (A) Accept service of process on behalf of the reciprocal; and (B) Appoint the commissioner agent of the reciprocal upon whom may be served all lawful process against or notice to the reciprocal; (3) Except for nonassessable policies, a provision for a contingent assessment liability of each subscriber in a specified amount in accordance with § 56-16-112 ; and (4) The maximum amount to be deducted from advance premiums or deposits to be paid the attorney, and the items of expense, in addition to losses, to be paid by the reciprocal.
(1) A designation and appointment of the attorney to act for and bind the subscriber in all transactions relating to or arising out of the operations of the reciprocal;
(2) A provision empowering the attorney to: (A) Accept service of process on behalf of the reciprocal; and (B) Appoint the commissioner agent of the reciprocal upon whom may be served all lawful process against or notice to the reciprocal;
(A) Accept service of process on behalf of the reciprocal; and
(B) Appoint the commissioner agent of the reciprocal upon whom may be served all lawful process against or notice to the reciprocal;
(3) Except for nonassessable policies, a provision for a contingent assessment liability of each subscriber in a specified amount in accordance with § 56-16-112 ; and
(4) The maximum amount to be deducted from advance premiums or deposits to be paid the attorney, and the items of expense, in addition to losses, to be paid by the reciprocal.
(b) The subscriber's agreement may: (1) Provide for the right of substitution of the attorney and revocation of the power of attorney; (2) Impose any restrictions upon the exercise of the power agreed upon by the subscribers; (3) Provide for the exercise of any right reserved to the subscribers directly or through the board of directors; or (4) Contain other lawful provisions considered advisable.
(1) Provide for the right of substitution of the attorney and revocation of the power of attorney;
(2) Impose any restrictions upon the exercise of the power agreed upon by the subscribers;
(3) Provide for the exercise of any right reserved to the subscribers directly or through the board of directors; or
(4) Contain other lawful provisions considered advisable.
Acts 1990, ch. 728, § 2; T.C.A. § 56-16-304.
Tenn. Code Ann. § 56-7-1010 — TN Code / Title 56 / Chapter 7 / Section 56-7-1010
Jurisdiction over insurers
Status: in_force

(a) Notwithstanding any other law, and except as provided in this title, any person or other entity that provides coverage in this state for medical, surgical, chiropractic, physical therapy, speech pathology, audiology, professional mental health, dental, hospital, or optometric expenses, whether the coverage is by direct payment, reimbursement, or otherwise, shall be presumed to be subject to the jurisdiction of the department unless the person or other entity shows that while providing the services it is subject to the jurisdiction of another agency of this or another state or the federal government. (b) A person or entity may show that it is subject to the jurisdiction of another agency of the state or federal government by providing to the commissioner the appropriate certificate, license or contract issued by the other governmental agency that permits or qualifies it to provide those services for which it is licensed or certified. (c) Any person or entity that is unable to show that it is subject to the jurisdiction of another agency of this or another state or the federal government shall submit to an examination by the commissioner to determine the organization and solvency of the person or the entity, and to determine whether or not the person or entity is in compliance with the applicable provisions of this code. (d) Any person or entity unable to show that it is subject to the jurisdiction of another agency of this state or another state or the federal government shall be subject to all appropriate provisions of this code regarding the conduct of its business. (e) Any production agency or administrator, licensed by the department, that advertises, sells, transacts or administers coverage in this state, as described in subsection (a), which is provided by any person or entity described in subsection (c), shall, if that coverage is not fully insured or otherwise fully covered by an admitted life or health insurer, nonprofit hospital service plan corporation, or nonprofit medical service plan corporation, advise any purchaser, prospective purchaser, and covered person of the lack of insurance or other coverage. Any administrator that advertises or administers coverage in this state that is described in subsection (a), that is provided by any person or entity described in subsection (c), shall advise any production agency of the elements of the coverage including the amount of stop-loss insurance in effect. Acts 1983, ch. 314, § 1.
(a) Notwithstanding any other law, and except as provided in this title, any person or other entity that provides coverage in this state for medical, surgical, chiropractic, physical therapy, speech pathology, audiology, professional mental health, dental, hospital, or optometric expenses, whether the coverage is by direct payment, reimbursement, or otherwise, shall be presumed to be subject to the jurisdiction of the department unless the person or other entity shows that while providing the services it is subject to the jurisdiction of another agency of this or another state or the federal government.
(b) A person or entity may show that it is subject to the jurisdiction of another agency of the state or federal government by providing to the commissioner the appropriate certificate, license or contract issued by the other governmental agency that permits or qualifies it to provide those services for which it is licensed or certified.
(c) Any person or entity that is unable to show that it is subject to the jurisdiction of another agency of this or another state or the federal government shall submit to an examination by the commissioner to determine the organization and solvency of the person or the entity, and to determine whether or not the person or entity is in compliance with the applicable provisions of this code.
(d) Any person or entity unable to show that it is subject to the jurisdiction of another agency of this state or another state or the federal government shall be subject to all appropriate provisions of this code regarding the conduct of its business.
(e) Any production agency or administrator, licensed by the department, that advertises, sells, transacts or administers coverage in this state, as described in subsection (a), which is provided by any person or entity described in subsection (c), shall, if that coverage is not fully insured or otherwise fully covered by an admitted life or health insurer, nonprofit hospital service plan corporation, or nonprofit medical service plan corporation, advise any purchaser, prospective purchaser, and covered person of the lack of insurance or other coverage. Any administrator that advertises or administers coverage in this state that is described in subsection (a), that is provided by any person or entity described in subsection (c), shall advise any production agency of the elements of the coverage including the amount of stop-loss insurance in effect.
Acts 1983, ch. 314, § 1.
Tenn. Code Ann. § 56-22-118 — TN Code / Title 56 / Chapter 22 / Section 56-22-118
County mutual insurance companies subject to same proceedings and actions as insurance companies
Status: in_force

The commissioner may subject a county mutual insurance company to any proceeding or action authorized pursuant to chapter 9 of this title, under the same terms as insurance companies. For all such purposes, county mutual insurance companies are deemed to meet the definition of insurance company set forth in chapter 9 of this title. Acts 2006, ch. 689, §§ 3, 21.
The commissioner may subject a county mutual insurance company to any proceeding or action authorized pursuant to chapter 9 of this title, under the same terms as insurance companies. For all such purposes, county mutual insurance companies are deemed to meet the definition of insurance company set forth in chapter 9 of this title.
Acts 2006, ch. 689, §§ 3, 21.
Tenn. Code Ann. § 56-8-101 — TN Code / Title 56 / Chapter 8 / Section 56-8-101
Short title - Purpose - Authority of commissioner
Status: in_force

(a) This part shall be known and may be cited as the "Tennessee Unfair Trade Practices and Unfair Claims Settlement Act of 2009". (b) The purpose of this part is to regulate trade and claims settlement practices in the business of insurance in accordance with the intent of congress as expressed in the Act of Congress of March 9, 1945, (Public Law 15, 79th Congress) and the Gramm-Leach-Bliley Act (Public Law 106-102, 106th Congress), by defining, or providing for the determination of, all such practices in this state that constitute unfair methods of competition or unfair or deceptive acts or practices and by prohibiting the trade practices and claim settlement practices so defined or determined. (c) Notwithstanding any other state law to the contrary, the commissioner shall have sole enforcement authority for this part, and nothing in this part shall be construed to create or imply a private cause of action for a violation of this part. Acts 2008 , ch. 1079, §§ 1, 2.
(a) This part shall be known and may be cited as the "Tennessee Unfair Trade Practices and Unfair Claims Settlement Act of 2009".
(b) The purpose of this part is to regulate trade and claims settlement practices in the business of insurance in accordance with the intent of congress as expressed in the Act of Congress of March 9, 1945, (Public Law 15, 79th Congress) and the Gramm-Leach-Bliley Act (Public Law 106-102, 106th Congress), by defining, or providing for the determination of, all such practices in this state that constitute unfair methods of competition or unfair or deceptive acts or practices and by prohibiting the trade practices and claim settlement practices so defined or determined.
(c) Notwithstanding any other state law to the contrary, the commissioner shall have sole enforcement authority for this part, and nothing in this part shall be construed to create or imply a private cause of action for a violation of this part.
Acts 2008 , ch. 1079, §§ 1, 2.
Tenn. Code Ann. § 56-3-105 — TN Code / Title 56 / Chapter 3 / Section 56-3-105
Regulation of compensation of officers, agents and employees of life insurance companies and fraternal benefit societies
Status: in_force

(a) A domestic stock or mutual life insurance company or fraternal benefit society shall not: (1) Pay any salary, compensation or emolument to any director or trustee regardless of amount, or to any officer, employee or other person, firm or corporation amounting in any one (1) year to more than the amount set forth in the appropriate schedule of the annual statement filed with the commissioner pursuant to § 56-1-501 , unless the payment has first been authorized by a vote of the board of directors of the company or society; (2) Pay any other compensation or emolument to any officer, director or trustee of the company or society who is paid a salary for services of more than one hundred dollars ($100) per month; or (3) Enter into an agreement for a term longer than twelve (12) months from the date of the agreement with any officer, director, trustee or salaried employee of the company or society providing for the payment of any salary, compensation or emolument for any services rendered or to be rendered. (b) This section shall not prohibit the life insurance company or society from entering into an agreement with: (1) Any officer or employee of the company or society for the payment of deferred compensation beyond the period of twelve (12) months from the date of the agreement; (2) Any officer or employee of the company or society for a stock option plan, stock purchase plan, stock bonus plan, or other incentive compensation plan, if, before the plan is entered into or becomes effective, it is first approved by the commissioner; (3) Any agent, general agent or district manager of the company or society providing for the payment of commissions on the regular commission basis; or (4) Any agent of the company or society providing for the payment of renewal commissions. (c) No domestic or foreign life insurance company or society doing business in this state shall calculate or pay, directly or indirectly, the compensation of any officer, director or trustee of the company or society as a percentage of the premiums collected or the insurance written by the company or society unless it first obtains the approval of the commissioner. Acts 1907, ch. 440, § 1; Shan., § 3348a25; Code 1932, § 6196; Acts 1959, ch. 84, § 1; 1961, ch. 34, § 1; 1967, ch. 30, § 1; 1969, ch. 161, § 1; impl. am. Acts 1971, ch. 137, § 2; 1977, ch. 11, § 1; T.C.A., §§ 56-231, 56-321; Acts 1981, ch. 269, § 1.
(a) A domestic stock or mutual life insurance company or fraternal benefit society shall not: (1) Pay any salary, compensation or emolument to any director or trustee regardless of amount, or to any officer, employee or other person, firm or corporation amounting in any one (1) year to more than the amount set forth in the appropriate schedule of the annual statement filed with the commissioner pursuant to § 56-1-501 , unless the payment has first been authorized by a vote of the board of directors of the company or society; (2) Pay any other compensation or emolument to any officer, director or trustee of the company or society who is paid a salary for services of more than one hundred dollars ($100) per month; or (3) Enter into an agreement for a term longer than twelve (12) months from the date of the agreement with any officer, director, trustee or salaried employee of the company or society providing for the payment of any salary, compensation or emolument for any services rendered or to be rendered.
(1) Pay any salary, compensation or emolument to any director or trustee regardless of amount, or to any officer, employee or other person, firm or corporation amounting in any one (1) year to more than the amount set forth in the appropriate schedule of the annual statement filed with the commissioner pursuant to § 56-1-501 , unless the payment has first been authorized by a vote of the board of directors of the company or society;
(2) Pay any other compensation or emolument to any officer, director or trustee of the company or society who is paid a salary for services of more than one hundred dollars ($100) per month; or
(3) Enter into an agreement for a term longer than twelve (12) months from the date of the agreement with any officer, director, trustee or salaried employee of the company or society providing for the payment of any salary, compensation or emolument for any services rendered or to be rendered.
(b) This section shall not prohibit the life insurance company or society from entering into an agreement with: (1) Any officer or employee of the company or society for the payment of deferred compensation beyond the period of twelve (12) months from the date of the agreement; (2) Any officer or employee of the company or society for a stock option plan, stock purchase plan, stock bonus plan, or other incentive compensation plan, if, before the plan is entered into or becomes effective, it is first approved by the commissioner; (3) Any agent, general agent or district manager of the company or society providing for the payment of commissions on the regular commission basis; or (4) Any agent of the company or society providing for the payment of renewal commissions.
(1) Any officer or employee of the company or society for the payment of deferred compensation beyond the period of twelve (12) months from the date of the agreement;
(2) Any officer or employee of the company or society for a stock option plan, stock purchase plan, stock bonus plan, or other incentive compensation plan, if, before the plan is entered into or becomes effective, it is first approved by the commissioner;
(3) Any agent, general agent or district manager of the company or society providing for the payment of commissions on the regular commission basis; or
(4) Any agent of the company or society providing for the payment of renewal commissions.
(c) No domestic or foreign life insurance company or society doing business in this state shall calculate or pay, directly or indirectly, the compensation of any officer, director or trustee of the company or society as a percentage of the premiums collected or the insurance written by the company or society unless it first obtains the approval of the commissioner.
Acts 1907, ch. 440, § 1; Shan., § 3348a25; Code 1932, § 6196; Acts 1959, ch. 84, § 1; 1961, ch. 34, § 1; 1967, ch. 30, § 1; 1969, ch. 161, § 1; impl. am. Acts 1971, ch. 137, § 2; 1977, ch. 11, § 1; T.C.A., §§ 56-231, 56-321; Acts 1981, ch. 269, § 1.
Tenn. Code Ann. § 56-9-308 — TN Code / Title 56 / Chapter 9 / Section 56-9-308
Liquidation order - Continuation or termination of insurance policies
Status: in_force

(a) All policies, including bonds and other noncancellable business, other than life or health insurance or annuities, in effect at the time of issuance of an order of liquidation, shall continue in force only for the lesser of: (1) A period of thirty (30) days from the date of entry of the liquidation orders; (2) The expiration of the policy coverage; (3) The date when the insured has replaced the insurance coverage with equivalent insurance in another insurer or otherwise terminated the policy; (4) The date when the liquidator has effected a transfer of the policy obligation pursuant to § 56-9-310(a)(10) ; or (5) The date proposed by the liquidator and approved by the court to cancel coverage. (b) An order of liquidation under § 56-9-307 shall terminate coverage at the time specified in subsection (a) for purposes of any other statute. (c) Policies of life or health insurance or annuities shall continue in force for the period and under the terms that are provided for by any applicable guaranty association or foreign guaranty association. (d) Policies of life or health insurance or annuities or any period of coverage of the policies not covered by a guaranty association or foreign guaranty association shall terminate under subsections (a) and (b). Acts 1991, ch. 142, § 4.
(a) All policies, including bonds and other noncancellable business, other than life or health insurance or annuities, in effect at the time of issuance of an order of liquidation, shall continue in force only for the lesser of: (1) A period of thirty (30) days from the date of entry of the liquidation orders; (2) The expiration of the policy coverage; (3) The date when the insured has replaced the insurance coverage with equivalent insurance in another insurer or otherwise terminated the policy; (4) The date when the liquidator has effected a transfer of the policy obligation pursuant to § 56-9-310(a)(10) ; or (5) The date proposed by the liquidator and approved by the court to cancel coverage.
(1) A period of thirty (30) days from the date of entry of the liquidation orders;
(2) The expiration of the policy coverage;
(3) The date when the insured has replaced the insurance coverage with equivalent insurance in another insurer or otherwise terminated the policy;
(4) The date when the liquidator has effected a transfer of the policy obligation pursuant to § 56-9-310(a)(10) ; or
(5) The date proposed by the liquidator and approved by the court to cancel coverage.
(b) An order of liquidation under § 56-9-307 shall terminate coverage at the time specified in subsection (a) for purposes of any other statute.
(c) Policies of life or health insurance or annuities shall continue in force for the period and under the terms that are provided for by any applicable guaranty association or foreign guaranty association.
(d) Policies of life or health insurance or annuities or any period of coverage of the policies not covered by a guaranty association or foreign guaranty association shall terminate under subsections (a) and (b).
Acts 1991, ch. 142, § 4.
Tenn. Code Ann. § 56-2-907 — TN Code / Title 56 / Chapter 2 / Section 56-2-907
Confidentiality
Status: in_force

(a) Documents, materials, or other information, including the CGAD, in the possession or control of the department that are obtained by, created by, or disclosed to the commissioner or any other person under this part, are recognized as being proprietary and containing trade secrets. All such documents, materials, or other information are confidential by law and privileged, are not subject to public inspection under § 10-7-503 or § 56-1-602 , are not subject to subpoena, and are not subject to discovery or admissible in evidence in any private civil action. However, the commissioner is authorized to use the documents, materials, or other information in the furtherance of any regulatory or legal action brought as part of the commissioner's official duties. The commissioner shall not otherwise make the documents, materials, or other information public without the prior written consent of the insurer. Nothing in this section requires the written consent of the insurer before the commissioner may share or receive confidential documents, materials, or other CGAD-related information pursuant to subsection (c) to assist in the performance of the commissioner's official duties. (b) Neither the commissioner nor any person that receives documents, materials, or other CGAD-related information, through examination or otherwise, while acting under the authority of the commissioner, or with whom the documents, materials, or other information are shared pursuant to this part, are permitted or required to testify in any private civil action concerning any confidential documents, materials, or information subject to subsection (a). (c) In order to assist the commissioner in the performance of the commissioner's regulatory duties, the commissioner: (1) May, as necessary and upon request, share documents, materials, or other CGAD-related information, including the confidential and privileged documents, materials, or information subject to subsection (a), and including proprietary and trade secret documents and materials, with other state, federal, or international financial regulatory agencies, including members of any supervisory college as set forth in § 56-11-116 , and with the NAIC, and with third-party consultants pursuant to § 56-9-108 ; provided, that the recipient agrees in writing to maintain the confidentiality and privileged status of the CGAD-related documents, materials, or other information and has verified in writing its legal authority to maintain such confidentiality; and (2) May receive documents, materials, or other CGAD-related information, including otherwise confidential and privileged documents, materials, or information, and including proprietary and trade-secret information or documents, from regulatory officials of other state, federal, or international financial regulatory agencies, including members of any supervisory college as set forth in § 56-11-116 , and from the NAIC, and shall maintain as confidential or privileged any such documents, materials, or information received with notice or the understanding that they are confidential or privileged under the laws of the jurisdiction that is the source of the documents, materials, or information. (d) The sharing of information and documents by the commissioner pursuant to this part does not constitute a delegation of regulatory authority or rulemaking, and the commissioner is solely responsible for the administration, execution, and enforcement of this part. (e) No waiver of any applicable privilege or claim of confidentiality in documents, proprietary and trade-secret materials, or other CGAD-related information shall occur as a result of disclosure of CGAD-related information or documents to the commissioner under this part or as a result of sharing as authorized under this part. Added by 2018 Tenn. Acts, ch. 873,s 8, eff. 1/1/2019.
(a) Documents, materials, or other information, including the CGAD, in the possession or control of the department that are obtained by, created by, or disclosed to the commissioner or any other person under this part, are recognized as being proprietary and containing trade secrets. All such documents, materials, or other information are confidential by law and privileged, are not subject to public inspection under § 10-7-503 or § 56-1-602 , are not subject to subpoena, and are not subject to discovery or admissible in evidence in any private civil action. However, the commissioner is authorized to use the documents, materials, or other information in the furtherance of any regulatory or legal action brought as part of the commissioner's official duties. The commissioner shall not otherwise make the documents, materials, or other information public without the prior written consent of the insurer. Nothing in this section requires the written consent of the insurer before the commissioner may share or receive confidential documents, materials, or other CGAD-related information pursuant to subsection (c) to assist in the performance of the commissioner's official duties.
(b) Neither the commissioner nor any person that receives documents, materials, or other CGAD-related information, through examination or otherwise, while acting under the authority of the commissioner, or with whom the documents, materials, or other information are shared pursuant to this part, are permitted or required to testify in any private civil action concerning any confidential documents, materials, or information subject to subsection (a).
(c) In order to assist the commissioner in the performance of the commissioner's regulatory duties, the commissioner: (1) May, as necessary and upon request, share documents, materials, or other CGAD-related information, including the confidential and privileged documents, materials, or information subject to subsection (a), and including proprietary and trade secret documents and materials, with other state, federal, or international financial regulatory agencies, including members of any supervisory college as set forth in § 56-11-116 , and with the NAIC, and with third-party consultants pursuant to § 56-9-108 ; provided, that the recipient agrees in writing to maintain the confidentiality and privileged status of the CGAD-related documents, materials, or other information and has verified in writing its legal authority to maintain such confidentiality; and (2) May receive documents, materials, or other CGAD-related information, including otherwise confidential and privileged documents, materials, or information, and including proprietary and trade-secret information or documents, from regulatory officials of other state, federal, or international financial regulatory agencies, including members of any supervisory college as set forth in § 56-11-116 , and from the NAIC, and shall maintain as confidential or privileged any such documents, materials, or information received with notice or the understanding that they are confidential or privileged under the laws of the jurisdiction that is the source of the documents, materials, or information.
(1) May, as necessary and upon request, share documents, materials, or other CGAD-related information, including the confidential and privileged documents, materials, or information subject to subsection (a), and including proprietary and trade secret documents and materials, with other state, federal, or international financial regulatory agencies, including members of any supervisory college as set forth in § 56-11-116 , and with the NAIC, and with third-party consultants pursuant to § 56-9-108 ; provided, that the recipient agrees in writing to maintain the confidentiality and privileged status of the CGAD-related documents, materials, or other information and has verified in writing its legal authority to maintain such confidentiality; and
(2) May receive documents, materials, or other CGAD-related information, including otherwise confidential and privileged documents, materials, or information, and including proprietary and trade-secret information or documents, from regulatory officials of other state, federal, or international financial regulatory agencies, including members of any supervisory college as set forth in § 56-11-116 , and from the NAIC, and shall maintain as confidential or privileged any such documents, materials, or information received with notice or the understanding that they are confidential or privileged under the laws of the jurisdiction that is the source of the documents, materials, or information.
(d) The sharing of information and documents by the commissioner pursuant to this part does not constitute a delegation of regulatory authority or rulemaking, and the commissioner is solely responsible for the administration, execution, and enforcement of this part.
(e) No waiver of any applicable privilege or claim of confidentiality in documents, proprietary and trade-secret materials, or other CGAD-related information shall occur as a result of disclosure of CGAD-related information or documents to the commissioner under this part or as a result of sharing as authorized under this part.
Added by 2018 Tenn. Acts, ch. 873,s 8, eff. 1/1/2019.
Tenn. Code Ann. § 56-35-117 — TN Code / Title 56 / Chapter 35 / Section 56-35-117
Exchange of information - Consultation and cooperation - Limitations
Status: in_force

In order to further more equitable establishment and adjustment of rates, including risk rates, or premiums and forms of contracts, policies and guarantees, the commissioner, every insurer and rating organization may exchange information and experience data with each other, and with the insurance supervisory officers and insurers in other states and with national organizations and associations and may consult and cooperate with them in respect to rates, including risk rates, or premiums and forms of contracts, policies and guarantees; and an insurer or rating organization licensed under this chapter may act in concert with each other and with others with respect to any and all matters pertaining to the making of rates, rating plans, or rating systems, or the preparation of forms of policies, contracts, or guarantees of title, underwriting rules, surveys and investigations, or the furnishing of loss and expense statistics or other information and data, or carrying on research. Acts 1955, ch. 173, § 12; T.C.A., § 56-3417; Acts 1983, ch. 139, § 3.
In order to further more equitable establishment and adjustment of rates, including risk rates, or premiums and forms of contracts, policies and guarantees, the commissioner, every insurer and rating organization may exchange information and experience data with each other, and with the insurance supervisory officers and insurers in other states and with national organizations and associations and may consult and cooperate with them in respect to rates, including risk rates, or premiums and forms of contracts, policies and guarantees; and an insurer or rating organization licensed under this chapter may act in concert with each other and with others with respect to any and all matters pertaining to the making of rates, rating plans, or rating systems, or the preparation of forms of policies, contracts, or guarantees of title, underwriting rules, surveys and investigations, or the furnishing of loss and expense statistics or other information and data, or carrying on research.
Acts 1955, ch. 173, § 12; T.C.A., § 56-3417; Acts 1983, ch. 139, § 3.
Tenn. Code Ann. § 56-2-107 — TN Code / Title 56 / Chapter 2 / Section 56-2-107
Acts of unauthorized insurers constituting doing business in state
Status: in_force

Any of the following acts in this state, effected by mail or otherwise by an unauthorized insurer, are included among those deemed to constitute transacting insurance business in this state: (1) The issuance or delivery of contracts of insurance to residents of this state; (2) The solicitation of applications for contracts of insurance; (3) The collection of premiums, membership fees, assessments or other considerations for contracts of insurance; or (4) The transaction of matters subsequent to the execution of contracts of insurance and arising out of them. Acts 1968, ch. 536, § 2; T.C.A., § 56-207.
Any of the following acts in this state, effected by mail or otherwise by an unauthorized insurer, are included among those deemed to constitute transacting insurance business in this state:
(1) The issuance or delivery of contracts of insurance to residents of this state;
(2) The solicitation of applications for contracts of insurance;
(3) The collection of premiums, membership fees, assessments or other considerations for contracts of insurance; or
(4) The transaction of matters subsequent to the execution of contracts of insurance and arising out of them.
Acts 1968, ch. 536, § 2; T.C.A., § 56-207.
Tenn. Code Ann. § 56-7-2706 — TN Code / Title 56 / Chapter 7 / Section 56-7-2706
Routine examinations and analysis
Status: in_force

Nothing in this part shall preclude a health insurer or life insurer from obtaining a routine physical examination or chemical, blood or urine analysis, or from asking questions related to the health of an applicant or the applicant's family. Amended by 2023 Tenn. Acts, ch. 246, s 7, eff. 7/1/2023. Acts 1997 , ch. 121, § 2.
Nothing in this part shall preclude a health insurer or life insurer from obtaining a routine physical examination or chemical, blood or urine analysis, or from asking questions related to the health of an applicant or the applicant's family.
Amended by 2023 Tenn. Acts, ch. 246, s 7, eff. 7/1/2023.
Acts 1997 , ch. 121, § 2.
Tenn. Code Ann. § 56-29-108 — TN Code / Title 56 / Chapter 29 / Section 56-29-108
Issuance of license by commissioner - Prerequisites
Status: in_force

The commissioner shall issue a license upon compliance with this chapter and other proper requirements of the commissioner, and upon being satisfied that: (1) The applicant is established as a bona fide nonprofit hospital service corporation with or without the right to provide medical expense indemnity; the hospital service benefits provided by the corporation are not an unnecessary duplication of similar service in the community served; it is desirable for public necessity and convenience; hospital contracts have been obtained, if possible, in the findings of the commissioner, with hospitals representing a majority of the bed capacity in the area where members are to be enrolled; and a fair opportunity has been given to all institutions of standing in the area to be served, to become member hospitals; (2) A provision has been made in the subscriber's contract authorizing hospital service in hospitals other than participating hospitals, in which case money benefits shall be provided as specified in the subscriber's contract and approved as fair by the commissioner; (3) Member hospitals of a hospital service plan agree to render service benefits of the plan of which it is a member at the agreed payment schedule to all subscribers; and (4) The rates charged are fair, reasonable, adequate and not unfairly discriminatory. Benefits to be provided are to be fair, reasonable and not unfairly discriminatory. Rates may differ between subscribers in recognized groups and subscribers not in groups, all subject as above to the approval of the commissioner. Acts 1949, ch. 234, § 6; C. Supp. 1950, § 4186.48 (Williams, § 4186.51); T.C.A. (orig. ed.), § 56-3108.
The commissioner shall issue a license upon compliance with this chapter and other proper requirements of the commissioner, and upon being satisfied that:
(1) The applicant is established as a bona fide nonprofit hospital service corporation with or without the right to provide medical expense indemnity; the hospital service benefits provided by the corporation are not an unnecessary duplication of similar service in the community served; it is desirable for public necessity and convenience; hospital contracts have been obtained, if possible, in the findings of the commissioner, with hospitals representing a majority of the bed capacity in the area where members are to be enrolled; and a fair opportunity has been given to all institutions of standing in the area to be served, to become member hospitals;
(2) A provision has been made in the subscriber's contract authorizing hospital service in hospitals other than participating hospitals, in which case money benefits shall be provided as specified in the subscriber's contract and approved as fair by the commissioner;
(3) Member hospitals of a hospital service plan agree to render service benefits of the plan of which it is a member at the agreed payment schedule to all subscribers; and
(4) The rates charged are fair, reasonable, adequate and not unfairly discriminatory. Benefits to be provided are to be fair, reasonable and not unfairly discriminatory. Rates may differ between subscribers in recognized groups and subscribers not in groups, all subject as above to the approval of the commissioner.
Acts 1949, ch. 234, § 6; C. Supp. 1950, § 4186.48 (Williams, § 4186.51); T.C.A. (orig. ed.), § 56-3108.
Tenn. Code Ann. § 56-2-105 — TN Code / Title 56 / Chapter 2 / Section 56-2-105
Certificate of authority required - Exceptions
Status: in_force

It is unlawful for any company to enter into a contract of insurance as an insurer or to transact insurance business in this state without a certificate of authority from the commissioner; provided, that this section shall not apply to: (1) Contracts procured by agents or brokers under the authority of the Surplus Lines Insurance Act, compiled in chapter 14 of this title; (2) Contracts of reinsurance; (3) Transactions in this state involving policies lawfully solicited, written and delivered outside of this state covering only subjects of insurance not resident, located or expressly to be performed in this state at the time of issuance or covering property in the course of transportation by land, air or water, to, from or through this state and including any preparation or storage incidental thereto, and which transactions are subsequent to the issuance of those policies; (4) Transactions in this state involving group or blanket insurance and group annuities where the master policy of the groups was lawfully issued and delivered in a state in which the company was authorized to transact insurance business; (5) Transactions in this state involving a policy issued prior to April 3, 1968; (6) Any life insurance or annuity company that holds a certificate of exemption from the commissioner as provided in § 56-2-106 ; or (7) (A) The procuring of contracts of insurance issued to an industrial insured; (B) For the purposes of subdivision (7)(A), an "industrial insured" is an insured: (i) Who procures the insurance of any risk or risks by use of the services of a full-time employee acting as an insurance manager or buyer; (ii) Whose aggregate annual premiums for insurance on all risks total at least twenty-five thousand dollars ($25,000); and (iii) Who has at least twenty-five (25) full-time employees. Acts 1968, ch. 536, § 1; 1969, ch. 270, § 19; T.C.A., § 56-205.
It is unlawful for any company to enter into a contract of insurance as an insurer or to transact insurance business in this state without a certificate of authority from the commissioner; provided, that this section shall not apply to:
(1) Contracts procured by agents or brokers under the authority of the Surplus Lines Insurance Act, compiled in chapter 14 of this title;
(2) Contracts of reinsurance;
(3) Transactions in this state involving policies lawfully solicited, written and delivered outside of this state covering only subjects of insurance not resident, located or expressly to be performed in this state at the time of issuance or covering property in the course of transportation by land, air or water, to, from or through this state and including any preparation or storage incidental thereto, and which transactions are subsequent to the issuance of those policies;
(4) Transactions in this state involving group or blanket insurance and group annuities where the master policy of the groups was lawfully issued and delivered in a state in which the company was authorized to transact insurance business;
(5) Transactions in this state involving a policy issued prior to April 3, 1968;
(6) Any life insurance or annuity company that holds a certificate of exemption from the commissioner as provided in § 56-2-106 ; or
(7) (A) The procuring of contracts of insurance issued to an industrial insured; (B) For the purposes of subdivision (7)(A), an "industrial insured" is an insured: (i) Who procures the insurance of any risk or risks by use of the services of a full-time employee acting as an insurance manager or buyer; (ii) Whose aggregate annual premiums for insurance on all risks total at least twenty-five thousand dollars ($25,000); and (iii) Who has at least twenty-five (25) full-time employees.
(A) The procuring of contracts of insurance issued to an industrial insured;
(B) For the purposes of subdivision (7)(A), an "industrial insured" is an insured: (i) Who procures the insurance of any risk or risks by use of the services of a full-time employee acting as an insurance manager or buyer; (ii) Whose aggregate annual premiums for insurance on all risks total at least twenty-five thousand dollars ($25,000); and (iii) Who has at least twenty-five (25) full-time employees.
(i) Who procures the insurance of any risk or risks by use of the services of a full-time employee acting as an insurance manager or buyer;
(ii) Whose aggregate annual premiums for insurance on all risks total at least twenty-five thousand dollars ($25,000); and
(iii) Who has at least twenty-five (25) full-time employees.
Acts 1968, ch. 536, § 1; 1969, ch. 270, § 19; T.C.A., § 56-205.
Tenn. Code Ann. § 56-7-1008 — TN Code / Title 56 / Chapter 7 / Section 56-7-1008
Uniform claim forms authorized
Status: in_force

(a) The commissioner has the discretion to prescribe by regulation, after due consultation with providers of health care or treatment, accident and sickness insurers, hospital, medical and dental service corporations and other prepayment organizations representative of those organizations, claim forms for reporting by health care providers. The prescribed forms shall include, but need not be limited to, information regarding the medical diagnosis, treatment and prognosis of the patient, together with the details of charges incident to the providing of the care, treatment or services, sufficient for the purpose of meeting the proof requirements of an accident and sickness insurance or hospital, medical or dental service contract. (b) The adoption of any uniform claim forms by the commissioner pursuant to this section shall not preclude an insurer, hospital, medical or dental service corporation or other prepayment organization from obtaining any necessary additional information regarding a claim from the claimant, provider of health care or treatment, or certifier of coverage. (c) Any regulation so adopted shall specify an effective date, which shall not be less than twelve (12) months after the date of adoption or promulgation, after which no accident and sickness insurer, hospital, medical or dental service corporation or other prepayment plan may require providers of health care or treatment to complete forms differing from those prescribed by the commissioner pursuant to this section. Acts 1980, ch. 506, § 1.
(a) The commissioner has the discretion to prescribe by regulation, after due consultation with providers of health care or treatment, accident and sickness insurers, hospital, medical and dental service corporations and other prepayment organizations representative of those organizations, claim forms for reporting by health care providers. The prescribed forms shall include, but need not be limited to, information regarding the medical diagnosis, treatment and prognosis of the patient, together with the details of charges incident to the providing of the care, treatment or services, sufficient for the purpose of meeting the proof requirements of an accident and sickness insurance or hospital, medical or dental service contract.
(b) The adoption of any uniform claim forms by the commissioner pursuant to this section shall not preclude an insurer, hospital, medical or dental service corporation or other prepayment organization from obtaining any necessary additional information regarding a claim from the claimant, provider of health care or treatment, or certifier of coverage.
(c) Any regulation so adopted shall specify an effective date, which shall not be less than twelve (12) months after the date of adoption or promulgation, after which no accident and sickness insurer, hospital, medical or dental service corporation or other prepayment plan may require providers of health care or treatment to complete forms differing from those prescribed by the commissioner pursuant to this section.
Acts 1980, ch. 506, § 1.
Tenn. Code Ann. § 56-22-115 — TN Code / Title 56 / Chapter 22 / Section 56-22-115
Examination of county mutual insurance company
Status: in_force

(a) The commissioner may investigate or examine the affairs of a county mutual insurance company to the same extent that the commissioner may investigate or examine the affairs of an insurance company doing business in this state. At least once every five (5) years, the commissioner shall examine the affairs of each county mutual insurance company holding a certificate of authority in this state as to both its financial condition and its compliance with the law. (b) After the completion of an examination undertaken under subsection (a), the requirements and procedures of § 56-1-411(d) shall be followed. (c) A county mutual insurance company examined by the commissioner shall pay all costs of the examination, including, but not limited to, the reasonable fees of actuaries, accountants, attorneys and other professionals that the commissioner may enter into a contract with to perform examination services on behalf of the commissioner. (d) All working papers, recorded information, documents or copies thereof produced by, obtained by or disclosed to the commissioner or any other person in the course of an examination made under this chapter shall be given confidential treatment and may not be made public by the commissioner or any other person, except to the extent provided under § 56-1-411 . Access may also be granted to the National Association of Insurance Commissioners under § 56-2-801 , or to any other state or federal agency or law enforcement authority as the commissioner deems appropriate. Acts 2006, ch. 689, §§3, 18; 2012 , ch. 633, § 2.
(a) The commissioner may investigate or examine the affairs of a county mutual insurance company to the same extent that the commissioner may investigate or examine the affairs of an insurance company doing business in this state. At least once every five (5) years, the commissioner shall examine the affairs of each county mutual insurance company holding a certificate of authority in this state as to both its financial condition and its compliance with the law.
(b) After the completion of an examination undertaken under subsection (a), the requirements and procedures of § 56-1-411(d) shall be followed.
(c) A county mutual insurance company examined by the commissioner shall pay all costs of the examination, including, but not limited to, the reasonable fees of actuaries, accountants, attorneys and other professionals that the commissioner may enter into a contract with to perform examination services on behalf of the commissioner.
(d) All working papers, recorded information, documents or copies thereof produced by, obtained by or disclosed to the commissioner or any other person in the course of an examination made under this chapter shall be given confidential treatment and may not be made public by the commissioner or any other person, except to the extent provided under § 56-1-411 . Access may also be granted to the National Association of Insurance Commissioners under § 56-2-801 , or to any other state or federal agency or law enforcement authority as the commissioner deems appropriate.
Acts 2006, ch. 689, §§3, 18; 2012 , ch. 633, § 2.
Tenn. Code Ann. § 56-6-410 — TN Code / Title 56 / Chapter 6 / Section 56-6-410
License requirements
Status: in_force

(a) No person shall act as, or hold out to be, an administrator in this state, other than an adjuster licensed in this state for the kinds of business for which the person is acting as an adjuster, unless the person holds a license as an administrator issued by the commissioner. Failure to hold the license shall subject the administrator to a fine of not less than one hundred dollars ($100) nor more than five hundred dollars ($500). The license shall be issued by the commissioner to an administrator unless the commissioner, after due notice and hearing, shall have determined that the administrator is not competent, trustworthy, financially responsible or of good personal and business reputation, or has had a previous application for an insurance license denied for cause within five (5) years. (b) All applications shall be accompanied by a fee of one hundred dollars ($100). The license is renewable annually on the date of issue. A request for renewal must be accompanied by a renewal fee of fifty dollars ($50.00). Prior to the issuance or renewal of the license of any administrator, a fidelity bond in a form and amount as determined by the commissioner shall be obtained by the licensee. (c) After notice and hearing, the commissioner may revoke the license or fine the administrator not more than five hundred dollars ($500), or both, or the commissioner may suspend the license, or fine the administrator not more than five hundred dollars ($500), or both, upon finding that either the administrator violated any of the requirements of §§ 56-6-402 and 56-6-404 - 56-6-409, or the administrator is not competent, trustworthy, financially responsible, or of good personal and business reputation. Acts 1980, ch. 640, § 10; 1981, ch. 297, § 1.
(a) No person shall act as, or hold out to be, an administrator in this state, other than an adjuster licensed in this state for the kinds of business for which the person is acting as an adjuster, unless the person holds a license as an administrator issued by the commissioner. Failure to hold the license shall subject the administrator to a fine of not less than one hundred dollars ($100) nor more than five hundred dollars ($500). The license shall be issued by the commissioner to an administrator unless the commissioner, after due notice and hearing, shall have determined that the administrator is not competent, trustworthy, financially responsible or of good personal and business reputation, or has had a previous application for an insurance license denied for cause within five (5) years.
(b) All applications shall be accompanied by a fee of one hundred dollars ($100). The license is renewable annually on the date of issue. A request for renewal must be accompanied by a renewal fee of fifty dollars ($50.00). Prior to the issuance or renewal of the license of any administrator, a fidelity bond in a form and amount as determined by the commissioner shall be obtained by the licensee.
(c) After notice and hearing, the commissioner may revoke the license or fine the administrator not more than five hundred dollars ($500), or both, or the commissioner may suspend the license, or fine the administrator not more than five hundred dollars ($500), or both, upon finding that either the administrator violated any of the requirements of §§ 56-6-402 and 56-6-404 - 56-6-409, or the administrator is not competent, trustworthy, financially responsible, or of good personal and business reputation.
Acts 1980, ch. 640, § 10; 1981, ch. 297, § 1.
Tenn. Code Ann. § 56-9-321 — TN Code / Title 56 / Chapter 9 / Section 56-9-321
Obligation to pay earned premiums to insurer - Penalties for failure to pay - Proceedings to collect unpaid premiums - Appeal from proceedings - Limitations on claims of insurer against insured
Status: in_force

(a) (1) An agent, broker, premium finance company, or any other person, other than the insured, responsible for the payment of a premium is obligated to pay any earned premium due the insurer at the time of the declaration of insolvency, as shown on the records of the insurer. The liquidator also has the right to recover from the person any part of an unearned premium that represents commission of the person. Credits or setoffs, or both, shall be allowed to an agent, broker, or premium finance company for any amounts advanced to the insurer by the agent, broker, or premium finance company on behalf of, but in the absence of a payment by, the insured. (2) An insured shall be obligated to pay any unpaid earned premium due the insurer at the time of the declaration of insolvency, as shown on the records of the insurer. (b) Upon satisfactory evidence of a violation of this section, the commissioner may pursue either one (1) or both of the following courses of action: (1) Suspend or revoke or refuse to renew the licenses of the offending party or parties; and (2) Impose a penalty of not more than one thousand dollars ($1,000) for each and every act in violation of this section by the offending party or parties. (c) Before the commissioner takes any action as set forth in subsection (b), the commissioner shall give written notice to the person, company, association or exchange accused of violating the law, stating specifically the nature of the alleged violation, and fixing a time and place, at least ten (10) days thereafter, when a hearing on the matter shall be held. After the hearing, or upon failure of the accused to appear at the hearing, the commissioner, if the commissioner finds a violation, shall impose any of the penalties under subsection (b) as the commissioner deems advisable. (d) When the commissioner takes action in any or all of the ways set out in subsection (b), the party aggrieved may appeal from the action to the chancery court of Davidson County. (e) With respect to any policy of insurance issued or delivered in this state, the claims of an insurer declared to be insolvent under the laws of any state, or of its liquidator, receiver, statutory successor or other legal representative, against the insured or against the agent through whom the policy was written are subject to the following limitations: (1) The insured is not liable to an insolvent insurer or its legal representative for any premium that had not been earned on a pro rata basis as of the date the insurer was declared insolvent. In addition, the insured is entitled to credit against any obligation owed to the insolvent insurer or its legal representative for any unearned premium that has been paid by the insured and for which the insured has not been reimbursed by the Tennessee insurance guaranty association; and (2) The agent through whom the policy was written also is not liable to the insolvent insurer or its legal representative for any premiums that had not been earned on a pro rata basis as of the date the insurer was declared insolvent. The agent is entitled to retain the commission due on earned premiums. The insured is entitled to any unearned premium that has been collected by the agent but not remitted to the insurer. Acts 1991, ch. 142, § 4.
(a) (1) An agent, broker, premium finance company, or any other person, other than the insured, responsible for the payment of a premium is obligated to pay any earned premium due the insurer at the time of the declaration of insolvency, as shown on the records of the insurer. The liquidator also has the right to recover from the person any part of an unearned premium that represents commission of the person. Credits or setoffs, or both, shall be allowed to an agent, broker, or premium finance company for any amounts advanced to the insurer by the agent, broker, or premium finance company on behalf of, but in the absence of a payment by, the insured. (2) An insured shall be obligated to pay any unpaid earned premium due the insurer at the time of the declaration of insolvency, as shown on the records of the insurer.
(1) An agent, broker, premium finance company, or any other person, other than the insured, responsible for the payment of a premium is obligated to pay any earned premium due the insurer at the time of the declaration of insolvency, as shown on the records of the insurer. The liquidator also has the right to recover from the person any part of an unearned premium that represents commission of the person. Credits or setoffs, or both, shall be allowed to an agent, broker, or premium finance company for any amounts advanced to the insurer by the agent, broker, or premium finance company on behalf of, but in the absence of a payment by, the insured.
(2) An insured shall be obligated to pay any unpaid earned premium due the insurer at the time of the declaration of insolvency, as shown on the records of the insurer.
(b) Upon satisfactory evidence of a violation of this section, the commissioner may pursue either one (1) or both of the following courses of action: (1) Suspend or revoke or refuse to renew the licenses of the offending party or parties; and (2) Impose a penalty of not more than one thousand dollars ($1,000) for each and every act in violation of this section by the offending party or parties.
(1) Suspend or revoke or refuse to renew the licenses of the offending party or parties; and
(2) Impose a penalty of not more than one thousand dollars ($1,000) for each and every act in violation of this section by the offending party or parties.
(c) Before the commissioner takes any action as set forth in subsection (b), the commissioner shall give written notice to the person, company, association or exchange accused of violating the law, stating specifically the nature of the alleged violation, and fixing a time and place, at least ten (10) days thereafter, when a hearing on the matter shall be held. After the hearing, or upon failure of the accused to appear at the hearing, the commissioner, if the commissioner finds a violation, shall impose any of the penalties under subsection (b) as the commissioner deems advisable.
(d) When the commissioner takes action in any or all of the ways set out in subsection (b), the party aggrieved may appeal from the action to the chancery court of Davidson County.
(e) With respect to any policy of insurance issued or delivered in this state, the claims of an insurer declared to be insolvent under the laws of any state, or of its liquidator, receiver, statutory successor or other legal representative, against the insured or against the agent through whom the policy was written are subject to the following limitations: (1) The insured is not liable to an insolvent insurer or its legal representative for any premium that had not been earned on a pro rata basis as of the date the insurer was declared insolvent. In addition, the insured is entitled to credit against any obligation owed to the insolvent insurer or its legal representative for any unearned premium that has been paid by the insured and for which the insured has not been reimbursed by the Tennessee insurance guaranty association; and (2) The agent through whom the policy was written also is not liable to the insolvent insurer or its legal representative for any premiums that had not been earned on a pro rata basis as of the date the insurer was declared insolvent. The agent is entitled to retain the commission due on earned premiums. The insured is entitled to any unearned premium that has been collected by the agent but not remitted to the insurer.
(1) The insured is not liable to an insolvent insurer or its legal representative for any premium that had not been earned on a pro rata basis as of the date the insurer was declared insolvent. In addition, the insured is entitled to credit against any obligation owed to the insolvent insurer or its legal representative for any unearned premium that has been paid by the insured and for which the insured has not been reimbursed by the Tennessee insurance guaranty association; and
(2) The agent through whom the policy was written also is not liable to the insolvent insurer or its legal representative for any premiums that had not been earned on a pro rata basis as of the date the insurer was declared insolvent. The agent is entitled to retain the commission due on earned premiums. The insured is entitled to any unearned premium that has been collected by the agent but not remitted to the insurer.
Acts 1991, ch. 142, § 4.
Tenn. Code Ann. § 56-7-3102 — TN Code / Title 56 / Chapter 7 / Section 56-7-3102
Part definitions
Status: in_force

As used in this part, unless the context otherwise requires: (1) "Covered entity": (A) Means an individual or entity that provides health coverage to covered individuals who are employed or reside in this state, and includes, but is not limited to: (i) A health insurance issuer; (ii) A managed health insurance issuer, as defined in § 56-32-128(a) ; (iii) A nonprofit hospital; (iv) A medication service organization; (v) An insurer; (vi) A health coverage plan; (vii) A health maintenance organization licensed to practice pursuant to this title; (viii) A health program administered by this state or its political subdivisions, including the TennCare programs administered pursuant to the waivers approved by the United States department of health and human services; (ix) A nonprofit insurance company; (x) A prepaid plan; (xi) A self-insured entity; (xii) Plans governed by the Employee Retirement Income Security Act of 1974 (ERISA) ( 29 U.S.C. § 1001 et seq.); and (xiii) An employer, labor union, or other group of persons organized in this state; and (B) Does not include: (i) A health plan that provides coverage only for accidental injury, specified disease, hospital indemnity, medicare supplement, disability income, or other long-term care; or (ii) A plan subject to regulation under medicare part D; (2) "Maximum allowable cost" means the maximum amount that a pharmacy benefits manager or covered entity will reimburse a pharmacy for the cost of a drug or a medical product or device; (3) "Maximum allowable cost list" means a list of drugs, medical products or devices, or both medical products and devices, for which a maximum allowable cost has been established by a pharmacy benefits manager or covered entity; (4) "Pharmacist" and "pharmacy" have the same meanings as those terms are defined in § 63-10-204 ; (5) "Pharmacy benefits manager" means a person, business or other entity and any wholly or partially owned subsidiary of the entity, that administers the medication and/or device portion of pharmacy benefits coverage provided by a covered entity. "Pharmacy benefits manager" includes, but is not limited to, a health insurance issuer, managed health insurance issuer as defined in § 56-32-128(a) , nonprofit hospital, medication service organization, insurer, health coverage plan, health maintenance organization licensed to practice pursuant to this title, a health program administered by the state or its political subdivisions, including the TennCare programs administered pursuant to the waivers approved by the United States department of health and human services, nonprofit insurance companies, prepaid plans, self-insured entities, plans governed by the Employee Retirement Income Security Act of 1974 (ERISA) ( 29 U.S.C. § 1001 et seq.), and all other corporations, entities or persons acting for a pharmacy benefits manager in a contractual or employment relationship in the performance of pharmacy benefits management for a covered entity and includes, but is not limited to, a mail order pharmacy; and (6) "Pharmacy services administrative organization" means an entity that provides contracting and other administrative services to pharmacies to assist them in their interaction with third-party payers, pharmacy benefits managers, drug wholesalers, and other entities. Amended by 2022 Tenn. Acts, ch. 1070, s 4, eff. 1/1/2023. Amended by 2022 Tenn. Acts, ch. 1070, s 3, eff. 1/1/2023. Amended by 2016 Tenn. Acts, ch. 631, s 1, eff. 3/23/2016. Amended by 2014 Tenn. Acts, ch. 857, s 1, eff. 1/1/2015. Acts 2007 , ch. 224, § 1.
As used in this part, unless the context otherwise requires:
(1) "Covered entity": (A) Means an individual or entity that provides health coverage to covered individuals who are employed or reside in this state, and includes, but is not limited to: (i) A health insurance issuer; (ii) A managed health insurance issuer, as defined in § 56-32-128(a) ; (iii) A nonprofit hospital; (iv) A medication service organization; (v) An insurer; (vi) A health coverage plan; (vii) A health maintenance organization licensed to practice pursuant to this title; (viii) A health program administered by this state or its political subdivisions, including the TennCare programs administered pursuant to the waivers approved by the United States department of health and human services; (ix) A nonprofit insurance company; (x) A prepaid plan; (xi) A self-insured entity; (xii) Plans governed by the Employee Retirement Income Security Act of 1974 (ERISA) ( 29 U.S.C. § 1001 et seq.); and (xiii) An employer, labor union, or other group of persons organized in this state; and (B) Does not include: (i) A health plan that provides coverage only for accidental injury, specified disease, hospital indemnity, medicare supplement, disability income, or other long-term care; or (ii) A plan subject to regulation under medicare part D;
(A) Means an individual or entity that provides health coverage to covered individuals who are employed or reside in this state, and includes, but is not limited to: (i) A health insurance issuer; (ii) A managed health insurance issuer, as defined in § 56-32-128(a) ; (iii) A nonprofit hospital; (iv) A medication service organization; (v) An insurer; (vi) A health coverage plan; (vii) A health maintenance organization licensed to practice pursuant to this title; (viii) A health program administered by this state or its political subdivisions, including the TennCare programs administered pursuant to the waivers approved by the United States department of health and human services; (ix) A nonprofit insurance company; (x) A prepaid plan; (xi) A self-insured entity; (xii) Plans governed by the Employee Retirement Income Security Act of 1974 (ERISA) ( 29 U.S.C. § 1001 et seq.); and (xiii) An employer, labor union, or other group of persons organized in this state; and
(i) A health insurance issuer;
(ii) A managed health insurance issuer, as defined in § 56-32-128(a) ;
(iii) A nonprofit hospital;
(iv) A medication service organization;
(v) An insurer;
(vi) A health coverage plan;
(vii) A health maintenance organization licensed to practice pursuant to this title;
(viii) A health program administered by this state or its political subdivisions, including the TennCare programs administered pursuant to the waivers approved by the United States department of health and human services;
(ix) A nonprofit insurance company;
(x) A prepaid plan;
(xi) A self-insured entity;
(xii) Plans governed by the Employee Retirement Income Security Act of 1974 (ERISA) ( 29 U.S.C. § 1001 et seq.); and
(xiii) An employer, labor union, or other group of persons organized in this state; and
(B) Does not include: (i) A health plan that provides coverage only for accidental injury, specified disease, hospital indemnity, medicare supplement, disability income, or other long-term care; or (ii) A plan subject to regulation under medicare part D;
(i) A health plan that provides coverage only for accidental injury, specified disease, hospital indemnity, medicare supplement, disability income, or other long-term care; or
(ii) A plan subject to regulation under medicare part D;
(2) "Maximum allowable cost" means the maximum amount that a pharmacy benefits manager or covered entity will reimburse a pharmacy for the cost of a drug or a medical product or device;
(3) "Maximum allowable cost list" means a list of drugs, medical products or devices, or both medical products and devices, for which a maximum allowable cost has been established by a pharmacy benefits manager or covered entity;
(4) "Pharmacist" and "pharmacy" have the same meanings as those terms are defined in § 63-10-204 ;
(5) "Pharmacy benefits manager" means a person, business or other entity and any wholly or partially owned subsidiary of the entity, that administers the medication and/or device portion of pharmacy benefits coverage provided by a covered entity. "Pharmacy benefits manager" includes, but is not limited to, a health insurance issuer, managed health insurance issuer as defined in § 56-32-128(a) , nonprofit hospital, medication service organization, insurer, health coverage plan, health maintenance organization licensed to practice pursuant to this title, a health program administered by the state or its political subdivisions, including the TennCare programs administered pursuant to the waivers approved by the United States department of health and human services, nonprofit insurance companies, prepaid plans, self-insured entities, plans governed by the Employee Retirement Income Security Act of 1974 (ERISA) ( 29 U.S.C. § 1001 et seq.), and all other corporations, entities or persons acting for a pharmacy benefits manager in a contractual or employment relationship in the performance of pharmacy benefits management for a covered entity and includes, but is not limited to, a mail order pharmacy; and
(6) "Pharmacy services administrative organization" means an entity that provides contracting and other administrative services to pharmacies to assist them in their interaction with third-party payers, pharmacy benefits managers, drug wholesalers, and other entities.
Amended by 2022 Tenn. Acts, ch. 1070, s 4, eff. 1/1/2023.
Amended by 2022 Tenn. Acts, ch. 1070, s 3, eff. 1/1/2023.
Amended by 2016 Tenn. Acts, ch. 631, s 1, eff. 3/23/2016.
Amended by 2014 Tenn. Acts, ch. 857, s 1, eff. 1/1/2015.
Acts 2007 , ch. 224, § 1.
Tenn. Code Ann. § 56-30-124 — TN Code / Title 56 / Chapter 30 / Section 56-30-124
Review of order of commissioner - Writ of certiorari
Status: in_force

A review of any order made by the commissioner pursuant to this chapter may be had in the circuit court of Davidson County, upon a writ of certiorari. Application for the writ shall be made within thirty (30) days after the entry of the order by the commissioner. Acts 1961, ch. 340, § 23; T.C.A., § 56-3524.
A review of any order made by the commissioner pursuant to this chapter may be had in the circuit court of Davidson County, upon a writ of certiorari. Application for the writ shall be made within thirty (30) days after the entry of the order by the commissioner.
Acts 1961, ch. 340, § 23; T.C.A., § 56-3524.
Tenn. Code Ann. § 56-45-107 — TN Code / Title 56 / Chapter 45 / Section 56-45-107
Purchasing group and insurers subject to laws of this state - Exemptions
Status: in_force

A purchasing group and its insurer or insurers are subject to all applicable laws of this state, except that a purchasing group and its insurer or insurers are exempt, in regard to liability insurance for the purchasing group, from any law that would: (1) Prohibit the establishment of a purchasing group; (2) Make it unlawful for an insurer to provide or offer to provide insurance on a basis providing, to a purchasing group or its members, advantages based on their loss and expense experience not afforded to other persons with respect to rates, policy forms, coverages or other matters; (3) Prohibit a purchasing group or its members from purchasing insurance on a group basis described in subdivision (2); (4) Prohibit a purchasing group from obtaining insurance on a group basis because the group has not been in existence for a minimum period of time or because any member has not belonged to the group for a minimum period of time; (5) Require that a purchasing group have a minimum number of members, common ownership or affiliation, or certain legal form; (6) Require that a certain percentage of a purchasing group obtain insurance on a group basis; (7) Otherwise discriminate against a purchasing group or any of its members; or (8) Require that any insurance policy issued to a purchasing group or any of its members be countersigned by an insurance agent or broker residing in this state. Acts 1991, ch. 142, § 6.
A purchasing group and its insurer or insurers are subject to all applicable laws of this state, except that a purchasing group and its insurer or insurers are exempt, in regard to liability insurance for the purchasing group, from any law that would:
(1) Prohibit the establishment of a purchasing group;
(2) Make it unlawful for an insurer to provide or offer to provide insurance on a basis providing, to a purchasing group or its members, advantages based on their loss and expense experience not afforded to other persons with respect to rates, policy forms, coverages or other matters;
(3) Prohibit a purchasing group or its members from purchasing insurance on a group basis described in subdivision (2);
(4) Prohibit a purchasing group from obtaining insurance on a group basis because the group has not been in existence for a minimum period of time or because any member has not belonged to the group for a minimum period of time;
(5) Require that a purchasing group have a minimum number of members, common ownership or affiliation, or certain legal form;
(6) Require that a certain percentage of a purchasing group obtain insurance on a group basis;
(7) Otherwise discriminate against a purchasing group or any of its members; or
(8) Require that any insurance policy issued to a purchasing group or any of its members be countersigned by an insurance agent or broker residing in this state.
Acts 1991, ch. 142, § 6.
Tenn. Code Ann. § 56-8-201 — TN Code / Title 56 / Chapter 8 / Section 56-8-201
Short title
Status: in_force

This part shall be known and may be cited as the "Domestic Violence Victims Health Insurance Protection Act." Acts 1996, ch. 723, § 6.
This part shall be known and may be cited as the "Domestic Violence Victims Health Insurance Protection Act."
Acts 1996, ch. 723, § 6.
Tenn. Code Ann. § 56-32-125 — TN Code / Title 56 / Chapter 32 / Section 56-32-125
Confidentiality of information
Status: in_force

(a) Any data or information pertaining to the diagnosis, treatment or health of any enrollee or applicant obtained from the person or from any provider by any HMO shall be held in confidence by the HMO and shall not be disclosed by the HMO to any person, except upon any one (1) of the following circumstances: (1) To the extent that it may be necessary to carry out the purposes of this chapter; (2) Upon the express consent of the enrollee or applicant; (3) In the event of a claim or litigation between an enrollee or applicant and the HMO wherein the data or information is pertinent; (4) To implement the purposes of title 71, chapter 5; or (5) When the data or information is required to be disclosed by the authority of another statute. (b) Nothing in this section shall be construed to amend § 63-1-150 regarding confidentiality of records and statements relating to quality improvement committees of the HMO that shall remain privileged and not subject to subpoena or discovery. Amended by 2017 Tenn. Acts, ch. 4,s 3, eff. 3/15/2017. Acts 1986, ch. 713, § 26; T.C.A. § 56-32-225.
(a) Any data or information pertaining to the diagnosis, treatment or health of any enrollee or applicant obtained from the person or from any provider by any HMO shall be held in confidence by the HMO and shall not be disclosed by the HMO to any person, except upon any one (1) of the following circumstances: (1) To the extent that it may be necessary to carry out the purposes of this chapter; (2) Upon the express consent of the enrollee or applicant; (3) In the event of a claim or litigation between an enrollee or applicant and the HMO wherein the data or information is pertinent; (4) To implement the purposes of title 71, chapter 5; or (5) When the data or information is required to be disclosed by the authority of another statute.
(1) To the extent that it may be necessary to carry out the purposes of this chapter;
(2) Upon the express consent of the enrollee or applicant;
(3) In the event of a claim or litigation between an enrollee or applicant and the HMO wherein the data or information is pertinent;
(4) To implement the purposes of title 71, chapter 5; or
(5) When the data or information is required to be disclosed by the authority of another statute.
(b) Nothing in this section shall be construed to amend § 63-1-150 regarding confidentiality of records and statements relating to quality improvement committees of the HMO that shall remain privileged and not subject to subpoena or discovery.
Amended by 2017 Tenn. Acts, ch. 4,s 3, eff. 3/15/2017.
Acts 1986, ch. 713, § 26; T.C.A. § 56-32-225.
Tenn. Code Ann. § 56-29-107 — TN Code / Title 56 / Chapter 29 / Section 56-29-107
Application for license - Accompanying documents - Filing fee
Status: in_force

Application for the license shall be made on a form approved by the commissioner, containing such information as the commissioner deems necessary. Each application for the license shall be accompanied by copies of the following documents: (1) Certificate of incorporation; (2) Bylaws; (3) Proposed contracts between the corporation and participating hospital or hospitals showing terms under which hospital service is to be furnished to subscribers; (4) Contracts to be issued to subscribers showing a table of the rates to be charged and the benefits to which they are entitled, showing medical expense indemnity benefits expressed in terms of dollars and showing hospital service benefits expressed in service rather than in dollars; however, with equitable arrangements to protect the interests of subscribers when it becomes impossible for the service to be provided. The contracts should make clear that the ultimate responsibility for hospital service to subscribers rests with the member hospital or hospitals; and (5) A statement of its financial condition and business in such form and detail as the commissioner may require, including the amounts of contribution paid for working capital, and the name or names of each contributor and the terms of the contributions, signed and sworn to by its president and secretary or other proper officers, and shall pay for the filing of the statement the sum of thirty dollars ($30.00). Contributions not paid, but agreed to be paid, may be reported as a separate item, but shall not be admitted as assets of the corporation. Acts 1949, ch. 234, § 5; C. Supp. 1950, § 4186.47 (Williams, § 4186.50); T.C.A. (orig. ed.), § 56-3107.
Application for the license shall be made on a form approved by the commissioner, containing such information as the commissioner deems necessary. Each application for the license shall be accompanied by copies of the following documents:
(1) Certificate of incorporation;
(2) Bylaws;
(3) Proposed contracts between the corporation and participating hospital or hospitals showing terms under which hospital service is to be furnished to subscribers;
(4) Contracts to be issued to subscribers showing a table of the rates to be charged and the benefits to which they are entitled, showing medical expense indemnity benefits expressed in terms of dollars and showing hospital service benefits expressed in service rather than in dollars; however, with equitable arrangements to protect the interests of subscribers when it becomes impossible for the service to be provided. The contracts should make clear that the ultimate responsibility for hospital service to subscribers rests with the member hospital or hospitals; and
(5) A statement of its financial condition and business in such form and detail as the commissioner may require, including the amounts of contribution paid for working capital, and the name or names of each contributor and the terms of the contributions, signed and sworn to by its president and secretary or other proper officers, and shall pay for the filing of the statement the sum of thirty dollars ($30.00). Contributions not paid, but agreed to be paid, may be reported as a separate item, but shall not be admitted as assets of the corporation.
Acts 1949, ch. 234, § 5; C. Supp. 1950, § 4186.47 (Williams, § 4186.50); T.C.A. (orig. ed.), § 56-3107.
Tenn. Code Ann. § 56-6-912 — TN Code / Title 56 / Chapter 6 / Section 56-6-912
Continuing education - Exemptions
Status: in_force

(a) An individual, who holds a public adjuster license and who is not exempt under subsection (b), shall satisfactorily complete a minimum of twenty-four (24) hours of continuing education courses, including ethics, reported on a biennial basis in conjunction with the license renewal cycle. The education required by this section shall be in addition to any other continuing education requirements required for other professional licenses held by the individuals licensed under this part. (b) This section shall not apply to: (1) Licensees not licensed for one (1) full year prior to the end of the applicable continuing education biennium; or (2) Licensees holding nonresident public adjuster licenses who have met the continuing education requirements of their home state and whose home state gives credit to residents of this state on substantially the same basis. (c) Except as set forth in subsection (b), only continuing education courses approved by the commissioner shall be used to satisfy the continuing education requirement of subsection (a). Acts 2006, ch. 997, § 13.
(a) An individual, who holds a public adjuster license and who is not exempt under subsection (b), shall satisfactorily complete a minimum of twenty-four (24) hours of continuing education courses, including ethics, reported on a biennial basis in conjunction with the license renewal cycle. The education required by this section shall be in addition to any other continuing education requirements required for other professional licenses held by the individuals licensed under this part.
(b) This section shall not apply to: (1) Licensees not licensed for one (1) full year prior to the end of the applicable continuing education biennium; or (2) Licensees holding nonresident public adjuster licenses who have met the continuing education requirements of their home state and whose home state gives credit to residents of this state on substantially the same basis.
(1) Licensees not licensed for one (1) full year prior to the end of the applicable continuing education biennium; or
(2) Licensees holding nonresident public adjuster licenses who have met the continuing education requirements of their home state and whose home state gives credit to residents of this state on substantially the same basis.
(c) Except as set forth in subsection (b), only continuing education courses approved by the commissioner shall be used to satisfy the continuing education requirement of subsection (a).
Acts 2006, ch. 997, § 13.
Tenn. Code Ann. § 56-7-313 — TN Code / Title 56 / Chapter 7 / Section 56-7-313
Certain provisions as to defaulted policies, loans and reserves cannot be waived
Status: in_force

No agreement between the company and the policyholder or applicant for insurance shall be held to waive §§ 56-2-115 , 56-7-312 , 56-7-401 and 56-7-2309 . Acts 1907, ch. 454, § 4; Shan., § 3348a36; Code 1932, § 6211; Acts 1945, ch. 56, § 9; C. Supp. 1950, § 6211; T.C.A. (orig. ed.), § 56-1124.
No agreement between the company and the policyholder or applicant for insurance shall be held to waive §§ 56-2-115 , 56-7-312 , 56-7-401 and 56-7-2309 .
Acts 1907, ch. 454, § 4; Shan., § 3348a36; Code 1932, § 6211; Acts 1945, ch. 56, § 9; C. Supp. 1950, § 6211; T.C.A. (orig. ed.), § 56-1124.
Tenn. Code Ann. § 56-13-413 — TN Code / Title 56 / Chapter 13 / Section 56-13-413
No securities considered to be insurance or reinsurance contracts
Status: in_force

No securities issued by an SPFC pursuant to an insurance securitization shall be considered to be insurance or reinsurance contracts. No investor in these securities or a holder of these securities, by sole means of this investment or holding, shall be considered to be transacting the business of insurance in this state. The underwriter's placement or selling agents and their partners, directors, officers, members, managers, employees, agents, representatives, and advisors involved in an insurance securitization pursuant to this part shall not be considered to be insurance producers or brokers or conducting business as an insurance or reinsurance company or agency, brokerage, intermediary, advisory, or consulting business only by virtue of their activities in connection with an insurance securitization. Acts 2011, ch. 468, § 1.
No securities issued by an SPFC pursuant to an insurance securitization shall be considered to be insurance or reinsurance contracts. No investor in these securities or a holder of these securities, by sole means of this investment or holding, shall be considered to be transacting the business of insurance in this state. The underwriter's placement or selling agents and their partners, directors, officers, members, managers, employees, agents, representatives, and advisors involved in an insurance securitization pursuant to this part shall not be considered to be insurance producers or brokers or conducting business as an insurance or reinsurance company or agency, brokerage, intermediary, advisory, or consulting business only by virtue of their activities in connection with an insurance securitization.
Acts 2011, ch. 468, § 1.
Tenn. Code Ann. § 56-4-104 — TN Code / Title 56 / Chapter 4 / Section 56-4-104
Receipt of illegal fees - Issuance of fraudulent certificate - Penalty
Status: in_force

If the commissioner exacts or receives, either directly or indirectly, any sum of money from any insurance company doing business in this state other than the fees allowed by law, or willfully issues a fraudulent or false certificate of soundness to the company; or, directly or indirectly, receives any money or other valuable thing for doing or not doing any official act as commissioner, other than the fees allowed by law, the commissioner commits a Class E felony. Acts 1873, ch. 58, § 17; Shan., § 3345; Code 1932, § 6170; T.C.A. (orig. ed.), § 56-404; Acts 1989, ch. 591, §§ 1,6.
If the commissioner exacts or receives, either directly or indirectly, any sum of money from any insurance company doing business in this state other than the fees allowed by law, or willfully issues a fraudulent or false certificate of soundness to the company; or, directly or indirectly, receives any money or other valuable thing for doing or not doing any official act as commissioner, other than the fees allowed by law, the commissioner commits a Class E felony.
Acts 1873, ch. 58, § 17; Shan., § 3345; Code 1932, § 6170; T.C.A. (orig. ed.), § 56-404; Acts 1989, ch. 591, §§ 1,6.
Tenn. Code Ann. § 56-16-205 — TN Code / Title 56 / Chapter 16 / Section 56-16-205
Subscriber's agreement and power of attorney - Modification
Status: in_force

Modification of the terms of the power of attorney and subscriber's agreement of a domestic reciprocal shall be made jointly by the attorney and the board of directors. The modification shall be filed with the attorney and the department, and the filing shall by operation of law bind all subscribers the same as if each subscriber individually adopted and executed the modified, altered or amended subscriber's agreement and power of attorney. No modification shall be effective retroactively, nor shall it affect any insurance contract issued prior to the modification. Acts 1990, ch. 728, § 2; T.C.A. § 56-16-305.
Modification of the terms of the power of attorney and subscriber's agreement of a domestic reciprocal shall be made jointly by the attorney and the board of directors. The modification shall be filed with the attorney and the department, and the filing shall by operation of law bind all subscribers the same as if each subscriber individually adopted and executed the modified, altered or amended subscriber's agreement and power of attorney. No modification shall be effective retroactively, nor shall it affect any insurance contract issued prior to the modification.
Acts 1990, ch. 728, § 2; T.C.A. § 56-16-305.
Tenn. Code Ann. § 56-25-610 — TN Code / Title 56 / Chapter 25 / Section 56-25-610
Unfair competition and unfair or deceptive practices
Status: in_force

Every society authorized to do business in this state is subject to chapter 8 of this title relating to unfair methods of competition and unfair or deceptive acts or practices. Nothing in those provisions shall be construed as applying to or affecting the right of any society to determine its eligibility requirements for membership, or be construed as applying to or affecting the offering of benefits exclusively to members or persons eligible for membership in the society by a subsidiary corporation or affiliated organization of the society. Acts 1990, ch. 703, § 1.
Every society authorized to do business in this state is subject to chapter 8 of this title relating to unfair methods of competition and unfair or deceptive acts or practices. Nothing in those provisions shall be construed as applying to or affecting the right of any society to determine its eligibility requirements for membership, or be construed as applying to or affecting the offering of benefits exclusively to members or persons eligible for membership in the society by a subsidiary corporation or affiliated organization of the society.
Acts 1990, ch. 703, § 1.
Tenn. Code Ann. § 56-7-3104 — TN Code / Title 56 / Chapter 7 / Section 56-7-3104
Calculation of reimbursement of pharmacy benefits manager
Status: in_force

(a) Reimbursement by a pharmacy benefits manager under a contract to a pharmacist or pharmacy for prescription drugs and other products and supplies that is calculated according to a formula that uses a nationally recognized reference in the pricing calculation shall use the most current nationally recognized reference price or amount in the actual or constructive possession of the pharmacy benefits manager or its agent. (b) For purposes of compliance with this section, pharmacy benefits managers shall be required to update the nationally recognized reference prices or amounts used for calculation of reimbursement for prescription drugs and other products and supplies no less than every three (3) business days. Acts 2007, ch. 224, § 1.
(a) Reimbursement by a pharmacy benefits manager under a contract to a pharmacist or pharmacy for prescription drugs and other products and supplies that is calculated according to a formula that uses a nationally recognized reference in the pricing calculation shall use the most current nationally recognized reference price or amount in the actual or constructive possession of the pharmacy benefits manager or its agent.
(b) For purposes of compliance with this section, pharmacy benefits managers shall be required to update the nationally recognized reference prices or amounts used for calculation of reimbursement for prescription drugs and other products and supplies no less than every three (3) business days.
Acts 2007, ch. 224, § 1.
Tenn. Code Ann. § 56-7-1802 — TN Code / Title 56 / Chapter 7 / Section 56-7-1802
Part definitions
Status: in_force

As used in this part, unless the context otherwise requires: (1) (A) "Commercial risk insurance" means insurance within the scope of this part that is not "personal risk insurance," as defined in § 56-5-102 , and subject to the exclusions set out in § 56-5-101 ; and (B) "Commercial risk insurance" does not include fidelity and surety bonds, or insurance written by a surplus lines insurer; and (2) "Nonpayment of premium" means failure of the named insured to discharge when due any of its obligations in connection with the payment of premiums on a policy of commercial risk insurance or any installment of the premium, whether the premium is payable directly to the insurer or its agents or indirectly under any premium finance plan or extension of credit. Acts 1986, ch. 656, § 2; 1987, ch. 274, § 1; 1991, ch. 102, § 1.
As used in this part, unless the context otherwise requires:
(1) (A) "Commercial risk insurance" means insurance within the scope of this part that is not "personal risk insurance," as defined in § 56-5-102 , and subject to the exclusions set out in § 56-5-101 ; and (B) "Commercial risk insurance" does not include fidelity and surety bonds, or insurance written by a surplus lines insurer; and
(A) "Commercial risk insurance" means insurance within the scope of this part that is not "personal risk insurance," as defined in § 56-5-102 , and subject to the exclusions set out in § 56-5-101 ; and
(B) "Commercial risk insurance" does not include fidelity and surety bonds, or insurance written by a surplus lines insurer; and
(2) "Nonpayment of premium" means failure of the named insured to discharge when due any of its obligations in connection with the payment of premiums on a policy of commercial risk insurance or any installment of the premium, whether the premium is payable directly to the insurer or its agents or indirectly under any premium finance plan or extension of credit.
Acts 1986, ch. 656, § 2; 1987, ch. 274, § 1; 1991, ch. 102, § 1.
Tenn. Code Ann. § 56-7-1108 — TN Code / Title 56 / Chapter 7 / Section 56-7-1108
Personal automobile insurance of municipal, county, and state employees
Status: in_force

Whenever a full-time employee of municipal, county, or state government is involved in a traffic accident while acting as the agent of the governmental employer and while operating a motor vehicle owned by the governmental employer, the accident shall in no way be considered by the employee's personal automobile insurance carrier in fixing insurance premiums, nor shall it cause any increase in the employee's personal automobile insurance premiums. Acts 1983, ch. 195, § 1.
Whenever a full-time employee of municipal, county, or state government is involved in a traffic accident while acting as the agent of the governmental employer and while operating a motor vehicle owned by the governmental employer, the accident shall in no way be considered by the employee's personal automobile insurance carrier in fixing insurance premiums, nor shall it cause any increase in the employee's personal automobile insurance premiums.
Acts 1983, ch. 195, § 1.
Tenn. Code Ann. § 56-7-107 — TN Code / Title 56 / Chapter 7 / Section 56-7-107
Suit on certificate issued under group insurance policy - Copy of policy attached to defendant's answer
Status: in_force

In any action against an insurance company by the holder of a certificate issued under a policy of group insurance, the defendant shall be required to attach to its pleading in the action a copy of a group insurance policy under which the certificate was issued, on which suit is brought, and the copy shall be receivable in evidence, without any cost to plaintiff, and the copy shall be duly attested and sworn to. Acts 1933, ch. 99, § 1; C. Supp. 1950, § 6435.1; T.C.A. (orig. ed.), § 56-1107.
In any action against an insurance company by the holder of a certificate issued under a policy of group insurance, the defendant shall be required to attach to its pleading in the action a copy of a group insurance policy under which the certificate was issued, on which suit is brought, and the copy shall be receivable in evidence, without any cost to plaintiff, and the copy shall be duly attested and sworn to.
Acts 1933, ch. 99, § 1; C. Supp. 1950, § 6435.1; T.C.A. (orig. ed.), § 56-1107.
Tenn. Code Ann. § 56-9-108 — TN Code / Title 56 / Chapter 9 / Section 56-9-108
Insurers subject to delinquency proceedings - Restrictions
Status: in_force

No insurer that is subject to any delinquency proceedings, whether formal or informal, administrative or judicial, shall: (1) Be released from the proceeding, unless the proceeding is converted into a judicial rehabilitation or liquidation proceeding; (2) Be permitted to solicit or accept new business or request or accept the restoration of any suspended or revoked license or certificate of authority; (3) Be returned to the control of its shareholders or private management; or (4) Have any of its assets returned to the control of its shareholders or private management until all payments of, or on account of, the insurer's contractual obligations by all guaranty associations, together with all expenses and interest on all the payments and expenses, have been repaid to the guaranty associations or a plan of repayment by the insurer has been approved by the guaranty association. Acts 1991, ch. 142, § 4.
No insurer that is subject to any delinquency proceedings, whether formal or informal, administrative or judicial, shall:
(1) Be released from the proceeding, unless the proceeding is converted into a judicial rehabilitation or liquidation proceeding;
(2) Be permitted to solicit or accept new business or request or accept the restoration of any suspended or revoked license or certificate of authority;
(3) Be returned to the control of its shareholders or private management; or
(4) Have any of its assets returned to the control of its shareholders or private management until all payments of, or on account of, the insurer's contractual obligations by all guaranty associations, together with all expenses and interest on all the payments and expenses, have been repaid to the guaranty associations or a plan of repayment by the insurer has been approved by the guaranty association.
Acts 1991, ch. 142, § 4.
Tenn. Code Ann. § 56-7-2321 — TN Code / Title 56 / Chapter 7 / Section 56-7-2321
Provision of group coverage in lieu of converted individual coverage
Status: in_force

The insurer may elect to provide group insurance coverage in lieu of the issuance of a converted individual policy. Acts 1980, ch. 537, § 1; 1992, ch. 984, § 1; T.C.A., § 56-7-1510.
The insurer may elect to provide group insurance coverage in lieu of the issuance of a converted individual policy.
Acts 1980, ch. 537, § 1; 1992, ch. 984, § 1; T.C.A., § 56-7-1510.
Tenn. Code Ann. § 56-51-105 — TN Code / Title 56 / Chapter 51 / Section 56-51-105
Certificate of authority required - Ambulance service plans - Exceptions
Status: in_force

(a) A person, corporation, partnership, or other entity may not operate a prepaid limited health service organization in this state without obtaining and maintaining a certificate of authority from the department pursuant to this chapter. (b) A political subdivision of this state that is operating an emergency medical services system and offers a prepaid ambulance service plan as a part of its emergency medical services system shall be exempt from this chapter and all other provisions of this title. (c) An insurer, while authorized to transact health insurance in this state, or a health maintenance organization possessing a valid certificate of authority in this state, or a duly licensed medical and hospital service corporation may also provide services under this chapter without additional qualification or authority, but shall be otherwise subject to the applicable provisions of this chapter. Acts 2000, ch. 948, § 5.
(a) A person, corporation, partnership, or other entity may not operate a prepaid limited health service organization in this state without obtaining and maintaining a certificate of authority from the department pursuant to this chapter.
(b) A political subdivision of this state that is operating an emergency medical services system and offers a prepaid ambulance service plan as a part of its emergency medical services system shall be exempt from this chapter and all other provisions of this title.
(c) An insurer, while authorized to transact health insurance in this state, or a health maintenance organization possessing a valid certificate of authority in this state, or a duly licensed medical and hospital service corporation may also provide services under this chapter without additional qualification or authority, but shall be otherwise subject to the applicable provisions of this chapter.
Acts 2000, ch. 948, § 5.
Tenn. Code Ann. § 56-7-1115 — TN Code / Title 56 / Chapter 7 / Section 56-7-1115
Automobile glass replacement or repair - Payment of claims
Status: in_force

(a) Any insurance company processing a claim submitted on behalf of an insured by a person who is engaged in automobile glass replacement or glass repair services or the provision of automobile glass products to whom the insured has assigned benefits under an insurance policy may refuse payment of any claim which involves an unfair, deceptive and/or fraudulent practice as provided in §§ 56-7-1113 - 56-7-1116. (b) When there is reason to believe the practices may have occurred, insurance companies may require verified proof that the insured has, in fact, fully incurred and paid any deductible and/or co-payment required under the insurance policy. Acts 2000, ch. 650, § 1.
(a) Any insurance company processing a claim submitted on behalf of an insured by a person who is engaged in automobile glass replacement or glass repair services or the provision of automobile glass products to whom the insured has assigned benefits under an insurance policy may refuse payment of any claim which involves an unfair, deceptive and/or fraudulent practice as provided in §§ 56-7-1113 - 56-7-1116.
(b) When there is reason to believe the practices may have occurred, insurance companies may require verified proof that the insured has, in fact, fully incurred and paid any deductible and/or co-payment required under the insurance policy.
Acts 2000, ch. 650, § 1.
Tenn. Code Ann. § 56-7-3207 — TN Code / Title 56 / Chapter 7 / Section 56-7-3207
Report of benefit percentage
Status: in_force

A pharmacy benefits manager has a responsibility to report to the plan and the patient any benefit percentage that either are entitled to as a benefit as a covered person. Added by 2021 Tenn. Acts, ch. 569,s 4, eff. 7/1/2021.
A pharmacy benefits manager has a responsibility to report to the plan and the patient any benefit percentage that either are entitled to as a benefit as a covered person.
Added by 2021 Tenn. Acts, ch. 569,s 4, eff. 7/1/2021.
Tenn. Code Ann. § 56-10-102 — TN Code / Title 56 / Chapter 10 / Section 56-10-102
Procedure for merger, consolidation or exchange of stock
Status: in_force

The constituent insurance companies may adopt a plan of merger or consolidation, or the domestic insurance company and the acquiring corporation may adopt a plan of exchange of stock, as provided in §§ 56-10-103 - 56-10-106. Acts 1968, ch. 448, § 2; T.C.A., § 56-3602.
The constituent insurance companies may adopt a plan of merger or consolidation, or the domestic insurance company and the acquiring corporation may adopt a plan of exchange of stock, as provided in §§ 56-10-103 - 56-10-106.
Acts 1968, ch. 448, § 2; T.C.A., § 56-3602.
Tenn. Code Ann. § 56-7-2367 — TN Code / Title 56 / Chapter 7 / Section 56-7-2367
Autism spectrum disorders
Status: in_force

(a) As used in this section, "autism spectrum disorders" means neurological disorders, usually appearing in the first three (3) years of a person's life, that affect normal brain functions and are typically manifested by impairments in communication and social interaction, as well as restrictive, repetitive, and stereotyped behaviors. (b) A contract or policy of an insurer that provides benefits for neurological disorders, whether under an individual or group health insurance policy providing coverage on an expense-incurred basis, an individual or group service contract issued by a health maintenance organization, a self-insured group arrangement to the extent not preempted by federal law or a managed health care delivery entity of any type or description shall provide benefits and coverage for treatment of autism spectrum disorders that are at least as comprehensive as those provided for other neurological disorders. These benefits and coverage for treatment shall be provided to any person less than twelve (12) years of age. (c) Benefits provided for treatment of autism spectrum disorders shall be subject to deductible and copayment requirements and benefit limits that are no more stringent than those established for the treatment of other neurological disorders. (d) An insurer that provides benefits for neurological disorders shall not refuse to renew policies, reissue policies, or otherwise terminate or restrict services to a person solely because the person is diagnosed with an autism spectrum disorder. (e) This section shall not expand the type or scope of treatment beyond that authorized for any other diagnosed neurological disorder and shall be effective upon any contract, policy, or plan that is delivered, issued for delivery, amended or renewed on or after January 1, 2007. (f) Nothing in this section shall apply to accident-only, specified disease, hospital indemnity, medicare supplement, long-term care, or other limited benefit hospital insurance policies. Acts 2006, ch. 894, § 1.
(a) As used in this section, "autism spectrum disorders" means neurological disorders, usually appearing in the first three (3) years of a person's life, that affect normal brain functions and are typically manifested by impairments in communication and social interaction, as well as restrictive, repetitive, and stereotyped behaviors.
(b) A contract or policy of an insurer that provides benefits for neurological disorders, whether under an individual or group health insurance policy providing coverage on an expense-incurred basis, an individual or group service contract issued by a health maintenance organization, a self-insured group arrangement to the extent not preempted by federal law or a managed health care delivery entity of any type or description shall provide benefits and coverage for treatment of autism spectrum disorders that are at least as comprehensive as those provided for other neurological disorders. These benefits and coverage for treatment shall be provided to any person less than twelve (12) years of age.
(c) Benefits provided for treatment of autism spectrum disorders shall be subject to deductible and copayment requirements and benefit limits that are no more stringent than those established for the treatment of other neurological disorders.
(d) An insurer that provides benefits for neurological disorders shall not refuse to renew policies, reissue policies, or otherwise terminate or restrict services to a person solely because the person is diagnosed with an autism spectrum disorder.
(e) This section shall not expand the type or scope of treatment beyond that authorized for any other diagnosed neurological disorder and shall be effective upon any contract, policy, or plan that is delivered, issued for delivery, amended or renewed on or after January 1, 2007.
(f) Nothing in this section shall apply to accident-only, specified disease, hospital indemnity, medicare supplement, long-term care, or other limited benefit hospital insurance policies.
Acts 2006, ch. 894, § 1.
Tenn. Code Ann. § 56-3-509 — TN Code / Title 56 / Chapter 3 / Section 56-3-509
Separate accounts - Insurance laws applicable - Required provisions of variable life agreements
Status: in_force

Except for §§ 56-7-401 , 56-7-2307(2), (7), (10) and (12) , and 56-7-2309 , and except as otherwise provided in this part, all pertinent provisions of the insurance laws of this state apply to separate accounts and agreements issued in connection with the accounts. Any individual variable life insurance agreement delivered or issued for delivery in this state shall contain grace, reinstatement and nonforfeiture provisions appropriate to the agreement. The reserve liability for variable benefits shall be established in accordance with actuarial procedures that recognize the variable nature of the benefits provided and any mortality guarantees. Acts 1967, ch. 353, § 9; T.C.A., § 56-266; Acts 1970, ch. 493, § 3; T.C.A., § 56-320.
Except for §§ 56-7-401 , 56-7-2307(2), (7), (10) and (12) , and 56-7-2309 , and except as otherwise provided in this part, all pertinent provisions of the insurance laws of this state apply to separate accounts and agreements issued in connection with the accounts. Any individual variable life insurance agreement delivered or issued for delivery in this state shall contain grace, reinstatement and nonforfeiture provisions appropriate to the agreement. The reserve liability for variable benefits shall be established in accordance with actuarial procedures that recognize the variable nature of the benefits provided and any mortality guarantees.
Acts 1967, ch. 353, § 9; T.C.A., § 56-266; Acts 1970, ch. 493, § 3; T.C.A., § 56-320.
Tenn. Code Ann. § 56-7-801 — TN Code / Title 56 / Chapter 7 / Section 56-7-801
Inspection of property insured against fire - No insurance exceeding fair value of property
Status: in_force

(a) Within ninety (90) days after making or writing any contract of fire insurance on any building or structure in this state, the company, its designee or agent, shall cause the building or structure to be inspected. (b) No company, agent or insurance producer shall knowingly issue, negotiate, continue or renew, or cause or permit to be issued, negotiated, continued or renewed any fire insurance policy upon property or interests in the property within this state of an amount that, with any existing insurance on the property, exceeds the fair value of the property. Amended by 2014 Tenn. Acts, ch. 652,s 1, eff. 4/8/2014. Acts 1927, ch. 72, § 1; mod. Code 1932, § 6172; T.C.A. (orig. ed.), § 56-1137.
(a) Within ninety (90) days after making or writing any contract of fire insurance on any building or structure in this state, the company, its designee or agent, shall cause the building or structure to be inspected.
(b) No company, agent or insurance producer shall knowingly issue, negotiate, continue or renew, or cause or permit to be issued, negotiated, continued or renewed any fire insurance policy upon property or interests in the property within this state of an amount that, with any existing insurance on the property, exceeds the fair value of the property.
Amended by 2014 Tenn. Acts, ch. 652,s 1, eff. 4/8/2014.
Acts 1927, ch. 72, § 1; mod. Code 1932, § 6172; T.C.A. (orig. ed.), § 56-1137.
Tenn. Code Ann. § 56-16-107 — TN Code / Title 56 / Chapter 16 / Section 56-16-107
License required
Status: in_force

No reciprocal shall engage in any insurance transaction in this state until it has obtained a license to do so in accordance with the applicable provisions of chapter 2, part 1 of this title. Acts 1990, ch. 728, § 2; T.C.A. § 56-16-207 .
No reciprocal shall engage in any insurance transaction in this state until it has obtained a license to do so in accordance with the applicable provisions of chapter 2, part 1 of this title.
Acts 1990, ch. 728, § 2; T.C.A. § 56-16-207 .
Tenn. Code Ann. § 56-7-3106 — TN Code / Title 56 / Chapter 7 / Section 56-7-3106
Placement of drug on maximum allowable cost list
Status: in_force

(a) Before a pharmacy benefits manager or covered entity may place a drug on a maximum allowable cost list, the pharmacy benefits manager or covered entity must find that the drug is generally available for purchase by pharmacies in this state from a national or regional wholesaler. (b) If a drug that has been placed on a maximum allowable cost list no longer meets the requirements of subsection (a), the drug shall be removed from the maximum allowable cost list by the pharmacy benefits manager or covered entity within five (5) business days after the date that the pharmacy benefits manager or covered entity becomes aware that the drug no longer meets the requirements of subsection (a). (c) Nothing in this part shall be construed as preventing a pharmacy benefits manager or covered entity from reimbursing claims for a generic drug at the previously determined maximum allowable cost even if the pharmacy benefits manager or covered entity reimburses for the equivalent brand name drug at the contracted brand rate after confirmation by a national or regional wholesaler and by the manufacturer that the generic drug is generally unavailable for purchase from a national or regional wholesaler. Added by 2014 Tenn. Acts, ch. 857,s 2, eff. 1/1/2015.
(a) Before a pharmacy benefits manager or covered entity may place a drug on a maximum allowable cost list, the pharmacy benefits manager or covered entity must find that the drug is generally available for purchase by pharmacies in this state from a national or regional wholesaler.
(b) If a drug that has been placed on a maximum allowable cost list no longer meets the requirements of subsection (a), the drug shall be removed from the maximum allowable cost list by the pharmacy benefits manager or covered entity within five (5) business days after the date that the pharmacy benefits manager or covered entity becomes aware that the drug no longer meets the requirements of subsection (a).
(c) Nothing in this part shall be construed as preventing a pharmacy benefits manager or covered entity from reimbursing claims for a generic drug at the previously determined maximum allowable cost even if the pharmacy benefits manager or covered entity reimburses for the equivalent brand name drug at the contracted brand rate after confirmation by a national or regional wholesaler and by the manufacturer that the generic drug is generally unavailable for purchase from a national or regional wholesaler.
Added by 2014 Tenn. Acts, ch. 857,s 2, eff. 1/1/2015.
Tenn. Code Ann. § 56-36-102 — TN Code / Title 56 / Chapter 36 / Section 56-36-102
Applicability
Status: in_force

This chapter does not apply to any reinsurance, group annuity purchased under a retirement plan or plan of deferred compensation established or maintained by an employer, including a partnership or sole proprietorship, or by an employee organization, or by both, other than a plan providing individual retirement accounts or individual retirement annuities under the Internal Revenue Code, § 408 ( 26 U.S.C. § 408 ), premium deposit fund, variable annuity, investment annuity, immediate annuity, any deferred annuity contract after annuity payments have commenced or reversionary annuity, nor to any contract that shall be delivered outside this state through an agent or other representative of the company issuing the contract. Acts 1978, ch. 590, § 2; T.C.A., § 56-4602.
This chapter does not apply to any reinsurance, group annuity purchased under a retirement plan or plan of deferred compensation established or maintained by an employer, including a partnership or sole proprietorship, or by an employee organization, or by both, other than a plan providing individual retirement accounts or individual retirement annuities under the Internal Revenue Code, § 408 ( 26 U.S.C. § 408 ), premium deposit fund, variable annuity, investment annuity, immediate annuity, any deferred annuity contract after annuity payments have commenced or reversionary annuity, nor to any contract that shall be delivered outside this state through an agent or other representative of the company issuing the contract.
Acts 1978, ch. 590, § 2; T.C.A., § 56-4602.
Tenn. Code Ann. § 56-13-411 — TN Code / Title 56 / Chapter 13 / Section 56-13-411
Asset management agreements
Status: in_force

An SPFC may enter into swap agreements, or other forms of asset management agreements, including guaranteed investment contracts, or other transactions that have the objective of leveling timing differences in funding of up-front or ongoing transaction expenses or managing asset, credit, or interest rate risk of the investments to ensure that the investments are sufficient to assure payment or repayment of the securities, and related interest or principal payments, issued pursuant to an SPFC insurance securitization transaction or the obligations of the SPFC under the SPFC contract. Acts 2011, ch. 468, § 1.
An SPFC may enter into swap agreements, or other forms of asset management agreements, including guaranteed investment contracts, or other transactions that have the objective of leveling timing differences in funding of up-front or ongoing transaction expenses or managing asset, credit, or interest rate risk of the investments to ensure that the investments are sufficient to assure payment or repayment of the securities, and related interest or principal payments, issued pursuant to an SPFC insurance securitization transaction or the obligations of the SPFC under the SPFC contract.
Acts 2011, ch. 468, § 1.
Tenn. Code Ann. § 56-37-101 — TN Code / Title 56 / Chapter 37 / Section 56-37-101
Short title
Status: in_force

This chapter shall be known and may be cited as the "Premium Finance Company Act of 1980." Acts 1980, ch. 920, § 1.
This chapter shall be known and may be cited as the "Premium Finance Company Act of 1980."
Acts 1980, ch. 920, § 1.
Tenn. Code Ann. § 56-2-207 — TN Code / Title 56 / Chapter 2 / Section 56-2-207
Reinsurance contracts - Liability of ceding and assuming insurers
Status: in_force

(a) (1) Every insurer authorized to do an insurance, surety or bonding business in this state, called the "ceding insurer" in this title, may, subject to the limitations of this section, reinsure its risks and policy liabilities in any other insurer, called the "assuming insurer" in this title, with the effects prescribed in this section; but no prohibition or limitation contained in this section shall invalidate the contract or reinsurance as between the parties. (2) No credit shall be allowed, as an admitted asset or as a deduction from liability, to any ceding insurer for reinsurance made, ceded, renewed, or otherwise becoming effective after June 12, 1947, unless the reinsurance is payable by the assuming insurer on the basis of the liability of the ceding insurer under the contract or contracts reinsured without diminution, because of the insolvency of the ceding insurer nor unless, under the contract or contracts of reinsurance, the liability for the reinsurance is assumed by the assuming insurer or insurers as of the same effective date. (3) The reinsurance agreement may provide that the liquidator or receiver or statutory successor of an insolvent ceding insurer shall give written notice of the pendency of a claim against the insolvent ceding insurer on the policy or bond reinsured, within a reasonable time after the claim is filed in the insolvency proceeding and that during the pendency of the claim, any assuming insurer may investigate the claim and interpose, at its own expense, in the proceeding where the claim is to be adjudicated, any defense or defenses that it may deem available to the ceding company or its liquidator or receiver or statutory successor. (4) The expense thus incurred by the assuming insurer shall be chargeable, subject to court approval, against the insolvent ceding insurer as part of the expense of liquidation to the extent of a proportionate share of the benefit, which may accrue to the ceding insurer, solely as a result of the defense undertaken by the assuming insurer. (b) Where two (2) or more assuming insurers are involved in the same claim and a majority in interest elect to interpose defense to the claim, the expense shall be apportioned in accordance with the terms of the reinsurance agreement, as though the expense had been incurred by the ceding company. (c) Notwithstanding anything in this section to the contrary, a risk retention group may not reinsure its risks in another risk retention group unless all of the members of the ceding risk retention group are eligible for membership in the assuming risk retention group. Amended by 2014 Tenn. Acts, ch. 559,s 8, eff. 3/21/2014. Acts 1947, ch. 154, § 1; C. Supp. 1950, § 6105.1 (Williams, § 6459.70); T.C.A. (orig. ed.), §§ 56-211, 56-225.
(a) (1) Every insurer authorized to do an insurance, surety or bonding business in this state, called the "ceding insurer" in this title, may, subject to the limitations of this section, reinsure its risks and policy liabilities in any other insurer, called the "assuming insurer" in this title, with the effects prescribed in this section; but no prohibition or limitation contained in this section shall invalidate the contract or reinsurance as between the parties. (2) No credit shall be allowed, as an admitted asset or as a deduction from liability, to any ceding insurer for reinsurance made, ceded, renewed, or otherwise becoming effective after June 12, 1947, unless the reinsurance is payable by the assuming insurer on the basis of the liability of the ceding insurer under the contract or contracts reinsured without diminution, because of the insolvency of the ceding insurer nor unless, under the contract or contracts of reinsurance, the liability for the reinsurance is assumed by the assuming insurer or insurers as of the same effective date. (3) The reinsurance agreement may provide that the liquidator or receiver or statutory successor of an insolvent ceding insurer shall give written notice of the pendency of a claim against the insolvent ceding insurer on the policy or bond reinsured, within a reasonable time after the claim is filed in the insolvency proceeding and that during the pendency of the claim, any assuming insurer may investigate the claim and interpose, at its own expense, in the proceeding where the claim is to be adjudicated, any defense or defenses that it may deem available to the ceding company or its liquidator or receiver or statutory successor. (4) The expense thus incurred by the assuming insurer shall be chargeable, subject to court approval, against the insolvent ceding insurer as part of the expense of liquidation to the extent of a proportionate share of the benefit, which may accrue to the ceding insurer, solely as a result of the defense undertaken by the assuming insurer.
(1) Every insurer authorized to do an insurance, surety or bonding business in this state, called the "ceding insurer" in this title, may, subject to the limitations of this section, reinsure its risks and policy liabilities in any other insurer, called the "assuming insurer" in this title, with the effects prescribed in this section; but no prohibition or limitation contained in this section shall invalidate the contract or reinsurance as between the parties.
(2) No credit shall be allowed, as an admitted asset or as a deduction from liability, to any ceding insurer for reinsurance made, ceded, renewed, or otherwise becoming effective after June 12, 1947, unless the reinsurance is payable by the assuming insurer on the basis of the liability of the ceding insurer under the contract or contracts reinsured without diminution, because of the insolvency of the ceding insurer nor unless, under the contract or contracts of reinsurance, the liability for the reinsurance is assumed by the assuming insurer or insurers as of the same effective date.
(3) The reinsurance agreement may provide that the liquidator or receiver or statutory successor of an insolvent ceding insurer shall give written notice of the pendency of a claim against the insolvent ceding insurer on the policy or bond reinsured, within a reasonable time after the claim is filed in the insolvency proceeding and that during the pendency of the claim, any assuming insurer may investigate the claim and interpose, at its own expense, in the proceeding where the claim is to be adjudicated, any defense or defenses that it may deem available to the ceding company or its liquidator or receiver or statutory successor.
(4) The expense thus incurred by the assuming insurer shall be chargeable, subject to court approval, against the insolvent ceding insurer as part of the expense of liquidation to the extent of a proportionate share of the benefit, which may accrue to the ceding insurer, solely as a result of the defense undertaken by the assuming insurer.
(b) Where two (2) or more assuming insurers are involved in the same claim and a majority in interest elect to interpose defense to the claim, the expense shall be apportioned in accordance with the terms of the reinsurance agreement, as though the expense had been incurred by the ceding company.
(c) Notwithstanding anything in this section to the contrary, a risk retention group may not reinsure its risks in another risk retention group unless all of the members of the ceding risk retention group are eligible for membership in the assuming risk retention group.
Amended by 2014 Tenn. Acts, ch. 559,s 8, eff. 3/21/2014.
Acts 1947, ch. 154, § 1; C. Supp. 1950, § 6105.1 (Williams, § 6459.70); T.C.A. (orig. ed.), §§ 56-211, 56-225.
Tenn. Code Ann. § 56-14-115 — TN Code / Title 56 / Chapter 14 / Section 56-14-115
Commissions
Status: in_force

Agents licensed in accordance with this chapter shall not pay the whole or any part of the commission on surplus lines insurance to any person, except that the commissions may be shared or divided with any other person licensed by the commissioner as a surplus lines agent or licensed pursuant to chapter 6 of this title. Amended by 2018 Tenn. Acts, ch. 580,s 3, eff. 3/16/2018. Acts 1969, ch. 270, § 15; T.C.A., § 56-3815; Acts 2011, ch. 446, § 1.
Agents licensed in accordance with this chapter shall not pay the whole or any part of the commission on surplus lines insurance to any person, except that the commissions may be shared or divided with any other person licensed by the commissioner as a surplus lines agent or licensed pursuant to chapter 6 of this title.
Amended by 2018 Tenn. Acts, ch. 580,s 3, eff. 3/16/2018.
Acts 1969, ch. 270, § 15; T.C.A., § 56-3815; Acts 2011, ch. 446, § 1.
Tenn. Code Ann. § 56-6-801 — TN Code / Title 56 / Chapter 6 / Section 56-6-801
Short title
Status: in_force

This part shall be known and may be cited as the "Reinsurance Intermediary Act." Acts 1993, ch. 253, § 9.
This part shall be known and may be cited as the "Reinsurance Intermediary Act."
Acts 1993, ch. 253, § 9.
Tenn. Code Ann. § 56-25-608 — TN Code / Title 56 / Chapter 25 / Section 56-25-608
Injunctions
Status: in_force

No application or petition for injunction against any domestic, foreign or alien society, or lodge thereof, shall be recognized in any court of this state unless made by the attorney general and reporter upon request of the commissioner. Acts 1990, ch. 703, § 1.
No application or petition for injunction against any domestic, foreign or alien society, or lodge thereof, shall be recognized in any court of this state unless made by the attorney general and reporter upon request of the commissioner.
Acts 1990, ch. 703, § 1.
Tenn. Code Ann. § 56-41-107 — TN Code / Title 56 / Chapter 41 / Section 56-41-107
Plan of operation - Methods regarding risks, rates, claims and coverage - Premiums - Deficits
Status: in_force

(a) The plan of operation shall provide for the method of underwriting and classifying risks, making and filing rates, adjusting and processing claims, and any other insurance or investment function that is necessary for the purpose of providing essential insurance coverage. (b) All policies issued by the association shall be subject to a nonprofit group retrospective rating plan to be approved by the commissioner, under which the final premium for all policyholders of the association, as a group, will be equal to the administrative expenses, loss and loss adjustment expenses, plus a reasonable allowance for contingencies and servicing. Policyholders shall be given full credit for all investment income, net of expenses and a reasonable management fee on policyholder supplied funds. Any additional premium resulting from a retrospective adjustment will first be collected from the stabilization fund set forth in § 56-41-108 . If these funds are insufficient to pay the entire amount due, the balance will be recouped through surcharges upon policyholders in accordance with a procedure approved by the commissioner. (c) In providing for the recoupment of deficits that may be incurred by the association, an option shall be offered to an insured each policy year to pay a capital stabilization charge that shall not exceed one hundred percent (100%) of the premium charged to the insurer in that year. The commissioner shall determine the amount of the charge from the appropriate factors of loss experience and risks associated with the plan of operation and the insurer. An insured who pays the stabilization charge shall not be required to pay any assessment to recoup a deficit in the plan incurred in any policy year for which the charge is paid. The plan of operation shall provide for the return to the insured so much of the insured's payment as remains after all actual or potential liabilities under the policy have been discharged. Acts 1987, ch. 439, § 6.
(a) The plan of operation shall provide for the method of underwriting and classifying risks, making and filing rates, adjusting and processing claims, and any other insurance or investment function that is necessary for the purpose of providing essential insurance coverage.
(b) All policies issued by the association shall be subject to a nonprofit group retrospective rating plan to be approved by the commissioner, under which the final premium for all policyholders of the association, as a group, will be equal to the administrative expenses, loss and loss adjustment expenses, plus a reasonable allowance for contingencies and servicing. Policyholders shall be given full credit for all investment income, net of expenses and a reasonable management fee on policyholder supplied funds. Any additional premium resulting from a retrospective adjustment will first be collected from the stabilization fund set forth in § 56-41-108 . If these funds are insufficient to pay the entire amount due, the balance will be recouped through surcharges upon policyholders in accordance with a procedure approved by the commissioner.
(c) In providing for the recoupment of deficits that may be incurred by the association, an option shall be offered to an insured each policy year to pay a capital stabilization charge that shall not exceed one hundred percent (100%) of the premium charged to the insurer in that year. The commissioner shall determine the amount of the charge from the appropriate factors of loss experience and risks associated with the plan of operation and the insurer. An insured who pays the stabilization charge shall not be required to pay any assessment to recoup a deficit in the plan incurred in any policy year for which the charge is paid. The plan of operation shall provide for the return to the insured so much of the insured's payment as remains after all actual or potential liabilities under the policy have been discharged.
Acts 1987, ch. 439, § 6.
Tenn. Code Ann. § 56-7-2362 — TN Code / Title 56 / Chapter 7 / Section 56-7-2362
Payment on authorized services - Correction of submitted claims
Status: in_force

(a) (1) If authorization is given and a pharmacy claim is adjudicated by a health insurer or its agent to any pharmacy services provider for care to be delivered to a covered beneficiary under any individual, franchise, blanket or group health insurance policy, medical service plan corporation contract, hospital service corporation contract, hospital and medical service corporation contract or fraternal benefit society, the health insurer acting directly or by delegation through an agent acting on behalf of the health insurer shall not subsequently rescind or modify that authorization or deny the authorized payment to the pharmacy services provider for the authorized service after the provider renders the authorized service in good faith and pursuant to the authorization, except for payments made as a result of the provider's misrepresentation or fraud. (2) If the bureau of TennCare provides notice to the health insurer or its agent that a person is eligible to participate in the TennCare program, and, if based on good faith reliance on the information, the health insurer makes a payment to a pharmacy provider for providing pharmacy services to the person enrolled in the TennCare program, and, if the bureau of TennCare later rescinds the eligibility for the person, then the bureau of TennCare shall remain liable to the health insurer for any amount the health insurer paid to the provider for the pharmacy services. The bureau of TennCare shall not be liable when the eligibility is rescinded in the case of fraud or death as defined in the contract. The bureau of TennCare shall not be liable due to an error or delay on the part of the managed care organization or its agents in processing eligibility information received from the bureau of TennCare. (b) Notwithstanding subsection (a), any organization may request the pharmacy to adjust or correct an adjudicated claim to correct incorrect data elements, including incorrect billing units, incorrect national drug code (NDC) numbers and incorrect prescriber identification numbers submitted in error and in good faith by the pharmacy. An organization shall provide the pharmacy an opportunity to correct claims submitted by the pharmacy in good faith. If the pharmacy does not correct the adjudicated claim requested within thirty (30) days of receipt of the request, then the organization may rescind, modify or recoup the funds paid on the requested claim and shall not be in violation of this section. Acts 2001, ch. 340, § 2.
(a) (1) If authorization is given and a pharmacy claim is adjudicated by a health insurer or its agent to any pharmacy services provider for care to be delivered to a covered beneficiary under any individual, franchise, blanket or group health insurance policy, medical service plan corporation contract, hospital service corporation contract, hospital and medical service corporation contract or fraternal benefit society, the health insurer acting directly or by delegation through an agent acting on behalf of the health insurer shall not subsequently rescind or modify that authorization or deny the authorized payment to the pharmacy services provider for the authorized service after the provider renders the authorized service in good faith and pursuant to the authorization, except for payments made as a result of the provider's misrepresentation or fraud. (2) If the bureau of TennCare provides notice to the health insurer or its agent that a person is eligible to participate in the TennCare program, and, if based on good faith reliance on the information, the health insurer makes a payment to a pharmacy provider for providing pharmacy services to the person enrolled in the TennCare program, and, if the bureau of TennCare later rescinds the eligibility for the person, then the bureau of TennCare shall remain liable to the health insurer for any amount the health insurer paid to the provider for the pharmacy services. The bureau of TennCare shall not be liable when the eligibility is rescinded in the case of fraud or death as defined in the contract. The bureau of TennCare shall not be liable due to an error or delay on the part of the managed care organization or its agents in processing eligibility information received from the bureau of TennCare.
(1) If authorization is given and a pharmacy claim is adjudicated by a health insurer or its agent to any pharmacy services provider for care to be delivered to a covered beneficiary under any individual, franchise, blanket or group health insurance policy, medical service plan corporation contract, hospital service corporation contract, hospital and medical service corporation contract or fraternal benefit society, the health insurer acting directly or by delegation through an agent acting on behalf of the health insurer shall not subsequently rescind or modify that authorization or deny the authorized payment to the pharmacy services provider for the authorized service after the provider renders the authorized service in good faith and pursuant to the authorization, except for payments made as a result of the provider's misrepresentation or fraud.
(2) If the bureau of TennCare provides notice to the health insurer or its agent that a person is eligible to participate in the TennCare program, and, if based on good faith reliance on the information, the health insurer makes a payment to a pharmacy provider for providing pharmacy services to the person enrolled in the TennCare program, and, if the bureau of TennCare later rescinds the eligibility for the person, then the bureau of TennCare shall remain liable to the health insurer for any amount the health insurer paid to the provider for the pharmacy services. The bureau of TennCare shall not be liable when the eligibility is rescinded in the case of fraud or death as defined in the contract. The bureau of TennCare shall not be liable due to an error or delay on the part of the managed care organization or its agents in processing eligibility information received from the bureau of TennCare.
(b) Notwithstanding subsection (a), any organization may request the pharmacy to adjust or correct an adjudicated claim to correct incorrect data elements, including incorrect billing units, incorrect national drug code (NDC) numbers and incorrect prescriber identification numbers submitted in error and in good faith by the pharmacy. An organization shall provide the pharmacy an opportunity to correct claims submitted by the pharmacy in good faith. If the pharmacy does not correct the adjudicated claim requested within thirty (30) days of receipt of the request, then the organization may rescind, modify or recoup the funds paid on the requested claim and shall not be in violation of this section.
Acts 2001, ch. 340, § 2.
Tenn. Code Ann. § 56-21-122 — TN Code / Title 56 / Chapter 21 / Section 56-21-122
Accepting or rejecting insurance shall not be compensated by commissions on premiums
Status: in_force

No officer or other person whose duty it is to determine the character of the risk and upon whose decision the application for insurance thereon shall finally be accepted or rejected shall receive as compensation any commission upon the premium; but the person's compensation shall be a fixed salary, fee, or the part of the net profits of the company as the board of directors may determine. Acts 1907, ch. 461, § 7; Shan., § 3369a21; Acts 1921, ch. 160, § 7; Code 1932, § 6272; T.C.A. (orig. ed.), § 56-2024.
No officer or other person whose duty it is to determine the character of the risk and upon whose decision the application for insurance thereon shall finally be accepted or rejected shall receive as compensation any commission upon the premium; but the person's compensation shall be a fixed salary, fee, or the part of the net profits of the company as the board of directors may determine.
Acts 1907, ch. 461, § 7; Shan., § 3369a21; Acts 1921, ch. 160, § 7; Code 1932, § 6272; T.C.A. (orig. ed.), § 56-2024.
Tenn. Code Ann. § 56-1-302 — TN Code / Title 56 / Chapter 1 / Section 56-1-302
Powers, duties and responsibilities of director - Alternative method of license renewals
Status: in_force

(a) Notwithstanding any contrary law, except title 55, chapter 17, the director has the power, duty and responsibility to: (1) Act as chief administrative officer for each board; (2) Employ all consultants, investigators, inspectors, legal counsel, and other personnel necessary to staff and carry out the functions of the boards, and assign the personnel in a manner designed to ensure their most efficient use, excluding the board of pharmacy and the state board for licensing contractors; (3) Provide office space and necessary quarters for the boards; (4) Maintain a central filing system for official records and documents of all boards; (5) Promulgate rules and regulations for all administrative functions and activities of the boards; (6) Enforce all regulations promulgated by the boards; (7) Collect and account for all fees prescribed to be paid to each board, and, unless otherwise prescribed by law, deposit the fees in the state treasury, and the commissioner of finance and administration shall make allotments out of the general fund as may be necessary to defray the expenses of the division and boards as provided by law; (8) Perform other duties the commissioner prescribes, or as prescribed by law; (9) (A) Issue monthly a press release containing a disciplinary report, which shall list all disciplinary actions taken by each board during the prior month. The report shall list, by board, the following: (i) Name and professional address of any person disciplined the prior month; (ii) Disciplinary action taken; and (iii) Any civil penalty imposed; and (B) The disciplinary report for the prior month shall be made available to newspapers of general circulation in each of the state's metropolitan areas, Nashville, Memphis, Knoxville, Chattanooga and the tri-cities area composed of Bristol, Johnson City and Kingsport, by the fifteenth of each following month. (b) (1) (A) Notwithstanding any other law to the contrary, the director shall establish an alternative system of renewals of licenses issued by any regulatory board attached to the division of regulatory boards of the department under § 4-3-1304 . The system shall be designed to allow for the distribution of the renewal workload as uniformly as is practicable throughout the calendar year. (B) Licenses issued under the alternative method are valid for twenty-four (24) months, and shall expire on the last day of the last month of the license period; however, during a transition period or at any time thereafter, if the director, after consultation with the affected board or boards, determines that the volume of work for any given interval is unduly burdensome or costly, either the licenses or renewals, or both of them, may be issued for terms of not less than six (6) months nor more than eighteen (18) months. The fee imposed for any license under the alternative interval method for a period other than twenty-four (24) months shall be proportionate to the annual fee and modified in no other manner, except that the proportional fee shall be rounded off to the nearest quarter of a dollar (25¢). (2) As used in subdivision (b)(1), "license" is defined as in § 4-5-102 . (c) Notwithstanding any other law to the contrary, the director of the division of regulatory boards of the department may implement a system for electronic submission of complaints or applications for licensure or registration to any regulatory program attached to the division, including any renewal thereof, and to notify licensees electronically of renewals, rulemaking or any other notification. Amended by 2017 Tenn. Acts, ch. 454,s 1, eff. 5/25/2017. Amended by 2013 Tenn. Acts, ch. 138,s 1, eff. 4/12/2013. Acts 1978, ch. 906, § 1; modified; T.C.A., § 56-145; Acts 1980, ch. 573, § 1; impl. am. Acts 1983, ch. 311, §§ 1-8; Acts 1983, ch. 313, § 1; 1989, ch. 389, § 3; 1990, ch. 1026, § 34.
(a) Notwithstanding any contrary law, except title 55, chapter 17, the director has the power, duty and responsibility to: (1) Act as chief administrative officer for each board; (2) Employ all consultants, investigators, inspectors, legal counsel, and other personnel necessary to staff and carry out the functions of the boards, and assign the personnel in a manner designed to ensure their most efficient use, excluding the board of pharmacy and the state board for licensing contractors; (3) Provide office space and necessary quarters for the boards; (4) Maintain a central filing system for official records and documents of all boards; (5) Promulgate rules and regulations for all administrative functions and activities of the boards; (6) Enforce all regulations promulgated by the boards; (7) Collect and account for all fees prescribed to be paid to each board, and, unless otherwise prescribed by law, deposit the fees in the state treasury, and the commissioner of finance and administration shall make allotments out of the general fund as may be necessary to defray the expenses of the division and boards as provided by law; (8) Perform other duties the commissioner prescribes, or as prescribed by law; (9) (A) Issue monthly a press release containing a disciplinary report, which shall list all disciplinary actions taken by each board during the prior month. The report shall list, by board, the following: (i) Name and professional address of any person disciplined the prior month; (ii) Disciplinary action taken; and (iii) Any civil penalty imposed; and (B) The disciplinary report for the prior month shall be made available to newspapers of general circulation in each of the state's metropolitan areas, Nashville, Memphis, Knoxville, Chattanooga and the tri-cities area composed of Bristol, Johnson City and Kingsport, by the fifteenth of each following month.
(1) Act as chief administrative officer for each board;
(2) Employ all consultants, investigators, inspectors, legal counsel, and other personnel necessary to staff and carry out the functions of the boards, and assign the personnel in a manner designed to ensure their most efficient use, excluding the board of pharmacy and the state board for licensing contractors;
(3) Provide office space and necessary quarters for the boards;
(4) Maintain a central filing system for official records and documents of all boards;
(5) Promulgate rules and regulations for all administrative functions and activities of the boards;
(6) Enforce all regulations promulgated by the boards;
(7) Collect and account for all fees prescribed to be paid to each board, and, unless otherwise prescribed by law, deposit the fees in the state treasury, and the commissioner of finance and administration shall make allotments out of the general fund as may be necessary to defray the expenses of the division and boards as provided by law;
(8) Perform other duties the commissioner prescribes, or as prescribed by law;
(9) (A) Issue monthly a press release containing a disciplinary report, which shall list all disciplinary actions taken by each board during the prior month. The report shall list, by board, the following: (i) Name and professional address of any person disciplined the prior month; (ii) Disciplinary action taken; and (iii) Any civil penalty imposed; and (B) The disciplinary report for the prior month shall be made available to newspapers of general circulation in each of the state's metropolitan areas, Nashville, Memphis, Knoxville, Chattanooga and the tri-cities area composed of Bristol, Johnson City and Kingsport, by the fifteenth of each following month.
(A) Issue monthly a press release containing a disciplinary report, which shall list all disciplinary actions taken by each board during the prior month. The report shall list, by board, the following: (i) Name and professional address of any person disciplined the prior month; (ii) Disciplinary action taken; and (iii) Any civil penalty imposed; and
(i) Name and professional address of any person disciplined the prior month;
(ii) Disciplinary action taken; and
(iii) Any civil penalty imposed; and
(B) The disciplinary report for the prior month shall be made available to newspapers of general circulation in each of the state's metropolitan areas, Nashville, Memphis, Knoxville, Chattanooga and the tri-cities area composed of Bristol, Johnson City and Kingsport, by the fifteenth of each following month.
(b) (1) (A) Notwithstanding any other law to the contrary, the director shall establish an alternative system of renewals of licenses issued by any regulatory board attached to the division of regulatory boards of the department under § 4-3-1304 . The system shall be designed to allow for the distribution of the renewal workload as uniformly as is practicable throughout the calendar year. (B) Licenses issued under the alternative method are valid for twenty-four (24) months, and shall expire on the last day of the last month of the license period; however, during a transition period or at any time thereafter, if the director, after consultation with the affected board or boards, determines that the volume of work for any given interval is unduly burdensome or costly, either the licenses or renewals, or both of them, may be issued for terms of not less than six (6) months nor more than eighteen (18) months. The fee imposed for any license under the alternative interval method for a period other than twenty-four (24) months shall be proportionate to the annual fee and modified in no other manner, except that the proportional fee shall be rounded off to the nearest quarter of a dollar (25¢). (2) As used in subdivision (b)(1), "license" is defined as in § 4-5-102 .
(1) (A) Notwithstanding any other law to the contrary, the director shall establish an alternative system of renewals of licenses issued by any regulatory board attached to the division of regulatory boards of the department under § 4-3-1304 . The system shall be designed to allow for the distribution of the renewal workload as uniformly as is practicable throughout the calendar year. (B) Licenses issued under the alternative method are valid for twenty-four (24) months, and shall expire on the last day of the last month of the license period; however, during a transition period or at any time thereafter, if the director, after consultation with the affected board or boards, determines that the volume of work for any given interval is unduly burdensome or costly, either the licenses or renewals, or both of them, may be issued for terms of not less than six (6) months nor more than eighteen (18) months. The fee imposed for any license under the alternative interval method for a period other than twenty-four (24) months shall be proportionate to the annual fee and modified in no other manner, except that the proportional fee shall be rounded off to the nearest quarter of a dollar (25¢).
(A) Notwithstanding any other law to the contrary, the director shall establish an alternative system of renewals of licenses issued by any regulatory board attached to the division of regulatory boards of the department under § 4-3-1304 . The system shall be designed to allow for the distribution of the renewal workload as uniformly as is practicable throughout the calendar year.
(B) Licenses issued under the alternative method are valid for twenty-four (24) months, and shall expire on the last day of the last month of the license period; however, during a transition period or at any time thereafter, if the director, after consultation with the affected board or boards, determines that the volume of work for any given interval is unduly burdensome or costly, either the licenses or renewals, or both of them, may be issued for terms of not less than six (6) months nor more than eighteen (18) months. The fee imposed for any license under the alternative interval method for a period other than twenty-four (24) months shall be proportionate to the annual fee and modified in no other manner, except that the proportional fee shall be rounded off to the nearest quarter of a dollar (25¢).
(2) As used in subdivision (b)(1), "license" is defined as in § 4-5-102 .
(c) Notwithstanding any other law to the contrary, the director of the division of regulatory boards of the department may implement a system for electronic submission of complaints or applications for licensure or registration to any regulatory program attached to the division, including any renewal thereof, and to notify licensees electronically of renewals, rulemaking or any other notification.
Amended by 2017 Tenn. Acts, ch. 454,s 1, eff. 5/25/2017.
Amended by 2013 Tenn. Acts, ch. 138,s 1, eff. 4/12/2013.
Acts 1978, ch. 906, § 1; modified; T.C.A., § 56-145; Acts 1980, ch. 573, § 1; impl. am. Acts 1983, ch. 311, §§ 1-8; Acts 1983, ch. 313, § 1; 1989, ch. 389, § 3; 1990, ch. 1026, § 34.
Tenn. Code Ann. § 56-43-107 — TN Code / Title 56 / Chapter 43 / Section 56-43-107
Exclusive agency or management contracts
Status: in_force

(a) No insurer may enter into any exclusive agency contract or management contract unless the contract is first filed with the commissioner and not disapproved under this section within thirty (30) days after filing, or a reasonable extended period as the commissioner may specify by notice within the thirty (30) days. (b) The commissioner shall disapprove a contract under subsection (a) if the commissioner finds that: (1) It subjects the insurer to excessive charges; (2) The contract extends for an unreasonable period of time; (3) The contract does not contain fair and adequate standards of performance; (4) The persons empowered under the contract to manage the insurer are not sufficiently trustworthy, competent, experienced and free from conflict of interest to manage the insurer with due regard for the interests of its insureds, creditors or the public; or (5) The contract contains provisions that impair the interests of the insurer's insureds or creditors of the public in this state. Acts 1989, ch. 423, § 6.
(a) No insurer may enter into any exclusive agency contract or management contract unless the contract is first filed with the commissioner and not disapproved under this section within thirty (30) days after filing, or a reasonable extended period as the commissioner may specify by notice within the thirty (30) days.
(b) The commissioner shall disapprove a contract under subsection (a) if the commissioner finds that: (1) It subjects the insurer to excessive charges; (2) The contract extends for an unreasonable period of time; (3) The contract does not contain fair and adequate standards of performance; (4) The persons empowered under the contract to manage the insurer are not sufficiently trustworthy, competent, experienced and free from conflict of interest to manage the insurer with due regard for the interests of its insureds, creditors or the public; or (5) The contract contains provisions that impair the interests of the insurer's insureds or creditors of the public in this state.
(1) It subjects the insurer to excessive charges;
(2) The contract extends for an unreasonable period of time;
(3) The contract does not contain fair and adequate standards of performance;
(4) The persons empowered under the contract to manage the insurer are not sufficiently trustworthy, competent, experienced and free from conflict of interest to manage the insurer with due regard for the interests of its insureds, creditors or the public; or
(5) The contract contains provisions that impair the interests of the insurer's insureds or creditors of the public in this state.
Acts 1989, ch. 423, § 6.
Tenn. Code Ann. § 56-6-306 — TN Code / Title 56 / Chapter 6 / Section 56-6-306
Transactions not loans - Industrial loan and thrift companies provisions inapplicable
Status: in_force

Time-price differential transactions as described in this part shall not be deemed to be loans or forbearances of money or things of value or the making of the loans or forbearances, nor shall they be regulated by or subject to title 45, chapter 5. Acts 1965, ch. 356, § 6; impl. am. Acts 1979, ch. 204, §§ 8, 26; T.C.A., § 56-719.
Time-price differential transactions as described in this part shall not be deemed to be loans or forbearances of money or things of value or the making of the loans or forbearances, nor shall they be regulated by or subject to title 45, chapter 5.
Acts 1965, ch. 356, § 6; impl. am. Acts 1979, ch. 204, §§ 8, 26; T.C.A., § 56-719.
Tenn. Code Ann. § 56-61-112 — TN Code / Title 56 / Chapter 61 / Section 56-61-112
Elections for conducting external review program
Status: in_force

(a) For purposes of this section, "approved entity" means: (1) The utilization review accreditation commission (URAC); or (2) Other nationally recognized private accrediting entity employing standards for the accreditation of external review programs that the commissioner deems are substantially equivalent to the standards for conducting an external review pursuant to §§ 56-61-113 - 56-61-118. (b) A health carrier may elect, in writing to the commissioner, to conduct its external review program in accordance with: (1) Sections 56-61-113 - 56-61-118, or (2) The external review program of an approved entity; provided, that the health carrier receives and maintains accreditation from the approved entity. Sections 56-61-120 and 56-61-121 shall not apply to a health carrier that receives and maintains accreditation from the approved entity. (c) The commissioner may evaluate the external review procedures of an approved entity. If after a hearing is conducted in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, the commissioner finds that an approved entity has amended its external review procedures to the extent that such procedures are no longer consistent with the purposes of this chapter, the commissioner shall issue a written order specifying in what respects those procedures are inconsistent. (d) A health carrier that has elected to conduct its external review program in accordance with the standards of an approved entity, that is the subject of the commissioner's order issued pursuant to subsection (c), shall have sixty (60) days from the effective date of the commissioner's order to: (1) Elect, in writing, to utilize another external review program under subsection (b); or (2) Demonstrate to the commissioner's satisfaction that the approved entity has subsequently amended its procedures so that such procedures are consistent with the purposes of this chapter. Acts 2010, ch. 980, § 13.
(a) For purposes of this section, "approved entity" means: (1) The utilization review accreditation commission (URAC); or (2) Other nationally recognized private accrediting entity employing standards for the accreditation of external review programs that the commissioner deems are substantially equivalent to the standards for conducting an external review pursuant to §§ 56-61-113 - 56-61-118.
(1) The utilization review accreditation commission (URAC); or
(2) Other nationally recognized private accrediting entity employing standards for the accreditation of external review programs that the commissioner deems are substantially equivalent to the standards for conducting an external review pursuant to §§ 56-61-113 - 56-61-118.
(b) A health carrier may elect, in writing to the commissioner, to conduct its external review program in accordance with: (1) Sections 56-61-113 - 56-61-118, or (2) The external review program of an approved entity; provided, that the health carrier receives and maintains accreditation from the approved entity. Sections 56-61-120 and 56-61-121 shall not apply to a health carrier that receives and maintains accreditation from the approved entity.
(1) Sections 56-61-113 - 56-61-118, or
(2) The external review program of an approved entity; provided, that the health carrier receives and maintains accreditation from the approved entity. Sections 56-61-120 and 56-61-121 shall not apply to a health carrier that receives and maintains accreditation from the approved entity.
(c) The commissioner may evaluate the external review procedures of an approved entity. If after a hearing is conducted in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, the commissioner finds that an approved entity has amended its external review procedures to the extent that such procedures are no longer consistent with the purposes of this chapter, the commissioner shall issue a written order specifying in what respects those procedures are inconsistent.
(d) A health carrier that has elected to conduct its external review program in accordance with the standards of an approved entity, that is the subject of the commissioner's order issued pursuant to subsection (c), shall have sixty (60) days from the effective date of the commissioner's order to: (1) Elect, in writing, to utilize another external review program under subsection (b); or (2) Demonstrate to the commissioner's satisfaction that the approved entity has subsequently amended its procedures so that such procedures are consistent with the purposes of this chapter.
(1) Elect, in writing, to utilize another external review program under subsection (b); or
(2) Demonstrate to the commissioner's satisfaction that the approved entity has subsequently amended its procedures so that such procedures are consistent with the purposes of this chapter.
Acts 2010, ch. 980, § 13.
Tenn. Code Ann. § 56-7-1009 — TN Code / Title 56 / Chapter 7 / Section 56-7-1009
Health care provider credentialing applications from the Council on Affordable Quality Healthcare (CAQH)
Status: in_force

(a) A health insurance entity, as defined in § 56-7-109 , that credentials or recredentials the providers in its networks shall accept, in addition to its own credentialing and recredentialing applications, the credentialing and recredentialing applications from the Council on Affordable Quality Healthcare (CAQH). If the health insurance entity is a participating organization of CAQH, then the health insurance entity shall accept the application from either CAQH by electronic means or from the provider by electronic means or by a paper copy. If the health insurance entity is not a participating organization of CAQH, then the health insurance entity shall accept the application only from the provider by electronic means or by a paper copy. In either case, the provider shall complete and submit the attestation clause of the health insurance entity before an application is considered complete, if the health insurance entity requires it. (b) Nothing in this section may be construed to require a health insurance entity to be a participating organization or pay a fee to CAQH. 2005, ch. 167, § 1.
(a) A health insurance entity, as defined in § 56-7-109 , that credentials or recredentials the providers in its networks shall accept, in addition to its own credentialing and recredentialing applications, the credentialing and recredentialing applications from the Council on Affordable Quality Healthcare (CAQH). If the health insurance entity is a participating organization of CAQH, then the health insurance entity shall accept the application from either CAQH by electronic means or from the provider by electronic means or by a paper copy. If the health insurance entity is not a participating organization of CAQH, then the health insurance entity shall accept the application only from the provider by electronic means or by a paper copy. In either case, the provider shall complete and submit the attestation clause of the health insurance entity before an application is considered complete, if the health insurance entity requires it.
(b) Nothing in this section may be construed to require a health insurance entity to be a participating organization or pay a fee to CAQH.
2005, ch. 167, § 1.
Tenn. Code Ann. § 56-7-3722 — TN Code / Title 56 / Chapter 7 / Section 56-7-3722
Rules
Status: in_force

The commissioner may promulgate rules to carry out this part in accordance with the Uniform Administrative Procedures Act, codified in title 4, chapter 5. Amended by 2023 Tenn. Acts, ch. 395, s 4, eff. 1/1/2025.
The commissioner may promulgate rules to carry out this part in accordance with the Uniform Administrative Procedures Act, codified in title 4, chapter 5.
Amended by 2023 Tenn. Acts, ch. 395, s 4, eff. 1/1/2025.
Tenn. Code Ann. § 56-6-1001 — TN Code / Title 56 / Chapter 6 / Section 56-6-1001
Part definitions
Status: in_force

As used in this part: (1) "Commissioner" means the commissioner of commerce and insurance; (2) "Crop" means and includes any agricultural product, including livestock, nursery product, tree and product from a tree, as well as anything insured by the Federal Crop Insurance Corporation under a crop insurance program; (3) "Department" means the department of commerce and insurance; (4) "Fingerprints" means an impression of the lines on the finger taken for purpose of identification. The impression may be electronic or in ink converted to electronic format; and (5) "Person" means a natural person. Acts 2009, ch. 476, § 2.
As used in this part:
(1) "Commissioner" means the commissioner of commerce and insurance;
(2) "Crop" means and includes any agricultural product, including livestock, nursery product, tree and product from a tree, as well as anything insured by the Federal Crop Insurance Corporation under a crop insurance program;
(3) "Department" means the department of commerce and insurance;
(4) "Fingerprints" means an impression of the lines on the finger taken for purpose of identification. The impression may be electronic or in ink converted to electronic format; and
(5) "Person" means a natural person.
Acts 2009, ch. 476, § 2.
Tenn. Code Ann. § 56-2-509 — TN Code / Title 56 / Chapter 2 / Section 56-2-509
Provisions supplemental
Status: in_force

Nothing in §§ 56-2-505 - 56-2-508 or this section shall limit or affect the right to serve any process, notice or demand required or permitted by law to be served upon any company in any other manner now or hereafter permitted by law. Acts 1968, ch. 536, § 11; T.C.A., § 56-259.
Nothing in §§ 56-2-505 - 56-2-508 or this section shall limit or affect the right to serve any process, notice or demand required or permitted by law to be served upon any company in any other manner now or hereafter permitted by law.
Acts 1968, ch. 536, § 11; T.C.A., § 56-259.
Tenn. Code Ann. § 56-22-105 — TN Code / Title 56 / Chapter 22 / Section 56-22-105
Application for certificate of authority - Minimum requirements
Status: in_force

(a) To apply for a certificate of authority, a person shall file with the commissioner an application on a form adopted by the commissioner, accompanied by a nonrefundable filing fee in the amount referenced in § 56-4-101(a)(1) . A person in this state applying for a certificate of authority to act as a county mutual insurance company shall, under penalty of refusal, suspension or revocation of the certificate of authority, declare that the statements made in the application are true, correct and complete to the best of the person's knowledge and belief. (b) An application for a certificate of authority shall include the following documentation, together with any other information or documentation the commissioner may require: (1) A certified copy of the articles of incorporation, charter or other such document; (2) A certified copy of the bylaws or other similar document; and (3) The names of the officers and directors of the county mutual insurance company. (c) No certificate of authority shall be granted or maintained, unless the applicant or county mutual insurance company can prove to the commissioner's satisfaction that it will be able to write at least one hundred (100) policies of insurance and possesses at least two hundred thousand dollars ($200,000) in surplus. Acts 2006, ch. 689, §§ 3, 8.
(a) To apply for a certificate of authority, a person shall file with the commissioner an application on a form adopted by the commissioner, accompanied by a nonrefundable filing fee in the amount referenced in § 56-4-101(a)(1) . A person in this state applying for a certificate of authority to act as a county mutual insurance company shall, under penalty of refusal, suspension or revocation of the certificate of authority, declare that the statements made in the application are true, correct and complete to the best of the person's knowledge and belief.
(b) An application for a certificate of authority shall include the following documentation, together with any other information or documentation the commissioner may require: (1) A certified copy of the articles of incorporation, charter or other such document; (2) A certified copy of the bylaws or other similar document; and (3) The names of the officers and directors of the county mutual insurance company.
(1) A certified copy of the articles of incorporation, charter or other such document;
(2) A certified copy of the bylaws or other similar document; and
(3) The names of the officers and directors of the county mutual insurance company.
(c) No certificate of authority shall be granted or maintained, unless the applicant or county mutual insurance company can prove to the commissioner's satisfaction that it will be able to write at least one hundred (100) policies of insurance and possesses at least two hundred thousand dollars ($200,000) in surplus.
Acts 2006, ch. 689, §§ 3, 8.
Tenn. Code Ann. § 56-11-201 — TN Code / Title 56 / Chapter 11 / Section 56-11-201
Purpose of part - Applicability - Confidentiality of ORSA summary report
Status: in_force

(a) The purpose of this part is to provide the requirements for maintaining a risk management framework and completing an Own Risk and Solvency Assessment (ORSA) and provide guidance and instructions for filing an ORSA Summary Report with the insurance commissioner of this state. (b) The requirements of this part shall apply to all insurers domiciled in this state and all health maintenance organizations licensed in this state unless exempt pursuant to § 56-11-206 . (c) The ORSA Summary Report will contain confidential and sensitive information related to an insurer, health maintenance organization or insurance group's identification of risks material and relevant to the insurer, health maintenance organization or insurance group filing the report. This information will include proprietary and trade secret information that has the potential for harm and competitive disadvantage to the insurer, health maintenance organization or insurance group if the information is made public. As such, the ORSA Summary Report shall be a confidential document filed with the commissioner and shared only as stated in this part and to assist the commissioner in the performance of the commissioner's duties, and that in no event shall the ORSA Summary Report be subject to public disclosure. Acts 2014, ch. 583, § 26.
(a) The purpose of this part is to provide the requirements for maintaining a risk management framework and completing an Own Risk and Solvency Assessment (ORSA) and provide guidance and instructions for filing an ORSA Summary Report with the insurance commissioner of this state.
(b) The requirements of this part shall apply to all insurers domiciled in this state and all health maintenance organizations licensed in this state unless exempt pursuant to § 56-11-206 .
(c) The ORSA Summary Report will contain confidential and sensitive information related to an insurer, health maintenance organization or insurance group's identification of risks material and relevant to the insurer, health maintenance organization or insurance group filing the report. This information will include proprietary and trade secret information that has the potential for harm and competitive disadvantage to the insurer, health maintenance organization or insurance group if the information is made public. As such, the ORSA Summary Report shall be a confidential document filed with the commissioner and shared only as stated in this part and to assist the commissioner in the performance of the commissioner's duties, and that in no event shall the ORSA Summary Report be subject to public disclosure.
Acts 2014, ch. 583, § 26.
Tenn. Code Ann. § 56-7-203 — TN Code / Title 56 / Chapter 7 / Section 56-7-203
Life insurance or annuity for or assigned to spouse or children or dependent relatives exempt from claims of creditors
Status: in_force

The net amount payable under any policy of life insurance or under any annuity contract upon the life of any person made for the benefit of, or assigned to, the spouse and/or children, or dependent relatives of the persons, shall be exempt from all claims of the creditors of the person arising out of or based upon any obligation created after January 1, 1932, whether or not the right to change the named beneficiary is reserved by or permitted to that person. Acts 1925, ch. 113, § 1; Shan. Supp., § 4232a; mod. Code 1932, § 8458; T.C.A. (orig. ed.), § 56-1110.
The net amount payable under any policy of life insurance or under any annuity contract upon the life of any person made for the benefit of, or assigned to, the spouse and/or children, or dependent relatives of the persons, shall be exempt from all claims of the creditors of the person arising out of or based upon any obligation created after January 1, 1932, whether or not the right to change the named beneficiary is reserved by or permitted to that person.
Acts 1925, ch. 113, § 1; Shan. Supp., § 4232a; mod. Code 1932, § 8458; T.C.A. (orig. ed.), § 56-1110.
Tenn. Code Ann. § 56-7-3701 — TN Code / Title 56 / Chapter 7 / Section 56-7-3701
Short title
Status: in_force

This part is known and may be cited as the "Prior Authorization Fairness Act." Amended by 2023 Tenn. Acts, ch. 395, s 4, eff. 1/1/2025.
This part is known and may be cited as the "Prior Authorization Fairness Act."
Amended by 2023 Tenn. Acts, ch. 395, s 4, eff. 1/1/2025.
Tenn. Code Ann. § 56-18-115 — TN Code / Title 56 / Chapter 18 / Section 56-18-115
Existing contracts not affected by conversion of stock life insurance company into mutual
Status: in_force

Neither the retirement of its capital stock nor any other action taken under this chapter shall affect existing suits, rights or contracts of the corporation. Any deposit made by the corporation under any requirement of an applicable statute of this state shall be retained by the commissioner in trust for the benefit and security of all of the policyholders of the corporation. Acts 1949, ch. 91, § 6; C. Supp. 1950, § 6433.18 (Williams, § 6433.22); T.C.A. (orig. ed.), § 56-1616.
Neither the retirement of its capital stock nor any other action taken under this chapter shall affect existing suits, rights or contracts of the corporation. Any deposit made by the corporation under any requirement of an applicable statute of this state shall be retained by the commissioner in trust for the benefit and security of all of the policyholders of the corporation.
Acts 1949, ch. 91, § 6; C. Supp. 1950, § 6433.18 (Williams, § 6433.22); T.C.A. (orig. ed.), § 56-1616.
Tenn. Code Ann. § 56-12-216 — TN Code / Title 56 / Chapter 12 / Section 56-12-216
Immunity from liability
Status: in_force

(a) There shall be no liability on the part of, and no cause of action of any nature shall arise against, any member insurer or its agents or employees, the association or its agents or employees, members of the board of directors, or the commissioner or the commissioner's representatives, for any action or omission by them in the performance of their powers and duties under this part. (b) This immunity shall extend to the participation in any organization of one (1) or more other state associations of similar purposes and to any such organization and its agents or employees. Acts 1988, ch. 1032, § 16.
(a) There shall be no liability on the part of, and no cause of action of any nature shall arise against, any member insurer or its agents or employees, the association or its agents or employees, members of the board of directors, or the commissioner or the commissioner's representatives, for any action or omission by them in the performance of their powers and duties under this part.
(b) This immunity shall extend to the participation in any organization of one (1) or more other state associations of similar purposes and to any such organization and its agents or employees.
Acts 1988, ch. 1032, § 16.
Tenn. Code Ann. § 56-6-113 — TN Code / Title 56 / Chapter 6 / Section 56-6-113
Commissions
Status: in_force

(a) An insurer or insurance producer shall not pay a commission, service fee, brokerage fee or other valuable consideration to a person for selling, soliciting or negotiating insurance in this state if that person is required to be licensed under this part and is not so licensed. (b) A person shall not accept a commission, service fee, brokerage or other valuable consideration for selling, soliciting or negotiating insurance in this state if that person is required to be licensed under this part and is not so licensed. (c) Renewal or other deferred commissions may be paid to a person for selling, soliciting or negotiating insurance in this state if the person was required to be licensed under this part at the time of the sale, solicitation or negotiation and was so licensed at that time. (d) An insurer or insurance producer may pay or assign commissions, service fees, brokerages or other valuable consideration to an insurance agency or to persons who do not sell, solicit or negotiate insurance in this state, unless the payment would violate § 56-8-104(5) or (8) . (e) An unlicensed person may make a referral to a licensed insurance producer if the person does not discuss the specific insurance policy terms and conditions. Except as prohibited by federal law, the unlicensed person may be compensated for the referral. However, an unlicensed person who is neither employed by nor affiliated with the licensed insurance producer may be compensated only if the compensation is a fixed dollar amount, not to exceed twenty-five dollars ($25.00) or such lesser amount as the commissioner may establish by rule, for each referral. In either event, the referral compensation must not depend on whether the referred customer purchases an insurance product from the licensed insurance producer. Amended by 2019 Tenn. Acts, ch. 165,s 1, eff. 4/18/2019. Acts 2002, ch. 798, § 14; 2008, ch. 1192, § 6.
(a) An insurer or insurance producer shall not pay a commission, service fee, brokerage fee or other valuable consideration to a person for selling, soliciting or negotiating insurance in this state if that person is required to be licensed under this part and is not so licensed.
(b) A person shall not accept a commission, service fee, brokerage or other valuable consideration for selling, soliciting or negotiating insurance in this state if that person is required to be licensed under this part and is not so licensed.
(c) Renewal or other deferred commissions may be paid to a person for selling, soliciting or negotiating insurance in this state if the person was required to be licensed under this part at the time of the sale, solicitation or negotiation and was so licensed at that time.
(d) An insurer or insurance producer may pay or assign commissions, service fees, brokerages or other valuable consideration to an insurance agency or to persons who do not sell, solicit or negotiate insurance in this state, unless the payment would violate § 56-8-104(5) or (8) .
(e) An unlicensed person may make a referral to a licensed insurance producer if the person does not discuss the specific insurance policy terms and conditions. Except as prohibited by federal law, the unlicensed person may be compensated for the referral. However, an unlicensed person who is neither employed by nor affiliated with the licensed insurance producer may be compensated only if the compensation is a fixed dollar amount, not to exceed twenty-five dollars ($25.00) or such lesser amount as the commissioner may establish by rule, for each referral. In either event, the referral compensation must not depend on whether the referred customer purchases an insurance product from the licensed insurance producer.
Amended by 2019 Tenn. Acts, ch. 165,s 1, eff. 4/18/2019.
Acts 2002, ch. 798, § 14; 2008, ch. 1192, § 6.
Tenn. Code Ann. § 56-7-2314 — TN Code / Title 56 / Chapter 7 / Section 56-7-2314
Conditions exempting insurer from conversion requirement
Status: in_force

The insurer shall not be required to issue a converted policy covering any person if the person is or could be covered by medicare under Title XVIII of the federal Social Security Act ( 42 U.S.C. § 1395 et seq.); furthermore, the insurer shall not be required to issue a converted policy covering any person if: (1) (A) The person is covered for similar benefits by another hospital, surgical, medical or major medical expense insurance policy or hospital or medical service subscriber contract or medical practice or other prepayment plan or by any other plan or program; (B) The person is eligible for similar benefits, whether or not covered for the benefits, under any arrangement of coverage for individuals in a group, whether on an insured or uninsured basis; or (C) Similar benefits are provided for or are available to the person, pursuant to or in accordance with the requirements of any state or federal law; and (2) The benefit provided under the sources referred to in subdivision (1)(A) for the person or benefits provided or available under the sources referred to in subdivisions (1)(B) and (C) for the person, together with the benefits provided by the converted policy, would result in overinsurance according to the insurer's standards. The insurer's standards must bear some reasonable relationship to actual health care costs in the area in which the insured lives at the time of conversion and must be filed with the commissioner prior to their use in denying coverage. Acts 1980, ch. 537, § 1; 1992, ch. 984, § 1; T.C.A., § 56-7-1503.
The insurer shall not be required to issue a converted policy covering any person if the person is or could be covered by medicare under Title XVIII of the federal Social Security Act ( 42 U.S.C. § 1395 et seq.); furthermore, the insurer shall not be required to issue a converted policy covering any person if:
(1) (A) The person is covered for similar benefits by another hospital, surgical, medical or major medical expense insurance policy or hospital or medical service subscriber contract or medical practice or other prepayment plan or by any other plan or program; (B) The person is eligible for similar benefits, whether or not covered for the benefits, under any arrangement of coverage for individuals in a group, whether on an insured or uninsured basis; or (C) Similar benefits are provided for or are available to the person, pursuant to or in accordance with the requirements of any state or federal law; and
(A) The person is covered for similar benefits by another hospital, surgical, medical or major medical expense insurance policy or hospital or medical service subscriber contract or medical practice or other prepayment plan or by any other plan or program;
(B) The person is eligible for similar benefits, whether or not covered for the benefits, under any arrangement of coverage for individuals in a group, whether on an insured or uninsured basis; or
(C) Similar benefits are provided for or are available to the person, pursuant to or in accordance with the requirements of any state or federal law; and
(2) The benefit provided under the sources referred to in subdivision (1)(A) for the person or benefits provided or available under the sources referred to in subdivisions (1)(B) and (C) for the person, together with the benefits provided by the converted policy, would result in overinsurance according to the insurer's standards. The insurer's standards must bear some reasonable relationship to actual health care costs in the area in which the insured lives at the time of conversion and must be filed with the commissioner prior to their use in denying coverage.
Acts 1980, ch. 537, § 1; 1992, ch. 984, § 1; T.C.A., § 56-7-1503.
Tenn. Code Ann. § 56-30-128 — TN Code / Title 56 / Chapter 30 / Section 56-30-128
Subscriptions for dental care for needy - Governmental or private contributions authorized
Status: in_force

A dental service plan corporation may, in its discretion, receive and accept from governmental or private agencies or from other persons as defined in this chapter, payments covering all or part of the costs of subscriptions to provide dental care for needy and other individuals. However, all contracts for dental care shall be between the dental service plan corporation and the person to receive the care. Acts 1961, ch. 340, § 27; T.C.A., § 56-3528.
A dental service plan corporation may, in its discretion, receive and accept from governmental or private agencies or from other persons as defined in this chapter, payments covering all or part of the costs of subscriptions to provide dental care for needy and other individuals. However, all contracts for dental care shall be between the dental service plan corporation and the person to receive the care.
Acts 1961, ch. 340, § 27; T.C.A., § 56-3528.
Tenn. Code Ann. § 56-42-111 — TN Code / Title 56 / Chapter 42 / Section 56-42-111
Penalties
Status: in_force

In addition to any other penalties provided by the laws of this state, any insurer and any producer found to have violated any requirement of this state relating to the regulation of long-term care insurance or the marketing of long-term care insurance shall be subject to a civil penalty of up to three (3) times the amount of any commissions paid for each policy involved in the violation or up to ten thousand dollars ($10,000), whichever is greater. Acts 2008, ch. 1058, § 15.
In addition to any other penalties provided by the laws of this state, any insurer and any producer found to have violated any requirement of this state relating to the regulation of long-term care insurance or the marketing of long-term care insurance shall be subject to a civil penalty of up to three (3) times the amount of any commissions paid for each policy involved in the violation or up to ten thousand dollars ($10,000), whichever is greater.
Acts 2008, ch. 1058, § 15.
Tenn. Code Ann. § 56-27-107 — TN Code / Title 56 / Chapter 27 / Section 56-27-107
Scope and extent of medical service
Status: in_force

A medical service plan corporation shall be authorized to provide either or both general and special medical and surgical care benefits, including service that may be necessarily incident to medical care. The extent and scope of a medical service plan shall be clearly shown in the subscription contract, and may be limited only as clearly shown in the contract, and as approved by the commissioner. Acts 1945, ch. 113, § 5; C. Supp. 1950, § 4186.22; T.C.A. (orig. ed.), § 56-2907.
A medical service plan corporation shall be authorized to provide either or both general and special medical and surgical care benefits, including service that may be necessarily incident to medical care. The extent and scope of a medical service plan shall be clearly shown in the subscription contract, and may be limited only as clearly shown in the contract, and as approved by the commissioner.
Acts 1945, ch. 113, § 5; C. Supp. 1950, § 4186.22; T.C.A. (orig. ed.), § 56-2907.
Tenn. Code Ann. § 56-12-117 — TN Code / Title 56 / Chapter 12 / Section 56-12-117
Stay of pending proceedings - Default judgment
Status: in_force

(a) All proceedings in which the association is obligated to defend by reason of this part shall be stayed for six (6) months from the date the insolvency is determined or such additional time as shall be granted either by the court in which the action is pending or by the chancery court of Davidson County, upon petition by the association for good cause shown to permit proper defense of such causes of action. (b) The association shall not be obligated to satisfy in part or in whole any decision, verdict, or finding based on the default of the insolvent insurer or its failure to defend an insured, but shall be permitted to defend such claim on its merits. Acts 1971, ch. 180, § 17; 1975, ch. 62, § 7; 1977, ch. 203, § 4; T.C.A., § 56-4017.
(a) All proceedings in which the association is obligated to defend by reason of this part shall be stayed for six (6) months from the date the insolvency is determined or such additional time as shall be granted either by the court in which the action is pending or by the chancery court of Davidson County, upon petition by the association for good cause shown to permit proper defense of such causes of action.
(b) The association shall not be obligated to satisfy in part or in whole any decision, verdict, or finding based on the default of the insolvent insurer or its failure to defend an insured, but shall be permitted to defend such claim on its merits.
Acts 1971, ch. 180, § 17; 1975, ch. 62, § 7; 1977, ch. 203, § 4; T.C.A., § 56-4017.
Tenn. Code Ann. § 56-7-2319 — TN Code / Title 56 / Chapter 7 / Section 56-7-2319
Optional election of retirement conversion rights
Status: in_force

In the event coverage would be continued under the group policy on an employee following retirement prior to the time the employee is or could be covered by medicare, the employee may elect, in lieu of the continuation of group insurance, to have the same conversion rights as would apply had the employee's insurance terminated at retirement by reason of termination of employment or membership. Acts 1980, ch. 537, § 1; 1992, ch. 984, § 1; T.C.A., § 56-7-1508.
In the event coverage would be continued under the group policy on an employee following retirement prior to the time the employee is or could be covered by medicare, the employee may elect, in lieu of the continuation of group insurance, to have the same conversion rights as would apply had the employee's insurance terminated at retirement by reason of termination of employment or membership.
Acts 1980, ch. 537, § 1; 1992, ch. 984, § 1; T.C.A., § 56-7-1508.
Tenn. Code Ann. § 56-6-119 — TN Code / Title 56 / Chapter 6 / Section 56-6-119
Reporting of actions
Status: in_force

(a) A producer shall report to the commissioner any administrative action taken against the producer in another jurisdiction or by another governmental agency in this state within thirty (30) days of the final disposition of the matter. This report shall include a copy of any order entered or other relevant legal documents. (b) Within thirty (30) days of the initial pretrial hearing date, a producer shall report to the commissioner any criminal prosecution of the producer taken in any jurisdiction. The report shall include a copy of the initial complaint filed, the order resulting from the hearing and any other relevant legal documents. Acts 2002, ch. 798, § 20.
(a) A producer shall report to the commissioner any administrative action taken against the producer in another jurisdiction or by another governmental agency in this state within thirty (30) days of the final disposition of the matter. This report shall include a copy of any order entered or other relevant legal documents.
(b) Within thirty (30) days of the initial pretrial hearing date, a producer shall report to the commissioner any criminal prosecution of the producer taken in any jurisdiction. The report shall include a copy of the initial complaint filed, the order resulting from the hearing and any other relevant legal documents.
Acts 2002, ch. 798, § 20.
Tenn. Code Ann. § 56-13-403 — TN Code / Title 56 / Chapter 13 / Section 56-13-403
Controlling provisions when conflict exists - Exemptions
Status: in_force

(a) No provisions of this title, other than those expressly provided in this part, shall apply to an SPFC, and those provisions apply only as modified by this part. If a conflict occurs between this title and this part, this part shall control. (b) The commissioner, by rule, regulation, or order, may exempt an SPFC or its protected cells, on a case-by-case basis, from this chapter if the commissioner determines regulation under this chapter to be inappropriate given the nature of the risks to be insured. Acts 2011, ch. 468, § 1.
(a) No provisions of this title, other than those expressly provided in this part, shall apply to an SPFC, and those provisions apply only as modified by this part. If a conflict occurs between this title and this part, this part shall control.
(b) The commissioner, by rule, regulation, or order, may exempt an SPFC or its protected cells, on a case-by-case basis, from this chapter if the commissioner determines regulation under this chapter to be inappropriate given the nature of the risks to be insured.
Acts 2011, ch. 468, § 1.