Tenn. Code Ann. § 56-7-2208 — TN Code / Title 56 / Chapter 7 / Section 56-7-2208
Formation of health group cooperative of small employers - Registration - Organization
Status: in_force

(a) A health group cooperative of small employers may be formed only for the purpose of obtaining insurance. A health group cooperative shall: (1) Contain at least one thousand (1,000) eligible employees or have at least ten (10) participating employers; (2) Establish requirements for membership. A small employer's participation in a cooperative is voluntary, but an employer electing to participate in a cooperative shall commit to purchasing coverage through the cooperative for three (3) years, unless allowed to terminate participation because of a financial hardship affecting the employer as determined by rules governing termination promulgated by the commissioner. These rules shall include, at a minimum, that "financial hardship" means the initiation of bankruptcy proceedings or dissolution of the employer. No health group cooperative shall exclude a small employer that otherwise meets the requirements for membership on the basis of a health status-related factor, as defined in § 56-7-2802 , in relation to the employee or a dependent of the employee; (3) Hold an open enrollment period at least once a year during which period eligible employers and eligible employees may join the health group cooperative; (4) Allow eligible employees and their dependents, upon initial enrollment and during subsequent open enrollment periods, to choose among health insurance plans from the insurer selected by and offered through the cooperative. A person covered by a health insurance plan offered through the cooperative that requires an enrollment period in excess of one (1) year is eligible to choose among available plans upon the completion of the enrollment period; (5) Offer coverage under all the selected insurers' plans offered through the cooperative to all eligible employees of member small employers and their dependents. Coverage shall be offered to all employees of member small employers and their dependents except as provided in § 56-7-2207(a)(4) ; (6) Not assume any risk or form self-insurance plans among its members unless it complies with chapter 26, part 2 of this title; provided, however, that compliance with § 56-26-204(a)(1)(C) shall not be required of health cooperatives; and (7) Have the option of using any type of rating arrangement with the insurer selected by the cooperative. At the cooperative's discretion, premiums may be paid to the health insurance plans by the cooperative or by member small employers. A health insurance plan offered through the health group cooperative that rates: (A) Each member small employer separately is subject to the laws governing small employer health insurance; and (B) The entire group as a whole shall charge each insured person based on a base rate within the health group cooperative, adjusted for case characteristics as permitted by § 56-7-2207 and plan selection, and is subject to the laws governing group accident and health insurance. (b) (1) The health group cooperative, prior to offering any health insurance plan through the cooperative, and annually after the initial offering, shall register with the department and demonstrate continued compliance with subdivision (b)(2). (2) The health group cooperative shall be organized as a nonprofit corporation and have the rights and duties pursuant to the Tennessee Nonprofit Corporation Act, compiled in title 48, chapters 51-68. On receipt of a certificate of incorporation from the secretary of state, the cooperative shall file written notification of the receipt of the certificate and a copy of the cooperative's organizational documents with the commissioner. The board of directors shall file annually with the commissioner a statement of all amounts collected and expenses incurred for the preceding year. (c) A small employer insurer may not form, or be a member of, a health group cooperative. An insurer may associate with a sponsoring entity, such as a business association, chamber of commerce, or other organization representing employers or serving an analogous function, to assist the sponsoring entity in forming a health group cooperative. Acts 2008, ch. 1036, § 3; 2010, ch. 687, § 1.
(a) A health group cooperative of small employers may be formed only for the purpose of obtaining insurance. A health group cooperative shall: (1) Contain at least one thousand (1,000) eligible employees or have at least ten (10) participating employers; (2) Establish requirements for membership. A small employer's participation in a cooperative is voluntary, but an employer electing to participate in a cooperative shall commit to purchasing coverage through the cooperative for three (3) years, unless allowed to terminate participation because of a financial hardship affecting the employer as determined by rules governing termination promulgated by the commissioner. These rules shall include, at a minimum, that "financial hardship" means the initiation of bankruptcy proceedings or dissolution of the employer. No health group cooperative shall exclude a small employer that otherwise meets the requirements for membership on the basis of a health status-related factor, as defined in § 56-7-2802 , in relation to the employee or a dependent of the employee; (3) Hold an open enrollment period at least once a year during which period eligible employers and eligible employees may join the health group cooperative; (4) Allow eligible employees and their dependents, upon initial enrollment and during subsequent open enrollment periods, to choose among health insurance plans from the insurer selected by and offered through the cooperative. A person covered by a health insurance plan offered through the cooperative that requires an enrollment period in excess of one (1) year is eligible to choose among available plans upon the completion of the enrollment period; (5) Offer coverage under all the selected insurers' plans offered through the cooperative to all eligible employees of member small employers and their dependents. Coverage shall be offered to all employees of member small employers and their dependents except as provided in § 56-7-2207(a)(4) ; (6) Not assume any risk or form self-insurance plans among its members unless it complies with chapter 26, part 2 of this title; provided, however, that compliance with § 56-26-204(a)(1)(C) shall not be required of health cooperatives; and (7) Have the option of using any type of rating arrangement with the insurer selected by the cooperative. At the cooperative's discretion, premiums may be paid to the health insurance plans by the cooperative or by member small employers. A health insurance plan offered through the health group cooperative that rates: (A) Each member small employer separately is subject to the laws governing small employer health insurance; and (B) The entire group as a whole shall charge each insured person based on a base rate within the health group cooperative, adjusted for case characteristics as permitted by § 56-7-2207 and plan selection, and is subject to the laws governing group accident and health insurance.
(1) Contain at least one thousand (1,000) eligible employees or have at least ten (10) participating employers;
(2) Establish requirements for membership. A small employer's participation in a cooperative is voluntary, but an employer electing to participate in a cooperative shall commit to purchasing coverage through the cooperative for three (3) years, unless allowed to terminate participation because of a financial hardship affecting the employer as determined by rules governing termination promulgated by the commissioner. These rules shall include, at a minimum, that "financial hardship" means the initiation of bankruptcy proceedings or dissolution of the employer. No health group cooperative shall exclude a small employer that otherwise meets the requirements for membership on the basis of a health status-related factor, as defined in § 56-7-2802 , in relation to the employee or a dependent of the employee;
(3) Hold an open enrollment period at least once a year during which period eligible employers and eligible employees may join the health group cooperative;
(4) Allow eligible employees and their dependents, upon initial enrollment and during subsequent open enrollment periods, to choose among health insurance plans from the insurer selected by and offered through the cooperative. A person covered by a health insurance plan offered through the cooperative that requires an enrollment period in excess of one (1) year is eligible to choose among available plans upon the completion of the enrollment period;
(5) Offer coverage under all the selected insurers' plans offered through the cooperative to all eligible employees of member small employers and their dependents. Coverage shall be offered to all employees of member small employers and their dependents except as provided in § 56-7-2207(a)(4) ;
(6) Not assume any risk or form self-insurance plans among its members unless it complies with chapter 26, part 2 of this title; provided, however, that compliance with § 56-26-204(a)(1)(C) shall not be required of health cooperatives; and
(7) Have the option of using any type of rating arrangement with the insurer selected by the cooperative. At the cooperative's discretion, premiums may be paid to the health insurance plans by the cooperative or by member small employers. A health insurance plan offered through the health group cooperative that rates: (A) Each member small employer separately is subject to the laws governing small employer health insurance; and (B) The entire group as a whole shall charge each insured person based on a base rate within the health group cooperative, adjusted for case characteristics as permitted by § 56-7-2207 and plan selection, and is subject to the laws governing group accident and health insurance.
(A) Each member small employer separately is subject to the laws governing small employer health insurance; and
(B) The entire group as a whole shall charge each insured person based on a base rate within the health group cooperative, adjusted for case characteristics as permitted by § 56-7-2207 and plan selection, and is subject to the laws governing group accident and health insurance.
(b) (1) The health group cooperative, prior to offering any health insurance plan through the cooperative, and annually after the initial offering, shall register with the department and demonstrate continued compliance with subdivision (b)(2). (2) The health group cooperative shall be organized as a nonprofit corporation and have the rights and duties pursuant to the Tennessee Nonprofit Corporation Act, compiled in title 48, chapters 51-68. On receipt of a certificate of incorporation from the secretary of state, the cooperative shall file written notification of the receipt of the certificate and a copy of the cooperative's organizational documents with the commissioner. The board of directors shall file annually with the commissioner a statement of all amounts collected and expenses incurred for the preceding year.
(1) The health group cooperative, prior to offering any health insurance plan through the cooperative, and annually after the initial offering, shall register with the department and demonstrate continued compliance with subdivision (b)(2).
(2) The health group cooperative shall be organized as a nonprofit corporation and have the rights and duties pursuant to the Tennessee Nonprofit Corporation Act, compiled in title 48, chapters 51-68. On receipt of a certificate of incorporation from the secretary of state, the cooperative shall file written notification of the receipt of the certificate and a copy of the cooperative's organizational documents with the commissioner. The board of directors shall file annually with the commissioner a statement of all amounts collected and expenses incurred for the preceding year.
(c) A small employer insurer may not form, or be a member of, a health group cooperative. An insurer may associate with a sponsoring entity, such as a business association, chamber of commerce, or other organization representing employers or serving an analogous function, to assist the sponsoring entity in forming a health group cooperative.
Acts 2008, ch. 1036, § 3; 2010, ch. 687, § 1.
Tenn. Code Ann. § 56-29-117 — TN Code / Title 56 / Chapter 29 / Section 56-29-117
Submission of contracts and schedule of rates to commissioner - Disapproval
Status: in_force

The corporation shall submit to the commissioner specimen copies of each different type of subscriber's contract and a schedule of rates applicable to the subscriber's contract that it proposes to issue in this state. The commissioner shall approve or disapprove a contract as provided for in §§ 56-26-102 and 56-26-202 and any regulations promulgated under the authority of that section. Sections 56-26-102 and 56-26-202 and related regulations shall apply to all hospital and medical service plans in the same manner as to the accident and sickness policies subject to §§ 56-26-102 and 56-26-202 . Acts 1949, ch. 234, § 7; C. Supp. 1950, § 4186.49 (Williams, § 4186.52); impl. am. Acts 1971, ch. 137, § 2; T.C.A. (orig. ed.), §56-3117; Acts 2011 , ch. 344, § 17.
The corporation shall submit to the commissioner specimen copies of each different type of subscriber's contract and a schedule of rates applicable to the subscriber's contract that it proposes to issue in this state. The commissioner shall approve or disapprove a contract as provided for in §§ 56-26-102 and 56-26-202 and any regulations promulgated under the authority of that section. Sections 56-26-102 and 56-26-202 and related regulations shall apply to all hospital and medical service plans in the same manner as to the accident and sickness policies subject to §§ 56-26-102 and 56-26-202 .
Acts 1949, ch. 234, § 7; C. Supp. 1950, § 4186.49 (Williams, § 4186.52); impl. am. Acts 1971, ch. 137, § 2; T.C.A. (orig. ed.), §56-3117; Acts 2011 , ch. 344, § 17.
Tenn. Code Ann. § 56-10-105 — TN Code / Title 56 / Chapter 10 / Section 56-10-105
Approval of shareholders
Status: in_force

The plan as approved by the commissioner shall then be submitted to a vote of the shareholders of each corporation that is a party to the plan at an annual or special meeting of the shareholders. Written notice of the meeting shall be given in the manner required by § 48-17-105 , shall state the right of a shareholder to dissent and receive fair value for the shareholder's shares, and shall contain a copy or summary of the plan of merger, consolidation, or exchange. The plan shall be approved upon receiving the affirmative votes of the holders of at least two thirds (2/3) of the outstanding shares of capital stock of each such corporation or of such larger proportion of shares as may be specified in the plan. Notwithstanding the approval, and at any time prior to the effective date of the plan as provided in § 56-10-109 , the plan may be abandoned pursuant to provisions therefor, if any, set forth in the plan. Acts 1968, ch. 448, § 2; impl. am. Acts 1971, ch. 137, § 2; T.C.A., § 56-3605.
The plan as approved by the commissioner shall then be submitted to a vote of the shareholders of each corporation that is a party to the plan at an annual or special meeting of the shareholders. Written notice of the meeting shall be given in the manner required by § 48-17-105 , shall state the right of a shareholder to dissent and receive fair value for the shareholder's shares, and shall contain a copy or summary of the plan of merger, consolidation, or exchange. The plan shall be approved upon receiving the affirmative votes of the holders of at least two thirds (2/3) of the outstanding shares of capital stock of each such corporation or of such larger proportion of shares as may be specified in the plan. Notwithstanding the approval, and at any time prior to the effective date of the plan as provided in § 56-10-109 , the plan may be abandoned pursuant to provisions therefor, if any, set forth in the plan.
Acts 1968, ch. 448, § 2; impl. am. Acts 1971, ch. 137, § 2; T.C.A., § 56-3605.
Tenn. Code Ann. § 56-2-209 — TN Code / Title 56 / Chapter 2 / Section 56-2-209
Assuming insurers - Determination of financial condition
Status: in_force

(a) (1) An asset or a reduction from liability for the reinsurance ceded by a domestic insurer to an assuming insurer not meeting the requirements of § 56-2-208 shall be allowed in an amount not exceeding the liabilities carried by the ceding insurer. However, the commissioner may adopt by rule pursuant to subsection (g) specific additional requirements relating to or setting forth: (A) The valuation of assets or reserve credits; (B) The amount and forms of security supporting reinsurance arrangements described in subsection (g); and (C) The circumstances pursuant to which credit will be reduced or eliminated. (2) The reduction shall be in the amount of funds held by or on behalf of the ceding insurer, including funds held in trust for the ceding insurer, under a reinsurance contract with the assuming insurer as security for the payment of obligations under the contract, if the security is held in the United States subject to withdrawal solely by, and under the exclusive control of, the ceding insurer, or, in the case of a trust, held in a qualified United States financial institution. This security may be in the form of: (A) Cash; (B) Securities listed by the Securities Valuation Office of the National Association of Insurance Commissioners, including those deemed exempt from filing as defined by the Purposes and Procedures Manual of the Securities Valuation Office, and qualifying as admitted assets; (C) Clean, irrevocable, unconditional letters of credit, issued or confirmed by a qualified United States financial institution no later than December 31 of the year for which filing is being made, and in the possession of the ceding company on or before the filing date of its annual statement; or (D) Any other form of security acceptable to the commissioner. (b) Letters of credit meeting applicable standards of issuer acceptability as of the dates of their issuance, or confirmation, shall, notwithstanding the issuing or confirming institution's subsequent failure to meet applicable standards of issuer acceptability, continue to be acceptable as security until their expiration, extension, renewal, modification or amendment, whichever first occurs. (c) For purposes of subdivision (a)(3), a "qualified United States financial institution" means an institution that: (1) Is organized or licensed, in the case of a United States office of a foreign banking organization, under the laws of the United States or any state in the United States; (2) Is regulated, supervised and examined by United States federal or state authorities having regulatory authority over banks and trust companies; and (3) Has been determined by either the commissioner, or the Securities Valuation Office of the National Association of Insurance Commissioners, to meet the standards of financial condition and standing considered necessary and appropriate to regulate the quality of financial institutions whose letters of credit will be acceptable to the commissioner. (d) For purposes of those provisions of this chapter specifying those institutions that are eligible to act as a fiduciary of a trust, "qualified United States financial institution" means an institution that: (1) Is organized or licensed, in the case of a United States branch or agency office of a foreign banking organization, under the laws of the United States or any state and has been granted authority to operate with fiduciary powers; and (2) Is regulated, supervised and examined by federal or state authorities having regulatory authority over banks and trust companies. (e) The commissioner may adopt rules and regulations implementing this section and § 56-2-208 . The rules and regulations shall be promulgated pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5. (f) This section and § 56-2-208 apply to all cessions after July 1, 1993, under reinsurance agreements that have had an inception, anniversary, or renewal date not less than six (6) months after July 1, 1993. (g) (1) The commissioner is further authorized to promulgate rules applicable to reinsurance arrangements described in this subdivision (g)(1) relating to: (A) Life insurance policies with guaranteed nonlevel gross premiums or guaranteed nonlevel benefits; (B) Universal life insurance policies with provisions resulting in the ability of a policyholder to keep a policy in force over a secondary guarantee period; (C) Variable annuities with guaranteed death or living benefits; (D) Long-term care insurance policies; or (E) Other life and health insurance and annuity products as to which the commissioner adopts regulatory requirements with respect to credit for reinsurance. (2) A rule promulgated pursuant to subdivision (g)(1)(A) or (g)(1)(B) may apply to any treaty containing: (A) Policies issued on or after January 1, 2015; or (B) Policies issued prior to January 1, 2015, if risk pertaining to such pre-2015 policies is ceded in connection with the treaty, in whole or in part, on or after January 1, 2015. (3) A rule promulgated pursuant to this subsection (g) may require the ceding insurer, in calculating the amounts or forms of security required to be held under rules promulgated under this authority, to use the Valuation Manual adopted by the National Association of Insurance Commissioners (NAIC) under Section 11B(1) of the NAIC Standard Valuation Law, including all amendments adopted by the NAIC and in effect on the date as of which the calculation is made, to the extent applicable. (4) A rule promulgated pursuant to this subsection (g) does not apply to cessions to an assuming insurer that: (A) Is certified in this state or certified in a minimum of five (5) other states; or (B) Maintains at least two hundred fifty million dollars ($250,000,000) in capital and surplus, determined in accordance with the NAIC Accounting Practices and Procedures Manual, including all amendments to such manual that are adopted by the NAIC, excluding the impact of any permitted or prescribed practices; and is: (i) Licensed in at least twenty-six (26) states; or (ii) Licensed in at least ten (10) states, and licensed or accredited in a total of at least thirty-five (35) states. (5) The authority to promulgate rules pursuant to this subsection (g) does not limit the commissioner's authority to adopt rules pursuant to subsection (e). All rules under this subsection (g) must be promulgated in accordance with the Uniform Administrative Procedures Act. Amended by 2018 Tenn. Acts, ch. 873, Secs.s 6, s 7 eff. 5/3/2018. Amended by 2016 Tenn. Acts, ch. 735, s 7, eff. 4/7/2016. Acts 1947, ch. 154, § 3; C. Supp. 1950, § 6105.3 (Williams, § 6459.72); T.C.A. (orig. ed.), §§ 56-213, 56-227; Acts 1993, ch. 253, § 8.
(a) (1) An asset or a reduction from liability for the reinsurance ceded by a domestic insurer to an assuming insurer not meeting the requirements of § 56-2-208 shall be allowed in an amount not exceeding the liabilities carried by the ceding insurer. However, the commissioner may adopt by rule pursuant to subsection (g) specific additional requirements relating to or setting forth: (A) The valuation of assets or reserve credits; (B) The amount and forms of security supporting reinsurance arrangements described in subsection (g); and (C) The circumstances pursuant to which credit will be reduced or eliminated. (2) The reduction shall be in the amount of funds held by or on behalf of the ceding insurer, including funds held in trust for the ceding insurer, under a reinsurance contract with the assuming insurer as security for the payment of obligations under the contract, if the security is held in the United States subject to withdrawal solely by, and under the exclusive control of, the ceding insurer, or, in the case of a trust, held in a qualified United States financial institution. This security may be in the form of: (A) Cash; (B) Securities listed by the Securities Valuation Office of the National Association of Insurance Commissioners, including those deemed exempt from filing as defined by the Purposes and Procedures Manual of the Securities Valuation Office, and qualifying as admitted assets; (C) Clean, irrevocable, unconditional letters of credit, issued or confirmed by a qualified United States financial institution no later than December 31 of the year for which filing is being made, and in the possession of the ceding company on or before the filing date of its annual statement; or (D) Any other form of security acceptable to the commissioner.
(1) An asset or a reduction from liability for the reinsurance ceded by a domestic insurer to an assuming insurer not meeting the requirements of § 56-2-208 shall be allowed in an amount not exceeding the liabilities carried by the ceding insurer. However, the commissioner may adopt by rule pursuant to subsection (g) specific additional requirements relating to or setting forth: (A) The valuation of assets or reserve credits; (B) The amount and forms of security supporting reinsurance arrangements described in subsection (g); and (C) The circumstances pursuant to which credit will be reduced or eliminated.
(A) The valuation of assets or reserve credits;
(B) The amount and forms of security supporting reinsurance arrangements described in subsection (g); and
(C) The circumstances pursuant to which credit will be reduced or eliminated.
(2) The reduction shall be in the amount of funds held by or on behalf of the ceding insurer, including funds held in trust for the ceding insurer, under a reinsurance contract with the assuming insurer as security for the payment of obligations under the contract, if the security is held in the United States subject to withdrawal solely by, and under the exclusive control of, the ceding insurer, or, in the case of a trust, held in a qualified United States financial institution. This security may be in the form of: (A) Cash; (B) Securities listed by the Securities Valuation Office of the National Association of Insurance Commissioners, including those deemed exempt from filing as defined by the Purposes and Procedures Manual of the Securities Valuation Office, and qualifying as admitted assets; (C) Clean, irrevocable, unconditional letters of credit, issued or confirmed by a qualified United States financial institution no later than December 31 of the year for which filing is being made, and in the possession of the ceding company on or before the filing date of its annual statement; or (D) Any other form of security acceptable to the commissioner.
(A) Cash;
(B) Securities listed by the Securities Valuation Office of the National Association of Insurance Commissioners, including those deemed exempt from filing as defined by the Purposes and Procedures Manual of the Securities Valuation Office, and qualifying as admitted assets;
(C) Clean, irrevocable, unconditional letters of credit, issued or confirmed by a qualified United States financial institution no later than December 31 of the year for which filing is being made, and in the possession of the ceding company on or before the filing date of its annual statement; or
(D) Any other form of security acceptable to the commissioner.
(b) Letters of credit meeting applicable standards of issuer acceptability as of the dates of their issuance, or confirmation, shall, notwithstanding the issuing or confirming institution's subsequent failure to meet applicable standards of issuer acceptability, continue to be acceptable as security until their expiration, extension, renewal, modification or amendment, whichever first occurs.
(c) For purposes of subdivision (a)(3), a "qualified United States financial institution" means an institution that: (1) Is organized or licensed, in the case of a United States office of a foreign banking organization, under the laws of the United States or any state in the United States; (2) Is regulated, supervised and examined by United States federal or state authorities having regulatory authority over banks and trust companies; and (3) Has been determined by either the commissioner, or the Securities Valuation Office of the National Association of Insurance Commissioners, to meet the standards of financial condition and standing considered necessary and appropriate to regulate the quality of financial institutions whose letters of credit will be acceptable to the commissioner.
(1) Is organized or licensed, in the case of a United States office of a foreign banking organization, under the laws of the United States or any state in the United States;
(2) Is regulated, supervised and examined by United States federal or state authorities having regulatory authority over banks and trust companies; and
(3) Has been determined by either the commissioner, or the Securities Valuation Office of the National Association of Insurance Commissioners, to meet the standards of financial condition and standing considered necessary and appropriate to regulate the quality of financial institutions whose letters of credit will be acceptable to the commissioner.
(d) For purposes of those provisions of this chapter specifying those institutions that are eligible to act as a fiduciary of a trust, "qualified United States financial institution" means an institution that: (1) Is organized or licensed, in the case of a United States branch or agency office of a foreign banking organization, under the laws of the United States or any state and has been granted authority to operate with fiduciary powers; and (2) Is regulated, supervised and examined by federal or state authorities having regulatory authority over banks and trust companies.
(1) Is organized or licensed, in the case of a United States branch or agency office of a foreign banking organization, under the laws of the United States or any state and has been granted authority to operate with fiduciary powers; and
(2) Is regulated, supervised and examined by federal or state authorities having regulatory authority over banks and trust companies.
(e) The commissioner may adopt rules and regulations implementing this section and § 56-2-208 . The rules and regulations shall be promulgated pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
(f) This section and § 56-2-208 apply to all cessions after July 1, 1993, under reinsurance agreements that have had an inception, anniversary, or renewal date not less than six (6) months after July 1, 1993.
(g) (1) The commissioner is further authorized to promulgate rules applicable to reinsurance arrangements described in this subdivision (g)(1) relating to: (A) Life insurance policies with guaranteed nonlevel gross premiums or guaranteed nonlevel benefits; (B) Universal life insurance policies with provisions resulting in the ability of a policyholder to keep a policy in force over a secondary guarantee period; (C) Variable annuities with guaranteed death or living benefits; (D) Long-term care insurance policies; or (E) Other life and health insurance and annuity products as to which the commissioner adopts regulatory requirements with respect to credit for reinsurance. (2) A rule promulgated pursuant to subdivision (g)(1)(A) or (g)(1)(B) may apply to any treaty containing: (A) Policies issued on or after January 1, 2015; or (B) Policies issued prior to January 1, 2015, if risk pertaining to such pre-2015 policies is ceded in connection with the treaty, in whole or in part, on or after January 1, 2015. (3) A rule promulgated pursuant to this subsection (g) may require the ceding insurer, in calculating the amounts or forms of security required to be held under rules promulgated under this authority, to use the Valuation Manual adopted by the National Association of Insurance Commissioners (NAIC) under Section 11B(1) of the NAIC Standard Valuation Law, including all amendments adopted by the NAIC and in effect on the date as of which the calculation is made, to the extent applicable. (4) A rule promulgated pursuant to this subsection (g) does not apply to cessions to an assuming insurer that: (A) Is certified in this state or certified in a minimum of five (5) other states; or (B) Maintains at least two hundred fifty million dollars ($250,000,000) in capital and surplus, determined in accordance with the NAIC Accounting Practices and Procedures Manual, including all amendments to such manual that are adopted by the NAIC, excluding the impact of any permitted or prescribed practices; and is: (i) Licensed in at least twenty-six (26) states; or (ii) Licensed in at least ten (10) states, and licensed or accredited in a total of at least thirty-five (35) states. (5) The authority to promulgate rules pursuant to this subsection (g) does not limit the commissioner's authority to adopt rules pursuant to subsection (e). All rules under this subsection (g) must be promulgated in accordance with the Uniform Administrative Procedures Act.
(1) The commissioner is further authorized to promulgate rules applicable to reinsurance arrangements described in this subdivision (g)(1) relating to: (A) Life insurance policies with guaranteed nonlevel gross premiums or guaranteed nonlevel benefits; (B) Universal life insurance policies with provisions resulting in the ability of a policyholder to keep a policy in force over a secondary guarantee period; (C) Variable annuities with guaranteed death or living benefits; (D) Long-term care insurance policies; or (E) Other life and health insurance and annuity products as to which the commissioner adopts regulatory requirements with respect to credit for reinsurance.
(A) Life insurance policies with guaranteed nonlevel gross premiums or guaranteed nonlevel benefits;
(B) Universal life insurance policies with provisions resulting in the ability of a policyholder to keep a policy in force over a secondary guarantee period;
(C) Variable annuities with guaranteed death or living benefits;
(D) Long-term care insurance policies; or
(E) Other life and health insurance and annuity products as to which the commissioner adopts regulatory requirements with respect to credit for reinsurance.
(2) A rule promulgated pursuant to subdivision (g)(1)(A) or (g)(1)(B) may apply to any treaty containing: (A) Policies issued on or after January 1, 2015; or (B) Policies issued prior to January 1, 2015, if risk pertaining to such pre-2015 policies is ceded in connection with the treaty, in whole or in part, on or after January 1, 2015.
(A) Policies issued on or after January 1, 2015; or
(B) Policies issued prior to January 1, 2015, if risk pertaining to such pre-2015 policies is ceded in connection with the treaty, in whole or in part, on or after January 1, 2015.
(3) A rule promulgated pursuant to this subsection (g) may require the ceding insurer, in calculating the amounts or forms of security required to be held under rules promulgated under this authority, to use the Valuation Manual adopted by the National Association of Insurance Commissioners (NAIC) under Section 11B(1) of the NAIC Standard Valuation Law, including all amendments adopted by the NAIC and in effect on the date as of which the calculation is made, to the extent applicable.
(4) A rule promulgated pursuant to this subsection (g) does not apply to cessions to an assuming insurer that: (A) Is certified in this state or certified in a minimum of five (5) other states; or (B) Maintains at least two hundred fifty million dollars ($250,000,000) in capital and surplus, determined in accordance with the NAIC Accounting Practices and Procedures Manual, including all amendments to such manual that are adopted by the NAIC, excluding the impact of any permitted or prescribed practices; and is: (i) Licensed in at least twenty-six (26) states; or (ii) Licensed in at least ten (10) states, and licensed or accredited in a total of at least thirty-five (35) states.
(A) Is certified in this state or certified in a minimum of five (5) other states; or
(B) Maintains at least two hundred fifty million dollars ($250,000,000) in capital and surplus, determined in accordance with the NAIC Accounting Practices and Procedures Manual, including all amendments to such manual that are adopted by the NAIC, excluding the impact of any permitted or prescribed practices; and is: (i) Licensed in at least twenty-six (26) states; or (ii) Licensed in at least ten (10) states, and licensed or accredited in a total of at least thirty-five (35) states.
(i) Licensed in at least twenty-six (26) states; or
(ii) Licensed in at least ten (10) states, and licensed or accredited in a total of at least thirty-five (35) states.
(5) The authority to promulgate rules pursuant to this subsection (g) does not limit the commissioner's authority to adopt rules pursuant to subsection (e). All rules under this subsection (g) must be promulgated in accordance with the Uniform Administrative Procedures Act.
Amended by 2018 Tenn. Acts, ch. 873, Secs.s 6, s 7 eff. 5/3/2018.
Amended by 2016 Tenn. Acts, ch. 735, s 7, eff. 4/7/2016.
Acts 1947, ch. 154, § 3; C. Supp. 1950, § 6105.3 (Williams, § 6459.72); T.C.A. (orig. ed.), §§ 56-213, 56-227; Acts 1993, ch. 253, § 8.
Tenn. Code Ann. § 56-6-1302 — TN Code / Title 56 / Chapter 6 / Section 56-6-1302
Prohibition against navigator selling, soliciting or negotiating policy of insurance
Status: in_force

No navigator shall sell, solicit or negotiate any policy of insurance, either within or outside of an exchange. Added by 2013 Tenn. Acts, ch. 377,s 1, eff. 7/1/2013.
No navigator shall sell, solicit or negotiate any policy of insurance, either within or outside of an exchange.
Added by 2013 Tenn. Acts, ch. 377,s 1, eff. 7/1/2013.
Tenn. Code Ann. § 56-13-123 — TN Code / Title 56 / Chapter 13 / Section 56-13-123
Foreign or alien insurer as domestic captive insurance company - Redomestication - Licensing - Taxation
Status: in_force

(a) Notwithstanding any other method authorized by law, a foreign or alien insurer may become a domestic captive insurance company by complying with all of the requirements of this chapter relative to the organization and licensing of a domestic captive insurance company of the same type with the approval of the commissioner. A company redomesticating to this state pursuant to this section may be organized under any lawful corporate form permitted by this chapter. (b) A redomestication pursuant to this section shall be authorized for insurance companies domiciled in foreign or alien jurisdictions that authorize the redomestication of insurance companies where, as a result of the actions taken by the company pursuant to this section to redomesticate to this state, shall no longer be a domestic legal entity of foreign or alien jurisdiction. A company wishing to redomesticate under this section must also provide evidence that the applicable regulatory authority of its domicile consents to the redomestication. (c) An insurance company wishing to redomesticate under this section shall file with the secretary of state its articles of association, charter, or other organizational document, together with appropriate amendments thereto adopted in accordance with the laws of this state and bring such articles of association, charter, or other organizational document into compliance with the laws of this state, along with an approval letter issued by the commissioner. The company may file with the secretary of state an election deferring the effective date of the redomestication. Upon filing and paying the required fees prescribed in title 48 and title 61, the secretary of state shall issue an acknowledgement letter to the applicant. The secretary of state is also authorized to promulgate rules that provide for a fee to cover the cost of a redomestication. (d) The company shall file a copy of the secretary of state's acknowledgement letter with the commissioner, who shall then issue a license pursuant to § 56-13-103 . (e) Upon the completion of a redomestication under this section, the captive insurance company shall be subject to the laws of this state and shall be considered domiciled in this state. The captive insurance company shall be deemed to have a formation date corresponding to its original formation date in the foreign or alien domicile. (f) For the purposes of the § 56-13-109 examination, any examination conducted by the foreign or alien domicile that is substantially similar to an examination that would have been done in this state had the company been domiciled in this state shall be recognized for the purposes of establishing the period of time when the next examination is due. (g) (1) A company redomesticating under this section shall only be liable for taxes due pursuant to § 56-13-114 on premiums paid to the company after redomestication. (2) A company redomesticating under this section after July 1 of any year shall only be subject to one-half (1/2) of the minimum premium tax specified in § 56-13-114(c) in its first year. (3) An alien company redomesticating under this section shall report all premium taxes due under § 56-13-114 but may, in either its first or its second year of operations, but not both, after redomesticating into this state, elect to forego the payment of premium taxes. However, a company making such an election that surrenders its license or redomesticates to another jurisdiction within five (5) years of redomestication into this state shall immediately pay a tax in an amount equal to the foregone premium tax plus ten percent (10%) per annum from the date the foregone premium tax would have been due. (h) This section shall not be the exclusive means of redomesticating an insurance company to this state and shall not restrict the ability of an insurance company to undergo a merger, consolidation, transfer of assets and liabilities, or utilize any other means permitted by law to effect the transfer of operations of a foreign or alien insurance company to this state. Added by 2016 Tenn. Acts, ch. 1018, s 1, eff. 4/28/2016.
(a) Notwithstanding any other method authorized by law, a foreign or alien insurer may become a domestic captive insurance company by complying with all of the requirements of this chapter relative to the organization and licensing of a domestic captive insurance company of the same type with the approval of the commissioner. A company redomesticating to this state pursuant to this section may be organized under any lawful corporate form permitted by this chapter.
(b) A redomestication pursuant to this section shall be authorized for insurance companies domiciled in foreign or alien jurisdictions that authorize the redomestication of insurance companies where, as a result of the actions taken by the company pursuant to this section to redomesticate to this state, shall no longer be a domestic legal entity of foreign or alien jurisdiction. A company wishing to redomesticate under this section must also provide evidence that the applicable regulatory authority of its domicile consents to the redomestication.
(c) An insurance company wishing to redomesticate under this section shall file with the secretary of state its articles of association, charter, or other organizational document, together with appropriate amendments thereto adopted in accordance with the laws of this state and bring such articles of association, charter, or other organizational document into compliance with the laws of this state, along with an approval letter issued by the commissioner. The company may file with the secretary of state an election deferring the effective date of the redomestication. Upon filing and paying the required fees prescribed in title 48 and title 61, the secretary of state shall issue an acknowledgement letter to the applicant. The secretary of state is also authorized to promulgate rules that provide for a fee to cover the cost of a redomestication.
(d) The company shall file a copy of the secretary of state's acknowledgement letter with the commissioner, who shall then issue a license pursuant to § 56-13-103 .
(e) Upon the completion of a redomestication under this section, the captive insurance company shall be subject to the laws of this state and shall be considered domiciled in this state. The captive insurance company shall be deemed to have a formation date corresponding to its original formation date in the foreign or alien domicile.
(f) For the purposes of the § 56-13-109 examination, any examination conducted by the foreign or alien domicile that is substantially similar to an examination that would have been done in this state had the company been domiciled in this state shall be recognized for the purposes of establishing the period of time when the next examination is due.
(g) (1) A company redomesticating under this section shall only be liable for taxes due pursuant to § 56-13-114 on premiums paid to the company after redomestication. (2) A company redomesticating under this section after July 1 of any year shall only be subject to one-half (1/2) of the minimum premium tax specified in § 56-13-114(c) in its first year. (3) An alien company redomesticating under this section shall report all premium taxes due under § 56-13-114 but may, in either its first or its second year of operations, but not both, after redomesticating into this state, elect to forego the payment of premium taxes. However, a company making such an election that surrenders its license or redomesticates to another jurisdiction within five (5) years of redomestication into this state shall immediately pay a tax in an amount equal to the foregone premium tax plus ten percent (10%) per annum from the date the foregone premium tax would have been due.
(1) A company redomesticating under this section shall only be liable for taxes due pursuant to § 56-13-114 on premiums paid to the company after redomestication.
(2) A company redomesticating under this section after July 1 of any year shall only be subject to one-half (1/2) of the minimum premium tax specified in § 56-13-114(c) in its first year.
(3) An alien company redomesticating under this section shall report all premium taxes due under § 56-13-114 but may, in either its first or its second year of operations, but not both, after redomesticating into this state, elect to forego the payment of premium taxes. However, a company making such an election that surrenders its license or redomesticates to another jurisdiction within five (5) years of redomestication into this state shall immediately pay a tax in an amount equal to the foregone premium tax plus ten percent (10%) per annum from the date the foregone premium tax would have been due.
(h) This section shall not be the exclusive means of redomesticating an insurance company to this state and shall not restrict the ability of an insurance company to undergo a merger, consolidation, transfer of assets and liabilities, or utilize any other means permitted by law to effect the transfer of operations of a foreign or alien insurance company to this state.
Added by 2016 Tenn. Acts, ch. 1018, s 1, eff. 4/28/2016.
Tenn. Code Ann. § 56-30-118 — TN Code / Title 56 / Chapter 30 / Section 56-30-118
Examination - Rehabilitation or liquidation
Status: in_force

The commissioner has the same authority to examine the dental service plan corporations as is granted to the commissioner for the examination of life and accident and health insurance companies, and has the same authority for the correction, rehabilitation or liquidation of the dental service plan corporations as is now provided by law for life and health and accident companies. Acts 1961, ch. 340, § 17; T.C.A., § 56-3518.
The commissioner has the same authority to examine the dental service plan corporations as is granted to the commissioner for the examination of life and accident and health insurance companies, and has the same authority for the correction, rehabilitation or liquidation of the dental service plan corporations as is now provided by law for life and health and accident companies.
Acts 1961, ch. 340, § 17; T.C.A., § 56-3518.
Tenn. Code Ann. § 56-7-3122 — TN Code / Title 56 / Chapter 7 / Section 56-7-3122
Applicability of part
Status: in_force

Notwithstanding another law, this part applies to plans governed by the Employee Retirement Income Security Act of 1974 (ERISA) ( 29 U.S.C. § 1001 et seq.). Added by 2022 Tenn. Acts, ch. 1070, s 7, eff. 1/1/2023.
Notwithstanding another law, this part applies to plans governed by the Employee Retirement Income Security Act of 1974 (ERISA) ( 29 U.S.C. § 1001 et seq.).
Added by 2022 Tenn. Acts, ch. 1070, s 7, eff. 1/1/2023.
Tenn. Code Ann. § 56-23-102 — TN Code / Title 56 / Chapter 23 / Section 56-23-102
False swearing to statement to obtain certificate of authority - Perjury - Denial of right to do business - Revocation of certificate
Status: in_force

(a) False swearing to the statement required by § 56-23-101 shall be deemed perjury, and those who commit it shall be punished as in other cases of perjury. (b) The company in whose interest the false statement is made shall be denied the right to do business for twelve (12) months thereafter, and if a certificate of authority be obtained thereby for the company, it shall be revoked by the commissioner and the company prohibited from doing business for twelve (12) months next after the discovery of the false statement. Acts 1973, ch. 293, § 2; T.C.A., § 56-4202.
(a) False swearing to the statement required by § 56-23-101 shall be deemed perjury, and those who commit it shall be punished as in other cases of perjury.
(b) The company in whose interest the false statement is made shall be denied the right to do business for twelve (12) months thereafter, and if a certificate of authority be obtained thereby for the company, it shall be revoked by the commissioner and the company prohibited from doing business for twelve (12) months next after the discovery of the false statement.
Acts 1973, ch. 293, § 2; T.C.A., § 56-4202.
Tenn. Code Ann. § 56-4-308 — TN Code / Title 56 / Chapter 4 / Section 56-4-308
Powers of commissioner - Failure to file return or filing false return
Status: in_force

(a) The commissioner is vested with the following powers: (1) To examine at the expense of the investment company, subject to this part, the books and records, for the purpose of determining the amount of taxes due, in the event of the failure of the investment company to make its return or for the purpose of verifying or correcting any return made; and (2) To issue distress warrants for the collection of any tax due and unpaid, or to institute suit in the courts of law or chancery, for the use and benefit of the state. (b) Upon the failure or refusal of any investment company subject to this part to file a return or upon the filing of a false return, the investment company shall thereafter be estopped to dispute the accuracy of the assessment made by the commissioner. Acts 1939, ch. 187, § 7; C. Supp. 1950, § 1248.39 (Williams, § 1248.166); T.C.A. (orig. ed.), §§ 67-4408, 67-4-1208; Acts 1988, ch. 526, § 11.
(a) The commissioner is vested with the following powers: (1) To examine at the expense of the investment company, subject to this part, the books and records, for the purpose of determining the amount of taxes due, in the event of the failure of the investment company to make its return or for the purpose of verifying or correcting any return made; and (2) To issue distress warrants for the collection of any tax due and unpaid, or to institute suit in the courts of law or chancery, for the use and benefit of the state.
(1) To examine at the expense of the investment company, subject to this part, the books and records, for the purpose of determining the amount of taxes due, in the event of the failure of the investment company to make its return or for the purpose of verifying or correcting any return made; and
(2) To issue distress warrants for the collection of any tax due and unpaid, or to institute suit in the courts of law or chancery, for the use and benefit of the state.
(b) Upon the failure or refusal of any investment company subject to this part to file a return or upon the filing of a false return, the investment company shall thereafter be estopped to dispute the accuracy of the assessment made by the commissioner.
Acts 1939, ch. 187, § 7; C. Supp. 1950, § 1248.39 (Williams, § 1248.166); T.C.A. (orig. ed.), §§ 67-4408, 67-4-1208; Acts 1988, ch. 526, § 11.
Tenn. Code Ann. § 56-13-105 — TN Code / Title 56 / Chapter 13 / Section 56-13-105
Capital and surplus requirements
Status: in_force

(a) No captive insurance company shall be issued a license unless it possesses and maintains unimpaired paid-in capital and surplus of: (1) In the case of a pure captive insurance company, not less than two hundred fifty thousand dollars ($250,000); (2) In the case of an association captive insurance company, not less than five hundred thousand dollars ($500,000); (3) In the case of an industrial insured captive insurance company, not less than five hundred thousand dollars ($500,000); (4) In the case of a risk retention group, not less than one million dollars ($1,000,000); (5) In the case of a protected cell captive insurance company, not less than one hundred thousand dollars ($100,000); and (6) In the case of an agency captive insurance company, not less than two hundred fifty thousand dollars ($250,000). (b) The commissioner may prescribe additional capital and surplus based upon the type, volume, and nature of insurance business to be transacted. (c) (1) Capital and surplus required under subsection (a) must be in the form of cash, cash equivalent, marketable securities, or an irrevocable letter of credit issued by a bank approved by the commissioner. (2) Marketable securities must consist of bonds of the United States, or any agency or instrumentality of the United States, which have been included in the three (3) highest grades by any of the recognized securities rating firms, bonds of this state, or bonds publicly issued by any solvent institution created or existing under the laws of the United States or any state of the United States, which have been included in the three (3) highest grades by any of the recognized securities rating firms. (3) Captive insurance companies using marketable securities to meet the capital and surplus requirements of subsection (a) shall file with the commissioner a certificate of an official with whom the securities are deposited, stating the time and amount, and that the official is satisfied that they are worth the amount required under subsection (a) and that the deposit is made with the official by the company for the protection of all policyholders and creditors. (4) Notwithstanding subdivision (c)(1), the commissioner may decline to accept as a deposit any specific issue of securities that the commissioner has determined may not provide the necessary protection to policyholders and creditors. (d) Except as otherwise provided in this chapter, chapter 9 of this title shall apply to captive insurance companies formed under this chapter. Amended by 2024 Tenn. Acts, ch. 643,s 5, eff. 4/4/2024. Amended by 2021 Tenn. Acts, ch. 537, s 13, eff. 7/1/2021. Amended by 2019 Tenn. Acts, ch. 452, s 3, eff. 5/22/2019. Amended by 2015 Tenn. Acts, ch. 156, s 4, eff. 4/17/2015. Amended by 2013 Tenn. Acts, ch. 139, s 1, eff. 4/12/2013. Acts 2011 , ch. 468, § 1.
(a) No captive insurance company shall be issued a license unless it possesses and maintains unimpaired paid-in capital and surplus of: (1) In the case of a pure captive insurance company, not less than two hundred fifty thousand dollars ($250,000); (2) In the case of an association captive insurance company, not less than five hundred thousand dollars ($500,000); (3) In the case of an industrial insured captive insurance company, not less than five hundred thousand dollars ($500,000); (4) In the case of a risk retention group, not less than one million dollars ($1,000,000); (5) In the case of a protected cell captive insurance company, not less than one hundred thousand dollars ($100,000); and (6) In the case of an agency captive insurance company, not less than two hundred fifty thousand dollars ($250,000).
(1) In the case of a pure captive insurance company, not less than two hundred fifty thousand dollars ($250,000);
(2) In the case of an association captive insurance company, not less than five hundred thousand dollars ($500,000);
(3) In the case of an industrial insured captive insurance company, not less than five hundred thousand dollars ($500,000);
(4) In the case of a risk retention group, not less than one million dollars ($1,000,000);
(5) In the case of a protected cell captive insurance company, not less than one hundred thousand dollars ($100,000); and
(6) In the case of an agency captive insurance company, not less than two hundred fifty thousand dollars ($250,000).
(b) The commissioner may prescribe additional capital and surplus based upon the type, volume, and nature of insurance business to be transacted.
(c) (1) Capital and surplus required under subsection (a) must be in the form of cash, cash equivalent, marketable securities, or an irrevocable letter of credit issued by a bank approved by the commissioner. (2) Marketable securities must consist of bonds of the United States, or any agency or instrumentality of the United States, which have been included in the three (3) highest grades by any of the recognized securities rating firms, bonds of this state, or bonds publicly issued by any solvent institution created or existing under the laws of the United States or any state of the United States, which have been included in the three (3) highest grades by any of the recognized securities rating firms. (3) Captive insurance companies using marketable securities to meet the capital and surplus requirements of subsection (a) shall file with the commissioner a certificate of an official with whom the securities are deposited, stating the time and amount, and that the official is satisfied that they are worth the amount required under subsection (a) and that the deposit is made with the official by the company for the protection of all policyholders and creditors. (4) Notwithstanding subdivision (c)(1), the commissioner may decline to accept as a deposit any specific issue of securities that the commissioner has determined may not provide the necessary protection to policyholders and creditors.
(1) Capital and surplus required under subsection (a) must be in the form of cash, cash equivalent, marketable securities, or an irrevocable letter of credit issued by a bank approved by the commissioner.
(2) Marketable securities must consist of bonds of the United States, or any agency or instrumentality of the United States, which have been included in the three (3) highest grades by any of the recognized securities rating firms, bonds of this state, or bonds publicly issued by any solvent institution created or existing under the laws of the United States or any state of the United States, which have been included in the three (3) highest grades by any of the recognized securities rating firms.
(3) Captive insurance companies using marketable securities to meet the capital and surplus requirements of subsection (a) shall file with the commissioner a certificate of an official with whom the securities are deposited, stating the time and amount, and that the official is satisfied that they are worth the amount required under subsection (a) and that the deposit is made with the official by the company for the protection of all policyholders and creditors.
(4) Notwithstanding subdivision (c)(1), the commissioner may decline to accept as a deposit any specific issue of securities that the commissioner has determined may not provide the necessary protection to policyholders and creditors.
(d) Except as otherwise provided in this chapter, chapter 9 of this title shall apply to captive insurance companies formed under this chapter.
Amended by 2024 Tenn. Acts, ch. 643,s 5, eff. 4/4/2024.
Amended by 2021 Tenn. Acts, ch. 537, s 13, eff. 7/1/2021.
Amended by 2019 Tenn. Acts, ch. 452, s 3, eff. 5/22/2019.
Amended by 2015 Tenn. Acts, ch. 156, s 4, eff. 4/17/2015.
Amended by 2013 Tenn. Acts, ch. 139, s 1, eff. 4/12/2013.
Acts 2011 , ch. 468, § 1.
Tenn. Code Ann. § 56-60-105 — TN Code / Title 56 / Chapter 60 / Section 56-60-105
Granting a third party access to a provider's health care services and contractual discounts pursuant to a provider network contract
Status: in_force

(a) A contracting entity shall only grant access to a provider's health care services and contractual discounts pursuant to the contracting entity's provider network contract if: (1) The provider network contract clearly and plainly authorizes the contracting entity to enter into an agreement with a third party allowing the third party to exercise the contracting entity's rights and responsibilities under the provider network contract as if the third party were the contracting entity; and (2) The third party accessing a provider's services and contractual discounts pursuant to the provider network contract is contractually obligated to comply with all applicable terms, limitations and conditions of the provider network contract. (b) A contracting entity that grants a third party access to a provider's health care services and contractual discounts pursuant to a provider network contract shall: (1) Identify and supply to a provider, upon request at the time a provider network contract is entered into with the provider, a written or electronic list of all third parties known at the time of contracting to which the contracting entity has or will grant access to the provider's health care services and contractual discounts pursuant to the provider network contract; (2) Maintain an Internet web site or a toll-free telephone number through which a provider may obtain a listing, updated at least quarterly, of the third parties to which the contracting entity or another third party has executed contracts to grant access to the provider's health care services and contractual discounts pursuant to the provider network contract; (3) Provide each third party who contracts with the contracting entity to gain access to the provider network contract a summary of the contracting entity's current standard provider contract terms; (4) Require that each third party who contracts with the contracting entity to gain access to the provider network contract: (A) Designate an individual or department responsible for responding to provider inquiries concerning the third party's access to the provider network contract; and (B) Include the following information on each remittance advice (RA), explanation of payment (EOP) or other similar documentation furnished to a provider when a contractual discount is exercised pursuant to the contracting entity's provider network contract: (i) The source of the contractual discount taken by the third party; and (ii) A direct toll-free telephone number answerable Monday through Friday during normal business hours for the individual or department designated to be responsible for responding to provider inquiries pursuant to subdivision (b)(4)(A); and (5) (A) Notify any third party who contracts with the contracting entity to gain access to a provider's services and contractual discounts pursuant to the provider network contract of the termination of the provider network contract within thirty (30) calendar days of the contracting entity's receipt of notification of the termination; (B) The notice required by subdivision (b)(5)(A) shall be provided through written notice, electronic communication or an update to an electronic database of provider listings. (c) Subject to any applicable continuity of care requirements, provisions of the provider network contract or contrary law: (1) A third party's right to access a provider's health care services and contractual discounts pursuant to a provider network contract shall terminate on the date the provider network contract is terminated; (2) Claims for health care services performed after the termination date of the provider network contract are not eligible for processing and payment in accordance with the provider network contract; and (3) Claims for health care services performed before the termination date of the provider network contract, but processed after the termination date, are eligible for processing and payment in accordance with the provider network contract. (d) (1) All information made available to a provider in accordance with the requirements of this chapter shall be confidential and shall not be disclosed to any individual or entity not involved in the provider's practice or the administration of such practice without the prior written consent of the contracting entity. (2) A contracting entity may reference or include within the contract or a related document the language contained in subdivision (d)(1), or language that is substantially similar in scope and purpose, in order to affirm each party's knowledge of and agreement to comply with the confidentiality provision. (3) This subsection (d) shall not preclude the information being disclosed for purposes of dispute resolution, enforcement of this chapter or assistance in enforcing this chapter. Acts 2009, ch. 466, § 6.
(a) A contracting entity shall only grant access to a provider's health care services and contractual discounts pursuant to the contracting entity's provider network contract if: (1) The provider network contract clearly and plainly authorizes the contracting entity to enter into an agreement with a third party allowing the third party to exercise the contracting entity's rights and responsibilities under the provider network contract as if the third party were the contracting entity; and (2) The third party accessing a provider's services and contractual discounts pursuant to the provider network contract is contractually obligated to comply with all applicable terms, limitations and conditions of the provider network contract.
(1) The provider network contract clearly and plainly authorizes the contracting entity to enter into an agreement with a third party allowing the third party to exercise the contracting entity's rights and responsibilities under the provider network contract as if the third party were the contracting entity; and
(2) The third party accessing a provider's services and contractual discounts pursuant to the provider network contract is contractually obligated to comply with all applicable terms, limitations and conditions of the provider network contract.
(b) A contracting entity that grants a third party access to a provider's health care services and contractual discounts pursuant to a provider network contract shall: (1) Identify and supply to a provider, upon request at the time a provider network contract is entered into with the provider, a written or electronic list of all third parties known at the time of contracting to which the contracting entity has or will grant access to the provider's health care services and contractual discounts pursuant to the provider network contract; (2) Maintain an Internet web site or a toll-free telephone number through which a provider may obtain a listing, updated at least quarterly, of the third parties to which the contracting entity or another third party has executed contracts to grant access to the provider's health care services and contractual discounts pursuant to the provider network contract; (3) Provide each third party who contracts with the contracting entity to gain access to the provider network contract a summary of the contracting entity's current standard provider contract terms; (4) Require that each third party who contracts with the contracting entity to gain access to the provider network contract: (A) Designate an individual or department responsible for responding to provider inquiries concerning the third party's access to the provider network contract; and (B) Include the following information on each remittance advice (RA), explanation of payment (EOP) or other similar documentation furnished to a provider when a contractual discount is exercised pursuant to the contracting entity's provider network contract: (i) The source of the contractual discount taken by the third party; and (ii) A direct toll-free telephone number answerable Monday through Friday during normal business hours for the individual or department designated to be responsible for responding to provider inquiries pursuant to subdivision (b)(4)(A); and (5) (A) Notify any third party who contracts with the contracting entity to gain access to a provider's services and contractual discounts pursuant to the provider network contract of the termination of the provider network contract within thirty (30) calendar days of the contracting entity's receipt of notification of the termination; (B) The notice required by subdivision (b)(5)(A) shall be provided through written notice, electronic communication or an update to an electronic database of provider listings.
(1) Identify and supply to a provider, upon request at the time a provider network contract is entered into with the provider, a written or electronic list of all third parties known at the time of contracting to which the contracting entity has or will grant access to the provider's health care services and contractual discounts pursuant to the provider network contract;
(2) Maintain an Internet web site or a toll-free telephone number through which a provider may obtain a listing, updated at least quarterly, of the third parties to which the contracting entity or another third party has executed contracts to grant access to the provider's health care services and contractual discounts pursuant to the provider network contract;
(3) Provide each third party who contracts with the contracting entity to gain access to the provider network contract a summary of the contracting entity's current standard provider contract terms;
(4) Require that each third party who contracts with the contracting entity to gain access to the provider network contract: (A) Designate an individual or department responsible for responding to provider inquiries concerning the third party's access to the provider network contract; and (B) Include the following information on each remittance advice (RA), explanation of payment (EOP) or other similar documentation furnished to a provider when a contractual discount is exercised pursuant to the contracting entity's provider network contract: (i) The source of the contractual discount taken by the third party; and (ii) A direct toll-free telephone number answerable Monday through Friday during normal business hours for the individual or department designated to be responsible for responding to provider inquiries pursuant to subdivision (b)(4)(A); and
(A) Designate an individual or department responsible for responding to provider inquiries concerning the third party's access to the provider network contract; and
(B) Include the following information on each remittance advice (RA), explanation of payment (EOP) or other similar documentation furnished to a provider when a contractual discount is exercised pursuant to the contracting entity's provider network contract: (i) The source of the contractual discount taken by the third party; and (ii) A direct toll-free telephone number answerable Monday through Friday during normal business hours for the individual or department designated to be responsible for responding to provider inquiries pursuant to subdivision (b)(4)(A); and
(i) The source of the contractual discount taken by the third party; and
(ii) A direct toll-free telephone number answerable Monday through Friday during normal business hours for the individual or department designated to be responsible for responding to provider inquiries pursuant to subdivision (b)(4)(A); and
(5) (A) Notify any third party who contracts with the contracting entity to gain access to a provider's services and contractual discounts pursuant to the provider network contract of the termination of the provider network contract within thirty (30) calendar days of the contracting entity's receipt of notification of the termination; (B) The notice required by subdivision (b)(5)(A) shall be provided through written notice, electronic communication or an update to an electronic database of provider listings.
(A) Notify any third party who contracts with the contracting entity to gain access to a provider's services and contractual discounts pursuant to the provider network contract of the termination of the provider network contract within thirty (30) calendar days of the contracting entity's receipt of notification of the termination;
(B) The notice required by subdivision (b)(5)(A) shall be provided through written notice, electronic communication or an update to an electronic database of provider listings.
(c) Subject to any applicable continuity of care requirements, provisions of the provider network contract or contrary law: (1) A third party's right to access a provider's health care services and contractual discounts pursuant to a provider network contract shall terminate on the date the provider network contract is terminated; (2) Claims for health care services performed after the termination date of the provider network contract are not eligible for processing and payment in accordance with the provider network contract; and (3) Claims for health care services performed before the termination date of the provider network contract, but processed after the termination date, are eligible for processing and payment in accordance with the provider network contract.
(1) A third party's right to access a provider's health care services and contractual discounts pursuant to a provider network contract shall terminate on the date the provider network contract is terminated;
(2) Claims for health care services performed after the termination date of the provider network contract are not eligible for processing and payment in accordance with the provider network contract; and
(3) Claims for health care services performed before the termination date of the provider network contract, but processed after the termination date, are eligible for processing and payment in accordance with the provider network contract.
(d) (1) All information made available to a provider in accordance with the requirements of this chapter shall be confidential and shall not be disclosed to any individual or entity not involved in the provider's practice or the administration of such practice without the prior written consent of the contracting entity. (2) A contracting entity may reference or include within the contract or a related document the language contained in subdivision (d)(1), or language that is substantially similar in scope and purpose, in order to affirm each party's knowledge of and agreement to comply with the confidentiality provision. (3) This subsection (d) shall not preclude the information being disclosed for purposes of dispute resolution, enforcement of this chapter or assistance in enforcing this chapter.
(1) All information made available to a provider in accordance with the requirements of this chapter shall be confidential and shall not be disclosed to any individual or entity not involved in the provider's practice or the administration of such practice without the prior written consent of the contracting entity.
(2) A contracting entity may reference or include within the contract or a related document the language contained in subdivision (d)(1), or language that is substantially similar in scope and purpose, in order to affirm each party's knowledge of and agreement to comply with the confidentiality provision.
(3) This subsection (d) shall not preclude the information being disclosed for purposes of dispute resolution, enforcement of this chapter or assistance in enforcing this chapter.
Acts 2009, ch. 466, § 6.
Tenn. Code Ann. § 56-43-104 — TN Code / Title 56 / Chapter 43 / Section 56-43-104
Certificate of authority - Required - Application
Status: in_force

(a) (1) No person may transact the business of legal insurance in this state without first obtaining a certificate of authority: (A) Under this chapter; or (B) Under the general laws pertaining to insurance. (2) Any person may apply to the commissioner for, and obtain, a certificate of authority to transact the business of legal insurance in compliance with this chapter. This section does not by itself enlarge the powers of any corporation given by its articles of incorporation or charter, but does authorize a corporation formed under the general business, insurance or general nonprofit corporation laws of this state to include in its powers the authority to transact legal insurance. (3) Any application shall be in a form prescribed by the commissioner. If the applicant is not domiciled in this state, the application must be accompanied by a power of attorney duly executed by the applicant appointing the commissioner, and duly authorized deputies, as the true and lawful attorneys of the applicant in and for this state, upon whom all lawful process in any legal action or proceeding against the applicant on a cause of action arising in this state may be served. (b) This chapter does not apply to any person issuing group, blanket or franchise policies if fewer than ten percent (10%) of the certificate holders or insureds reside in this state and the person is regulated to a comparable extent by another state in which a larger number of certificate holders or insureds reside. Acts 1989, ch. 423, § 3.
(a) (1) No person may transact the business of legal insurance in this state without first obtaining a certificate of authority: (A) Under this chapter; or (B) Under the general laws pertaining to insurance. (2) Any person may apply to the commissioner for, and obtain, a certificate of authority to transact the business of legal insurance in compliance with this chapter. This section does not by itself enlarge the powers of any corporation given by its articles of incorporation or charter, but does authorize a corporation formed under the general business, insurance or general nonprofit corporation laws of this state to include in its powers the authority to transact legal insurance. (3) Any application shall be in a form prescribed by the commissioner. If the applicant is not domiciled in this state, the application must be accompanied by a power of attorney duly executed by the applicant appointing the commissioner, and duly authorized deputies, as the true and lawful attorneys of the applicant in and for this state, upon whom all lawful process in any legal action or proceeding against the applicant on a cause of action arising in this state may be served.
(1) No person may transact the business of legal insurance in this state without first obtaining a certificate of authority: (A) Under this chapter; or (B) Under the general laws pertaining to insurance.
(A) Under this chapter; or
(B) Under the general laws pertaining to insurance.
(2) Any person may apply to the commissioner for, and obtain, a certificate of authority to transact the business of legal insurance in compliance with this chapter. This section does not by itself enlarge the powers of any corporation given by its articles of incorporation or charter, but does authorize a corporation formed under the general business, insurance or general nonprofit corporation laws of this state to include in its powers the authority to transact legal insurance.
(3) Any application shall be in a form prescribed by the commissioner. If the applicant is not domiciled in this state, the application must be accompanied by a power of attorney duly executed by the applicant appointing the commissioner, and duly authorized deputies, as the true and lawful attorneys of the applicant in and for this state, upon whom all lawful process in any legal action or proceeding against the applicant on a cause of action arising in this state may be served.
(b) This chapter does not apply to any person issuing group, blanket or franchise policies if fewer than ten percent (10%) of the certificate holders or insureds reside in this state and the person is regulated to a comparable extent by another state in which a larger number of certificate holders or insureds reside.
Acts 1989, ch. 423, § 3.
Tenn. Code Ann. § 56-7-2806 — TN Code / Title 56 / Chapter 7 / Section 56-7-2806
Guaranteed renewability of coverage for employers in the group market
Status: in_force

(a) If a health insurance issuer offers health insurance coverage in the small or large group market in connection with a group health plan, the issuer must renew or continue in force the coverage at the option of the plan sponsor of the plan except as provided in this section. (b) General Exceptions. A health insurance issuer may nonrenew or discontinue health insurance coverage offered in connection with a group health plan in the small or large group market based only on one (1) or more of the following: (1) The plan sponsor has failed to pay premiums or contributions in accordance with the terms of the health insurance coverage or the issuer has not received timely premium payments; (2) The plan sponsor has performed an act or practice that constitutes fraud or made an intentional misrepresentation of material fact under the terms of the coverage; (3) The plan sponsor has failed to comply with a material plan provision relating to employer contribution or group participation rules, as permitted by this part or other applicable insurance law; (4) The issuer is ceasing to offer coverage in the market in accordance with subsection (c) and other applicable insurance law; (5) In the case of a health insurance issuer that offers health insurance coverage in the market through a network plan, there is no longer any enrollee in connection with the plan who lives, resides, or works in the service area of the issuer, or in the area for which the issuer is authorized to do business, and in the case of the small group market, the issuer would deny enrollment with respect to the plan under § 56-7-2805(b)(1)(A) ; and (6) In the case of health insurance coverage that is made available in the small or large group market only through one (1) or more bona fide associations, the membership of an employer in the association, on the basis of which the coverage is provided, ceases, but only if the coverage is terminated under this subdivision (b)(6) uniformly without regard to any health status-related factor relating to any covered individual. (c) Requirements for Uniform Termination of Coverage. (1) In any case in which an issuer decides to discontinue offering a particular type of group health insurance coverage offered in the small or large group market, coverage of the type may be discontinued by the issuer in accordance with state law in the market only if: (A) The issuer provides notice to each plan sponsor provided coverage of this type in the market, and participants and beneficiaries covered under the coverage, of the discontinuation at least ninety (90) days prior to the date of the discontinuation of the coverage; (B) The issuer offers to each plan sponsor provided coverage of this type in the market the option to purchase all, or, in the case of the large group market, any, other health insurance coverage currently being offered by the issuer to a group health plan in the market; and (C) In exercising the option to discontinue coverage of this type and in offering the option of coverage under subdivision (c)(2)(B), the issuer acts uniformly without regard to the claims experience of those sponsors or any health status-related factor relating to any participants or beneficiaries covered or new participants or beneficiaries who may become eligible for the coverage. (2) (A) In any case in which a health insurance issuer elects to discontinue offering all health insurance coverage in the small group market or the large group market, or both markets, in this state, health insurance coverage may be discontinued by the issuer only in accordance with applicable state law and if: (i) The issuer provides notice to the commissioner and to each plan sponsor, and participants and beneficiaries covered under the coverage, of the discontinuation at least one hundred eighty (180) days prior to the date of the discontinuation of the coverage; and (ii) All health insurance issued or delivered for issuance in this state in the market or markets is discontinued and coverage under the health insurance coverage in the market or markets is not renewed. (B) In the case of a discontinuation under subdivision (c)(2)(A) in a market, the issuer may not provide for the issuance of any health insurance coverage in the market and this state during the five-year period beginning on the date of the discontinuation of the last health insurance coverage not so renewed. (d) Exception for Uniform Modification of Coverage. At the time of coverage renewal, a health insurance issuer may modify the health insurance coverage for a product offered to a group health plan: (1) In the large group market; or (2) In the small group market if, for coverage that is available in the market other than only through one (1) or more bona fide associations, the modification is consistent with state law and effective on a uniform basis among group health plans with that product. (e) Application to Coverage Offered Only through Associations. In applying this section in the case of health insurance coverage that is made available by a health insurance issuer in the small or large group market to employers only through one (1) or more associations, a reference to "plan sponsor" is deemed, with respect to coverage provided to an employer member of the association, to include a reference to the employer. Acts 1997, ch. 157, § 7.
(a) If a health insurance issuer offers health insurance coverage in the small or large group market in connection with a group health plan, the issuer must renew or continue in force the coverage at the option of the plan sponsor of the plan except as provided in this section.
(b) General Exceptions. A health insurance issuer may nonrenew or discontinue health insurance coverage offered in connection with a group health plan in the small or large group market based only on one (1) or more of the following: (1) The plan sponsor has failed to pay premiums or contributions in accordance with the terms of the health insurance coverage or the issuer has not received timely premium payments; (2) The plan sponsor has performed an act or practice that constitutes fraud or made an intentional misrepresentation of material fact under the terms of the coverage; (3) The plan sponsor has failed to comply with a material plan provision relating to employer contribution or group participation rules, as permitted by this part or other applicable insurance law; (4) The issuer is ceasing to offer coverage in the market in accordance with subsection (c) and other applicable insurance law; (5) In the case of a health insurance issuer that offers health insurance coverage in the market through a network plan, there is no longer any enrollee in connection with the plan who lives, resides, or works in the service area of the issuer, or in the area for which the issuer is authorized to do business, and in the case of the small group market, the issuer would deny enrollment with respect to the plan under § 56-7-2805(b)(1)(A) ; and (6) In the case of health insurance coverage that is made available in the small or large group market only through one (1) or more bona fide associations, the membership of an employer in the association, on the basis of which the coverage is provided, ceases, but only if the coverage is terminated under this subdivision (b)(6) uniformly without regard to any health status-related factor relating to any covered individual.
(1) The plan sponsor has failed to pay premiums or contributions in accordance with the terms of the health insurance coverage or the issuer has not received timely premium payments;
(2) The plan sponsor has performed an act or practice that constitutes fraud or made an intentional misrepresentation of material fact under the terms of the coverage;
(3) The plan sponsor has failed to comply with a material plan provision relating to employer contribution or group participation rules, as permitted by this part or other applicable insurance law;
(4) The issuer is ceasing to offer coverage in the market in accordance with subsection (c) and other applicable insurance law;
(5) In the case of a health insurance issuer that offers health insurance coverage in the market through a network plan, there is no longer any enrollee in connection with the plan who lives, resides, or works in the service area of the issuer, or in the area for which the issuer is authorized to do business, and in the case of the small group market, the issuer would deny enrollment with respect to the plan under § 56-7-2805(b)(1)(A) ; and
(6) In the case of health insurance coverage that is made available in the small or large group market only through one (1) or more bona fide associations, the membership of an employer in the association, on the basis of which the coverage is provided, ceases, but only if the coverage is terminated under this subdivision (b)(6) uniformly without regard to any health status-related factor relating to any covered individual.
(c) Requirements for Uniform Termination of Coverage. (1) In any case in which an issuer decides to discontinue offering a particular type of group health insurance coverage offered in the small or large group market, coverage of the type may be discontinued by the issuer in accordance with state law in the market only if: (A) The issuer provides notice to each plan sponsor provided coverage of this type in the market, and participants and beneficiaries covered under the coverage, of the discontinuation at least ninety (90) days prior to the date of the discontinuation of the coverage; (B) The issuer offers to each plan sponsor provided coverage of this type in the market the option to purchase all, or, in the case of the large group market, any, other health insurance coverage currently being offered by the issuer to a group health plan in the market; and (C) In exercising the option to discontinue coverage of this type and in offering the option of coverage under subdivision (c)(2)(B), the issuer acts uniformly without regard to the claims experience of those sponsors or any health status-related factor relating to any participants or beneficiaries covered or new participants or beneficiaries who may become eligible for the coverage. (2) (A) In any case in which a health insurance issuer elects to discontinue offering all health insurance coverage in the small group market or the large group market, or both markets, in this state, health insurance coverage may be discontinued by the issuer only in accordance with applicable state law and if: (i) The issuer provides notice to the commissioner and to each plan sponsor, and participants and beneficiaries covered under the coverage, of the discontinuation at least one hundred eighty (180) days prior to the date of the discontinuation of the coverage; and (ii) All health insurance issued or delivered for issuance in this state in the market or markets is discontinued and coverage under the health insurance coverage in the market or markets is not renewed. (B) In the case of a discontinuation under subdivision (c)(2)(A) in a market, the issuer may not provide for the issuance of any health insurance coverage in the market and this state during the five-year period beginning on the date of the discontinuation of the last health insurance coverage not so renewed.
(1) In any case in which an issuer decides to discontinue offering a particular type of group health insurance coverage offered in the small or large group market, coverage of the type may be discontinued by the issuer in accordance with state law in the market only if: (A) The issuer provides notice to each plan sponsor provided coverage of this type in the market, and participants and beneficiaries covered under the coverage, of the discontinuation at least ninety (90) days prior to the date of the discontinuation of the coverage; (B) The issuer offers to each plan sponsor provided coverage of this type in the market the option to purchase all, or, in the case of the large group market, any, other health insurance coverage currently being offered by the issuer to a group health plan in the market; and (C) In exercising the option to discontinue coverage of this type and in offering the option of coverage under subdivision (c)(2)(B), the issuer acts uniformly without regard to the claims experience of those sponsors or any health status-related factor relating to any participants or beneficiaries covered or new participants or beneficiaries who may become eligible for the coverage.
(A) The issuer provides notice to each plan sponsor provided coverage of this type in the market, and participants and beneficiaries covered under the coverage, of the discontinuation at least ninety (90) days prior to the date of the discontinuation of the coverage;
(B) The issuer offers to each plan sponsor provided coverage of this type in the market the option to purchase all, or, in the case of the large group market, any, other health insurance coverage currently being offered by the issuer to a group health plan in the market; and
(C) In exercising the option to discontinue coverage of this type and in offering the option of coverage under subdivision (c)(2)(B), the issuer acts uniformly without regard to the claims experience of those sponsors or any health status-related factor relating to any participants or beneficiaries covered or new participants or beneficiaries who may become eligible for the coverage.
(2) (A) In any case in which a health insurance issuer elects to discontinue offering all health insurance coverage in the small group market or the large group market, or both markets, in this state, health insurance coverage may be discontinued by the issuer only in accordance with applicable state law and if: (i) The issuer provides notice to the commissioner and to each plan sponsor, and participants and beneficiaries covered under the coverage, of the discontinuation at least one hundred eighty (180) days prior to the date of the discontinuation of the coverage; and (ii) All health insurance issued or delivered for issuance in this state in the market or markets is discontinued and coverage under the health insurance coverage in the market or markets is not renewed. (B) In the case of a discontinuation under subdivision (c)(2)(A) in a market, the issuer may not provide for the issuance of any health insurance coverage in the market and this state during the five-year period beginning on the date of the discontinuation of the last health insurance coverage not so renewed.
(A) In any case in which a health insurance issuer elects to discontinue offering all health insurance coverage in the small group market or the large group market, or both markets, in this state, health insurance coverage may be discontinued by the issuer only in accordance with applicable state law and if: (i) The issuer provides notice to the commissioner and to each plan sponsor, and participants and beneficiaries covered under the coverage, of the discontinuation at least one hundred eighty (180) days prior to the date of the discontinuation of the coverage; and (ii) All health insurance issued or delivered for issuance in this state in the market or markets is discontinued and coverage under the health insurance coverage in the market or markets is not renewed.
(i) The issuer provides notice to the commissioner and to each plan sponsor, and participants and beneficiaries covered under the coverage, of the discontinuation at least one hundred eighty (180) days prior to the date of the discontinuation of the coverage; and
(ii) All health insurance issued or delivered for issuance in this state in the market or markets is discontinued and coverage under the health insurance coverage in the market or markets is not renewed.
(B) In the case of a discontinuation under subdivision (c)(2)(A) in a market, the issuer may not provide for the issuance of any health insurance coverage in the market and this state during the five-year period beginning on the date of the discontinuation of the last health insurance coverage not so renewed.
(d) Exception for Uniform Modification of Coverage. At the time of coverage renewal, a health insurance issuer may modify the health insurance coverage for a product offered to a group health plan: (1) In the large group market; or (2) In the small group market if, for coverage that is available in the market other than only through one (1) or more bona fide associations, the modification is consistent with state law and effective on a uniform basis among group health plans with that product.
(1) In the large group market; or
(2) In the small group market if, for coverage that is available in the market other than only through one (1) or more bona fide associations, the modification is consistent with state law and effective on a uniform basis among group health plans with that product.
(e) Application to Coverage Offered Only through Associations. In applying this section in the case of health insurance coverage that is made available by a health insurance issuer in the small or large group market to employers only through one (1) or more associations, a reference to "plan sponsor" is deemed, with respect to coverage provided to an employer member of the association, to include a reference to the employer.
Acts 1997, ch. 157, § 7.
Tenn. Code Ann. § 56-1-312 — TN Code / Title 56 / Chapter 1 / Section 56-1-312
Default on student loans by members of regulated professions
Status: in_force

(a) (1) Upon receiving a copy of a final order as provided in subsection (b) from the Tennessee student assistance corporation (TSAC), or a guarantee agency that has an agreement with the United States secretary of education, referred to as "guarantee agency" in this section, each board, commission or agency, referred to as the "licensing authority" in this section, attached to the division of regulatory boards shall suspend, deny or revoke the license of, or take other appropriate disciplinary action against, any person who has defaulted on a repayment or service obligation under any federal family education loan program, the federal Higher Education Act of 1965 ( 20 U.S.C. § 1001 et seq.), as amended, a student loan guaranteed or administered by TSAC, or any other state or federal educational loan or service-conditional scholarship program. (2) Notwithstanding subdivision (a)(1), a licensing authority may elect not to suspend, deny, or revoke the license of a person if the default or delinquency is the result of a medical hardship that prevented the person from working in the person's licensed field and the medical hardship significantly contributed to the default or delinquency. (b) (1) Each board, commission, committee, agency or other governmental entity created pursuant to this title shall accept any determination of default from TSAC or a guarantee agency, after TSAC or the guarantee agency has afforded a debtor an opportunity to be heard in accordance with subdivision (b)(2); and the board, commission, committee, agency or other governmental entity shall rescind any disciplinary action and restore any license or certificate upon receiving notice from the corporation or guarantee agency that the person has agreed to serve the person's obligation or is in compliance with an approved repayment plan. (2) (A) Unless a debtor has made satisfactory arrangements according to the lender, TSAC or the guarantee agency, which may include administrative wage garnishment, voluntary payment arrangements, or deferment/forbearance, then the debtor shall be regarded as delinquent or in default. If a debtor is delinquent or in default on a repayment or service obligation under a guaranteed student loan identified in subsection (a), or the debtor has failed to enter into a payment plan or comply with a payment plan previously approved by TSAC or the guarantee agency, then TSAC or the guarantee agency shall issue to the debtor a notice of intent to file an order with the appropriate licensing authority to suspend, deny or revoke the debtor's license or certificate. The notice must: (i) Be served upon the debtor personally or by certified mail with return receipt requested; and (ii) State that the debtor's license or certificate will be suspended, denied or revoked ninety (90) days after service unless within that time the debtor: (a) Pays the entire debt stated in the notice; (b) Enters into a payment plan or complies with a payment plan previously entered into and approved by TSAC or the guarantee agency; or (c) Requests a hearing before TSAC or the guarantee agency. (B) The hearing request by the debtor shall be made in writing and must be received by TSAC or the guarantee agency within twenty (20) days of the date the notice is served. (C) TSAC or the guarantee agency, upon receipt of a request for a hearing from the debtor, shall schedule a hearing to determine whether suspension, denial or revocation of the debtor's license or certificate is appropriate. The debtor's license or certificate may not be suspended, denied or revoked until a determination is reached following the hearing. The only issues that may be determined in the hearing are: (i) The amount of the debt, if any; (ii) Whether the debtor is delinquent or in default; (iii) Whether the debtor has entered into, or the debtor is willing to enter into, a payment plan or to comply with a payment plan previously entered into and approved by TSAC or the guarantee agency; and (iv) Whether the debtor's default or delinquency is the result of a medical hardship that prevented the debtor from working in the debtor's licensed field and the medical hardship significantly contributed to the default or delinquency. (D) If a debtor fails to respond to the notice of intent, fails to timely request a hearing, or fails to appear at a regularly scheduled hearing, the debtor's defenses, objections, or request for a payment plan or compliance with a payment plan may be determined to be without merit; and TSAC or the guarantee agency shall enter a final decision and order, requesting suspension, denial or revocation of the debtor's license or certificate, and further requesting the licensing authority to order the debtor to refrain from engaging in the licensed activity or activity for which a certificate has been issued. TSAC or the guarantee agency shall send a copy of the order to the licensing authority and the debtor. (E) The administrative hearings shall be conducted in the same manner as those conducted pursuant to §§ 36-5-703 and 36-5-704 . (F) (i) When TSAC or the guarantee agency determines that the debt is paid in full or the debtor has entered into a payment plan or complied with a payment plan previously approved by TSAC or the guarantee agency, TSAC or the guarantee agency shall terminate the order suspending, denying or revoking the license or certificate. TSAC or the guarantee agency shall send a copy of the order terminating the suspension, denial or revocation to the licensing authority and the debtor. Notwithstanding any other law, rule or regulation to the contrary, when the license or certificate is reinstated, the licensing authority shall not impose a reinstatement fee that exceeds fifty dollars ($50.00). (ii) Entry of an order terminating suspension, denial or revocation of a license or certificate does not limit the ability of TSAC or the guarantee agency to issue a new order suspending, denying or revoking the license or certificate of the same debtor in the event of another delinquency or default. (G) TSAC is authorized to promulgate necessary rules and regulations in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, to implement this subsection (b). (c) Each board, commission or agency attached to the division of regulatory boards shall promulgate rules and regulations to effectuate the purposes of this section. Amended by 2018 Tenn. Acts, ch. 744,s 10, eff. 1/1/2019. Amended by 2018 Tenn. Acts, ch. 744,s 9, eff. 1/1/2019. Acts 1999, ch. 476, § 2.
(a) (1) Upon receiving a copy of a final order as provided in subsection (b) from the Tennessee student assistance corporation (TSAC), or a guarantee agency that has an agreement with the United States secretary of education, referred to as "guarantee agency" in this section, each board, commission or agency, referred to as the "licensing authority" in this section, attached to the division of regulatory boards shall suspend, deny or revoke the license of, or take other appropriate disciplinary action against, any person who has defaulted on a repayment or service obligation under any federal family education loan program, the federal Higher Education Act of 1965 ( 20 U.S.C. § 1001 et seq.), as amended, a student loan guaranteed or administered by TSAC, or any other state or federal educational loan or service-conditional scholarship program. (2) Notwithstanding subdivision (a)(1), a licensing authority may elect not to suspend, deny, or revoke the license of a person if the default or delinquency is the result of a medical hardship that prevented the person from working in the person's licensed field and the medical hardship significantly contributed to the default or delinquency.
(1) Upon receiving a copy of a final order as provided in subsection (b) from the Tennessee student assistance corporation (TSAC), or a guarantee agency that has an agreement with the United States secretary of education, referred to as "guarantee agency" in this section, each board, commission or agency, referred to as the "licensing authority" in this section, attached to the division of regulatory boards shall suspend, deny or revoke the license of, or take other appropriate disciplinary action against, any person who has defaulted on a repayment or service obligation under any federal family education loan program, the federal Higher Education Act of 1965 ( 20 U.S.C. § 1001 et seq.), as amended, a student loan guaranteed or administered by TSAC, or any other state or federal educational loan or service-conditional scholarship program.
(2) Notwithstanding subdivision (a)(1), a licensing authority may elect not to suspend, deny, or revoke the license of a person if the default or delinquency is the result of a medical hardship that prevented the person from working in the person's licensed field and the medical hardship significantly contributed to the default or delinquency.
(b) (1) Each board, commission, committee, agency or other governmental entity created pursuant to this title shall accept any determination of default from TSAC or a guarantee agency, after TSAC or the guarantee agency has afforded a debtor an opportunity to be heard in accordance with subdivision (b)(2); and the board, commission, committee, agency or other governmental entity shall rescind any disciplinary action and restore any license or certificate upon receiving notice from the corporation or guarantee agency that the person has agreed to serve the person's obligation or is in compliance with an approved repayment plan. (2) (A) Unless a debtor has made satisfactory arrangements according to the lender, TSAC or the guarantee agency, which may include administrative wage garnishment, voluntary payment arrangements, or deferment/forbearance, then the debtor shall be regarded as delinquent or in default. If a debtor is delinquent or in default on a repayment or service obligation under a guaranteed student loan identified in subsection (a), or the debtor has failed to enter into a payment plan or comply with a payment plan previously approved by TSAC or the guarantee agency, then TSAC or the guarantee agency shall issue to the debtor a notice of intent to file an order with the appropriate licensing authority to suspend, deny or revoke the debtor's license or certificate. The notice must: (i) Be served upon the debtor personally or by certified mail with return receipt requested; and (ii) State that the debtor's license or certificate will be suspended, denied or revoked ninety (90) days after service unless within that time the debtor: (a) Pays the entire debt stated in the notice; (b) Enters into a payment plan or complies with a payment plan previously entered into and approved by TSAC or the guarantee agency; or (c) Requests a hearing before TSAC or the guarantee agency. (B) The hearing request by the debtor shall be made in writing and must be received by TSAC or the guarantee agency within twenty (20) days of the date the notice is served. (C) TSAC or the guarantee agency, upon receipt of a request for a hearing from the debtor, shall schedule a hearing to determine whether suspension, denial or revocation of the debtor's license or certificate is appropriate. The debtor's license or certificate may not be suspended, denied or revoked until a determination is reached following the hearing. The only issues that may be determined in the hearing are: (i) The amount of the debt, if any; (ii) Whether the debtor is delinquent or in default; (iii) Whether the debtor has entered into, or the debtor is willing to enter into, a payment plan or to comply with a payment plan previously entered into and approved by TSAC or the guarantee agency; and (iv) Whether the debtor's default or delinquency is the result of a medical hardship that prevented the debtor from working in the debtor's licensed field and the medical hardship significantly contributed to the default or delinquency. (D) If a debtor fails to respond to the notice of intent, fails to timely request a hearing, or fails to appear at a regularly scheduled hearing, the debtor's defenses, objections, or request for a payment plan or compliance with a payment plan may be determined to be without merit; and TSAC or the guarantee agency shall enter a final decision and order, requesting suspension, denial or revocation of the debtor's license or certificate, and further requesting the licensing authority to order the debtor to refrain from engaging in the licensed activity or activity for which a certificate has been issued. TSAC or the guarantee agency shall send a copy of the order to the licensing authority and the debtor. (E) The administrative hearings shall be conducted in the same manner as those conducted pursuant to §§ 36-5-703 and 36-5-704 . (F) (i) When TSAC or the guarantee agency determines that the debt is paid in full or the debtor has entered into a payment plan or complied with a payment plan previously approved by TSAC or the guarantee agency, TSAC or the guarantee agency shall terminate the order suspending, denying or revoking the license or certificate. TSAC or the guarantee agency shall send a copy of the order terminating the suspension, denial or revocation to the licensing authority and the debtor. Notwithstanding any other law, rule or regulation to the contrary, when the license or certificate is reinstated, the licensing authority shall not impose a reinstatement fee that exceeds fifty dollars ($50.00). (ii) Entry of an order terminating suspension, denial or revocation of a license or certificate does not limit the ability of TSAC or the guarantee agency to issue a new order suspending, denying or revoking the license or certificate of the same debtor in the event of another delinquency or default. (G) TSAC is authorized to promulgate necessary rules and regulations in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, to implement this subsection (b).
(1) Each board, commission, committee, agency or other governmental entity created pursuant to this title shall accept any determination of default from TSAC or a guarantee agency, after TSAC or the guarantee agency has afforded a debtor an opportunity to be heard in accordance with subdivision (b)(2); and the board, commission, committee, agency or other governmental entity shall rescind any disciplinary action and restore any license or certificate upon receiving notice from the corporation or guarantee agency that the person has agreed to serve the person's obligation or is in compliance with an approved repayment plan.
(2) (A) Unless a debtor has made satisfactory arrangements according to the lender, TSAC or the guarantee agency, which may include administrative wage garnishment, voluntary payment arrangements, or deferment/forbearance, then the debtor shall be regarded as delinquent or in default. If a debtor is delinquent or in default on a repayment or service obligation under a guaranteed student loan identified in subsection (a), or the debtor has failed to enter into a payment plan or comply with a payment plan previously approved by TSAC or the guarantee agency, then TSAC or the guarantee agency shall issue to the debtor a notice of intent to file an order with the appropriate licensing authority to suspend, deny or revoke the debtor's license or certificate. The notice must: (i) Be served upon the debtor personally or by certified mail with return receipt requested; and (ii) State that the debtor's license or certificate will be suspended, denied or revoked ninety (90) days after service unless within that time the debtor: (a) Pays the entire debt stated in the notice; (b) Enters into a payment plan or complies with a payment plan previously entered into and approved by TSAC or the guarantee agency; or (c) Requests a hearing before TSAC or the guarantee agency. (B) The hearing request by the debtor shall be made in writing and must be received by TSAC or the guarantee agency within twenty (20) days of the date the notice is served. (C) TSAC or the guarantee agency, upon receipt of a request for a hearing from the debtor, shall schedule a hearing to determine whether suspension, denial or revocation of the debtor's license or certificate is appropriate. The debtor's license or certificate may not be suspended, denied or revoked until a determination is reached following the hearing. The only issues that may be determined in the hearing are: (i) The amount of the debt, if any; (ii) Whether the debtor is delinquent or in default; (iii) Whether the debtor has entered into, or the debtor is willing to enter into, a payment plan or to comply with a payment plan previously entered into and approved by TSAC or the guarantee agency; and (iv) Whether the debtor's default or delinquency is the result of a medical hardship that prevented the debtor from working in the debtor's licensed field and the medical hardship significantly contributed to the default or delinquency. (D) If a debtor fails to respond to the notice of intent, fails to timely request a hearing, or fails to appear at a regularly scheduled hearing, the debtor's defenses, objections, or request for a payment plan or compliance with a payment plan may be determined to be without merit; and TSAC or the guarantee agency shall enter a final decision and order, requesting suspension, denial or revocation of the debtor's license or certificate, and further requesting the licensing authority to order the debtor to refrain from engaging in the licensed activity or activity for which a certificate has been issued. TSAC or the guarantee agency shall send a copy of the order to the licensing authority and the debtor. (E) The administrative hearings shall be conducted in the same manner as those conducted pursuant to §§ 36-5-703 and 36-5-704 . (F) (i) When TSAC or the guarantee agency determines that the debt is paid in full or the debtor has entered into a payment plan or complied with a payment plan previously approved by TSAC or the guarantee agency, TSAC or the guarantee agency shall terminate the order suspending, denying or revoking the license or certificate. TSAC or the guarantee agency shall send a copy of the order terminating the suspension, denial or revocation to the licensing authority and the debtor. Notwithstanding any other law, rule or regulation to the contrary, when the license or certificate is reinstated, the licensing authority shall not impose a reinstatement fee that exceeds fifty dollars ($50.00). (ii) Entry of an order terminating suspension, denial or revocation of a license or certificate does not limit the ability of TSAC or the guarantee agency to issue a new order suspending, denying or revoking the license or certificate of the same debtor in the event of another delinquency or default. (G) TSAC is authorized to promulgate necessary rules and regulations in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, to implement this subsection (b).
(A) Unless a debtor has made satisfactory arrangements according to the lender, TSAC or the guarantee agency, which may include administrative wage garnishment, voluntary payment arrangements, or deferment/forbearance, then the debtor shall be regarded as delinquent or in default. If a debtor is delinquent or in default on a repayment or service obligation under a guaranteed student loan identified in subsection (a), or the debtor has failed to enter into a payment plan or comply with a payment plan previously approved by TSAC or the guarantee agency, then TSAC or the guarantee agency shall issue to the debtor a notice of intent to file an order with the appropriate licensing authority to suspend, deny or revoke the debtor's license or certificate. The notice must: (i) Be served upon the debtor personally or by certified mail with return receipt requested; and (ii) State that the debtor's license or certificate will be suspended, denied or revoked ninety (90) days after service unless within that time the debtor: (a) Pays the entire debt stated in the notice; (b) Enters into a payment plan or complies with a payment plan previously entered into and approved by TSAC or the guarantee agency; or (c) Requests a hearing before TSAC or the guarantee agency.
(i) Be served upon the debtor personally or by certified mail with return receipt requested; and
(ii) State that the debtor's license or certificate will be suspended, denied or revoked ninety (90) days after service unless within that time the debtor: (a) Pays the entire debt stated in the notice; (b) Enters into a payment plan or complies with a payment plan previously entered into and approved by TSAC or the guarantee agency; or (c) Requests a hearing before TSAC or the guarantee agency.
(a) Pays the entire debt stated in the notice;
(b) Enters into a payment plan or complies with a payment plan previously entered into and approved by TSAC or the guarantee agency; or
(c) Requests a hearing before TSAC or the guarantee agency.
(B) The hearing request by the debtor shall be made in writing and must be received by TSAC or the guarantee agency within twenty (20) days of the date the notice is served.
(C) TSAC or the guarantee agency, upon receipt of a request for a hearing from the debtor, shall schedule a hearing to determine whether suspension, denial or revocation of the debtor's license or certificate is appropriate. The debtor's license or certificate may not be suspended, denied or revoked until a determination is reached following the hearing. The only issues that may be determined in the hearing are: (i) The amount of the debt, if any; (ii) Whether the debtor is delinquent or in default; (iii) Whether the debtor has entered into, or the debtor is willing to enter into, a payment plan or to comply with a payment plan previously entered into and approved by TSAC or the guarantee agency; and (iv) Whether the debtor's default or delinquency is the result of a medical hardship that prevented the debtor from working in the debtor's licensed field and the medical hardship significantly contributed to the default or delinquency.
(i) The amount of the debt, if any;
(ii) Whether the debtor is delinquent or in default;
(iii) Whether the debtor has entered into, or the debtor is willing to enter into, a payment plan or to comply with a payment plan previously entered into and approved by TSAC or the guarantee agency; and
(iv) Whether the debtor's default or delinquency is the result of a medical hardship that prevented the debtor from working in the debtor's licensed field and the medical hardship significantly contributed to the default or delinquency.
(D) If a debtor fails to respond to the notice of intent, fails to timely request a hearing, or fails to appear at a regularly scheduled hearing, the debtor's defenses, objections, or request for a payment plan or compliance with a payment plan may be determined to be without merit; and TSAC or the guarantee agency shall enter a final decision and order, requesting suspension, denial or revocation of the debtor's license or certificate, and further requesting the licensing authority to order the debtor to refrain from engaging in the licensed activity or activity for which a certificate has been issued. TSAC or the guarantee agency shall send a copy of the order to the licensing authority and the debtor.
(E) The administrative hearings shall be conducted in the same manner as those conducted pursuant to §§ 36-5-703 and 36-5-704 .
(F) (i) When TSAC or the guarantee agency determines that the debt is paid in full or the debtor has entered into a payment plan or complied with a payment plan previously approved by TSAC or the guarantee agency, TSAC or the guarantee agency shall terminate the order suspending, denying or revoking the license or certificate. TSAC or the guarantee agency shall send a copy of the order terminating the suspension, denial or revocation to the licensing authority and the debtor. Notwithstanding any other law, rule or regulation to the contrary, when the license or certificate is reinstated, the licensing authority shall not impose a reinstatement fee that exceeds fifty dollars ($50.00). (ii) Entry of an order terminating suspension, denial or revocation of a license or certificate does not limit the ability of TSAC or the guarantee agency to issue a new order suspending, denying or revoking the license or certificate of the same debtor in the event of another delinquency or default.
(i) When TSAC or the guarantee agency determines that the debt is paid in full or the debtor has entered into a payment plan or complied with a payment plan previously approved by TSAC or the guarantee agency, TSAC or the guarantee agency shall terminate the order suspending, denying or revoking the license or certificate. TSAC or the guarantee agency shall send a copy of the order terminating the suspension, denial or revocation to the licensing authority and the debtor. Notwithstanding any other law, rule or regulation to the contrary, when the license or certificate is reinstated, the licensing authority shall not impose a reinstatement fee that exceeds fifty dollars ($50.00).
(ii) Entry of an order terminating suspension, denial or revocation of a license or certificate does not limit the ability of TSAC or the guarantee agency to issue a new order suspending, denying or revoking the license or certificate of the same debtor in the event of another delinquency or default.
(G) TSAC is authorized to promulgate necessary rules and regulations in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, to implement this subsection (b).
(c) Each board, commission or agency attached to the division of regulatory boards shall promulgate rules and regulations to effectuate the purposes of this section.
Amended by 2018 Tenn. Acts, ch. 744,s 10, eff. 1/1/2019.
Amended by 2018 Tenn. Acts, ch. 744,s 9, eff. 1/1/2019.
Acts 1999, ch. 476, § 2.
Tenn. Code Ann. § 56-21-126 — TN Code / Title 56 / Chapter 21 / Section 56-21-126
Reinsurance of fire risks to be deducted in determining limit of insurance
Status: in_force

The reinsurance which any state mutual fire insurance company may secure upon any risk it has outstanding shall be deducted in determining whether the amount of the risk exceeds the limit that by law such company may insure. Acts 1925, ch. 85, § 4; Shan. Supp., § 3369a29b5; Code 1932, § 6283; T.C.A. (orig. ed.), § 56-2028.
The reinsurance which any state mutual fire insurance company may secure upon any risk it has outstanding shall be deducted in determining whether the amount of the risk exceeds the limit that by law such company may insure.
Acts 1925, ch. 85, § 4; Shan. Supp., § 3369a29b5; Code 1932, § 6283; T.C.A. (orig. ed.), § 56-2028.
Tenn. Code Ann. § 56-20-115 — TN Code / Title 56 / Chapter 20 / Section 56-20-115
Fees of commissioner
Status: in_force

The commissioner shall collect and pay into the state treasury the fees prescribed by § 56-4-101 for issuing each new certificate of authority for filing the company's annual statement and for amendments to the company's certificate of authority. Acts 1895, ch. 220, § 11; Shan., § 3369; Code 1932, § 6251; Acts 1979, ch. 298, §2; T.C.A. (orig. ed.), § 56-1915.
The commissioner shall collect and pay into the state treasury the fees prescribed by § 56-4-101 for issuing each new certificate of authority for filing the company's annual statement and for amendments to the company's certificate of authority.
Acts 1895, ch. 220, § 11; Shan., § 3369; Code 1932, § 6251; Acts 1979, ch. 298, §2; T.C.A. (orig. ed.), § 56-1915.
Tenn. Code Ann. § 56-6-1403 — TN Code / Title 56 / Chapter 6 / Section 56-6-1403
Limited lines travel insurance producer license - Travel insurance supervising entity license - Brochures for prospective purchasers - Prohibited acts of nonlicensed employees or representatives
Status: in_force

(a) Notwithstanding any other law to the contrary: (1) Pursuant to the Tennessee Insurance Producer Licensing Act of 2002, compiled in part 1 of this chapter, the commissioner may issue to an individual or business entity that has filed with the commissioner an application in a form and manner prescribed by the commissioner, a limited lines travel insurance producer license, which authorizes the limited lines travel insurance producer to sell, solicit, or negotiate travel insurance through a licensed insurer; (2) Pursuant to this chapter, the commissioner may issue a travel insurance supervising entity license to an individual or business entity that has filed with the commissioner an application in a form and manner prescribed by the commissioner, which authorizes the travel insurance supervising entity to sell, solicit, or negotiate travel insurance through a travel retailer only if the following conditions are met: (A) The travel insurance supervising entity or travel retailer provides to purchasers of travel insurance: (i) A description of the material terms or the actual material terms of the insurance coverage; (ii) A description of the process for filing a claim; (iii) A description of the review or cancellation process for the travel insurance policy; and (iv) The identity and contact information of the insurer and limited lines travel insurance producer; (B) At the time of licensure, the travel insurance supervising entity establishes and maintains a register, in a form prescribed by the commissioner, of each travel retailer that offers travel insurance on the travel insurance supervising entity's behalf. The register shall be maintained and updated annually by the travel insurance supervising entity and shall include the name, address, and contact information of the travel retailer and an officer or person who directs or controls the travel retailer's operations, and the travel retailer's federal tax identification number. The travel insurance supervising entity shall submit the register to the department of commerce and insurance upon reasonable request. The travel insurance supervising entity shall also certify that the travel retailer register complies with 18 U.S.C. § 1033 . The grounds for the suspension, revocation, and penalties applicable to resident insurance producers under § 56-6-1407 are applicable to the limited lines travel insurance producers, travel insurance supervising entity, and travel retailers; (C) The travel insurance supervising entity has designated one (1) of its employees who is a licensed individual producer as the designated responsible producer (DRP) responsible for the travel insurance supervising entity's compliance with the travel insurance laws and rules of this state; (D) The commissioner finds that the DRP, president, secretary, treasurer, and any other officer or person who directs or controls the travel insurance supervising entity's insurance operations have not committed any act that is a ground for denial, suspension, or revocation set forth in § 56-6-112 ; (E) The travel insurance supervising entity has paid all applicable insurance producer licensing fees as set forth in § 56-6-121 ; and (F) The travel insurance supervising entity requires each employee and authorized representative of the travel retailer whose duties include offering and disseminating travel insurance to receive a program of instruction or training, which may be subject to review by the commissioner. The training material shall, at a minimum, contain instructions on the types of insurance offered, ethical sales practices, and required disclosures to prospective customers; (3) The initial license issued to a travel insurance supervising entity pursuant to subdivision (a)(2) shall be valid for a period of twelve (12) months and expire annually on March 1; and (4) Travel insurance supervising entities, and those registered under their licenses, are exempt from examination, prelicensing, and continuing education requirements under this part. (b) Any travel retailer offering or disseminating travel insurance shall make available to prospective purchasers brochures or other written materials that have been approved by the travel insurer. The materials must include information that, at a minimum: (1) Provide the identity and contact information of the insurer and the travel insurance supervising entity; (2) Explain that the purchase of travel insurance is not required in order to purchase any other product or service from the travel retailer; and (3) Explain that an unlicensed travel retailer is permitted to provide general information about the insurance offered by the travel retailer, including a description of the coverage and price, but is not qualified or authorized to answer technical questions about the terms and conditions of the insurance offered by the travel retailer or to evaluate the adequacy of the customer's existing insurance coverage. (c) A travel retailer's employees or authorized representatives who are not licensed as insurance producers shall not: (1) Evaluate or interpret the technical terms, benefits, and conditions of the offered travel insurance coverage; (2) Evaluate or provide advice concerning a prospective purchaser's existing insurance coverage; or (3) Hold themselves out as licensed insurers, licensed producers, or insurance experts. Amended by 2022 Tenn. Acts, ch. 703, s 5, eff. 7/1/2022. Amended by 2022 Tenn. Acts, ch. 703, s 4, eff. 7/1/2022. Added by 2015 Tenn. Acts, ch. 460, s 3, eff. 1/1/2016.
(a) Notwithstanding any other law to the contrary: (1) Pursuant to the Tennessee Insurance Producer Licensing Act of 2002, compiled in part 1 of this chapter, the commissioner may issue to an individual or business entity that has filed with the commissioner an application in a form and manner prescribed by the commissioner, a limited lines travel insurance producer license, which authorizes the limited lines travel insurance producer to sell, solicit, or negotiate travel insurance through a licensed insurer; (2) Pursuant to this chapter, the commissioner may issue a travel insurance supervising entity license to an individual or business entity that has filed with the commissioner an application in a form and manner prescribed by the commissioner, which authorizes the travel insurance supervising entity to sell, solicit, or negotiate travel insurance through a travel retailer only if the following conditions are met: (A) The travel insurance supervising entity or travel retailer provides to purchasers of travel insurance: (i) A description of the material terms or the actual material terms of the insurance coverage; (ii) A description of the process for filing a claim; (iii) A description of the review or cancellation process for the travel insurance policy; and (iv) The identity and contact information of the insurer and limited lines travel insurance producer; (B) At the time of licensure, the travel insurance supervising entity establishes and maintains a register, in a form prescribed by the commissioner, of each travel retailer that offers travel insurance on the travel insurance supervising entity's behalf. The register shall be maintained and updated annually by the travel insurance supervising entity and shall include the name, address, and contact information of the travel retailer and an officer or person who directs or controls the travel retailer's operations, and the travel retailer's federal tax identification number. The travel insurance supervising entity shall submit the register to the department of commerce and insurance upon reasonable request. The travel insurance supervising entity shall also certify that the travel retailer register complies with 18 U.S.C. § 1033 . The grounds for the suspension, revocation, and penalties applicable to resident insurance producers under § 56-6-1407 are applicable to the limited lines travel insurance producers, travel insurance supervising entity, and travel retailers; (C) The travel insurance supervising entity has designated one (1) of its employees who is a licensed individual producer as the designated responsible producer (DRP) responsible for the travel insurance supervising entity's compliance with the travel insurance laws and rules of this state; (D) The commissioner finds that the DRP, president, secretary, treasurer, and any other officer or person who directs or controls the travel insurance supervising entity's insurance operations have not committed any act that is a ground for denial, suspension, or revocation set forth in § 56-6-112 ; (E) The travel insurance supervising entity has paid all applicable insurance producer licensing fees as set forth in § 56-6-121 ; and (F) The travel insurance supervising entity requires each employee and authorized representative of the travel retailer whose duties include offering and disseminating travel insurance to receive a program of instruction or training, which may be subject to review by the commissioner. The training material shall, at a minimum, contain instructions on the types of insurance offered, ethical sales practices, and required disclosures to prospective customers; (3) The initial license issued to a travel insurance supervising entity pursuant to subdivision (a)(2) shall be valid for a period of twelve (12) months and expire annually on March 1; and (4) Travel insurance supervising entities, and those registered under their licenses, are exempt from examination, prelicensing, and continuing education requirements under this part.
(1) Pursuant to the Tennessee Insurance Producer Licensing Act of 2002, compiled in part 1 of this chapter, the commissioner may issue to an individual or business entity that has filed with the commissioner an application in a form and manner prescribed by the commissioner, a limited lines travel insurance producer license, which authorizes the limited lines travel insurance producer to sell, solicit, or negotiate travel insurance through a licensed insurer;
(2) Pursuant to this chapter, the commissioner may issue a travel insurance supervising entity license to an individual or business entity that has filed with the commissioner an application in a form and manner prescribed by the commissioner, which authorizes the travel insurance supervising entity to sell, solicit, or negotiate travel insurance through a travel retailer only if the following conditions are met: (A) The travel insurance supervising entity or travel retailer provides to purchasers of travel insurance: (i) A description of the material terms or the actual material terms of the insurance coverage; (ii) A description of the process for filing a claim; (iii) A description of the review or cancellation process for the travel insurance policy; and (iv) The identity and contact information of the insurer and limited lines travel insurance producer; (B) At the time of licensure, the travel insurance supervising entity establishes and maintains a register, in a form prescribed by the commissioner, of each travel retailer that offers travel insurance on the travel insurance supervising entity's behalf. The register shall be maintained and updated annually by the travel insurance supervising entity and shall include the name, address, and contact information of the travel retailer and an officer or person who directs or controls the travel retailer's operations, and the travel retailer's federal tax identification number. The travel insurance supervising entity shall submit the register to the department of commerce and insurance upon reasonable request. The travel insurance supervising entity shall also certify that the travel retailer register complies with 18 U.S.C. § 1033 . The grounds for the suspension, revocation, and penalties applicable to resident insurance producers under § 56-6-1407 are applicable to the limited lines travel insurance producers, travel insurance supervising entity, and travel retailers; (C) The travel insurance supervising entity has designated one (1) of its employees who is a licensed individual producer as the designated responsible producer (DRP) responsible for the travel insurance supervising entity's compliance with the travel insurance laws and rules of this state; (D) The commissioner finds that the DRP, president, secretary, treasurer, and any other officer or person who directs or controls the travel insurance supervising entity's insurance operations have not committed any act that is a ground for denial, suspension, or revocation set forth in § 56-6-112 ; (E) The travel insurance supervising entity has paid all applicable insurance producer licensing fees as set forth in § 56-6-121 ; and (F) The travel insurance supervising entity requires each employee and authorized representative of the travel retailer whose duties include offering and disseminating travel insurance to receive a program of instruction or training, which may be subject to review by the commissioner. The training material shall, at a minimum, contain instructions on the types of insurance offered, ethical sales practices, and required disclosures to prospective customers;
(A) The travel insurance supervising entity or travel retailer provides to purchasers of travel insurance: (i) A description of the material terms or the actual material terms of the insurance coverage; (ii) A description of the process for filing a claim; (iii) A description of the review or cancellation process for the travel insurance policy; and (iv) The identity and contact information of the insurer and limited lines travel insurance producer;
(i) A description of the material terms or the actual material terms of the insurance coverage;
(ii) A description of the process for filing a claim;
(iii) A description of the review or cancellation process for the travel insurance policy; and
(iv) The identity and contact information of the insurer and limited lines travel insurance producer;
(B) At the time of licensure, the travel insurance supervising entity establishes and maintains a register, in a form prescribed by the commissioner, of each travel retailer that offers travel insurance on the travel insurance supervising entity's behalf. The register shall be maintained and updated annually by the travel insurance supervising entity and shall include the name, address, and contact information of the travel retailer and an officer or person who directs or controls the travel retailer's operations, and the travel retailer's federal tax identification number. The travel insurance supervising entity shall submit the register to the department of commerce and insurance upon reasonable request. The travel insurance supervising entity shall also certify that the travel retailer register complies with 18 U.S.C. § 1033 . The grounds for the suspension, revocation, and penalties applicable to resident insurance producers under § 56-6-1407 are applicable to the limited lines travel insurance producers, travel insurance supervising entity, and travel retailers;
(C) The travel insurance supervising entity has designated one (1) of its employees who is a licensed individual producer as the designated responsible producer (DRP) responsible for the travel insurance supervising entity's compliance with the travel insurance laws and rules of this state;
(D) The commissioner finds that the DRP, president, secretary, treasurer, and any other officer or person who directs or controls the travel insurance supervising entity's insurance operations have not committed any act that is a ground for denial, suspension, or revocation set forth in § 56-6-112 ;
(E) The travel insurance supervising entity has paid all applicable insurance producer licensing fees as set forth in § 56-6-121 ; and
(F) The travel insurance supervising entity requires each employee and authorized representative of the travel retailer whose duties include offering and disseminating travel insurance to receive a program of instruction or training, which may be subject to review by the commissioner. The training material shall, at a minimum, contain instructions on the types of insurance offered, ethical sales practices, and required disclosures to prospective customers;
(3) The initial license issued to a travel insurance supervising entity pursuant to subdivision (a)(2) shall be valid for a period of twelve (12) months and expire annually on March 1; and
(4) Travel insurance supervising entities, and those registered under their licenses, are exempt from examination, prelicensing, and continuing education requirements under this part.
(b) Any travel retailer offering or disseminating travel insurance shall make available to prospective purchasers brochures or other written materials that have been approved by the travel insurer. The materials must include information that, at a minimum: (1) Provide the identity and contact information of the insurer and the travel insurance supervising entity; (2) Explain that the purchase of travel insurance is not required in order to purchase any other product or service from the travel retailer; and (3) Explain that an unlicensed travel retailer is permitted to provide general information about the insurance offered by the travel retailer, including a description of the coverage and price, but is not qualified or authorized to answer technical questions about the terms and conditions of the insurance offered by the travel retailer or to evaluate the adequacy of the customer's existing insurance coverage.
(1) Provide the identity and contact information of the insurer and the travel insurance supervising entity;
(2) Explain that the purchase of travel insurance is not required in order to purchase any other product or service from the travel retailer; and
(3) Explain that an unlicensed travel retailer is permitted to provide general information about the insurance offered by the travel retailer, including a description of the coverage and price, but is not qualified or authorized to answer technical questions about the terms and conditions of the insurance offered by the travel retailer or to evaluate the adequacy of the customer's existing insurance coverage.
(c) A travel retailer's employees or authorized representatives who are not licensed as insurance producers shall not: (1) Evaluate or interpret the technical terms, benefits, and conditions of the offered travel insurance coverage; (2) Evaluate or provide advice concerning a prospective purchaser's existing insurance coverage; or (3) Hold themselves out as licensed insurers, licensed producers, or insurance experts.
(1) Evaluate or interpret the technical terms, benefits, and conditions of the offered travel insurance coverage;
(2) Evaluate or provide advice concerning a prospective purchaser's existing insurance coverage; or
(3) Hold themselves out as licensed insurers, licensed producers, or insurance experts.
Amended by 2022 Tenn. Acts, ch. 703, s 5, eff. 7/1/2022.
Amended by 2022 Tenn. Acts, ch. 703, s 4, eff. 7/1/2022.
Added by 2015 Tenn. Acts, ch. 460, s 3, eff. 1/1/2016.
Tenn. Code Ann. § 56-21-109 — TN Code / Title 56 / Chapter 21 / Section 56-21-109
Reinsurance reserve - Computation
Status: in_force

When computing reinsurance reserve, policy fees, membership and endorsement fees, all agents' commissions and salaries of all agents required to have a certificate of authority from the department of commerce and insurance shall be excluded as a part of the premium receipts. The unpaid premiums in the course of collection and the unpaid premium notes of the policyholders not over twelve (12) months due shall be treated as ledger assets. Acts 1907, ch. 461, § 4; Shan., § 3369a13; Acts 1921, ch. 160, § 4; Code 1932, § 6264; T.C.A. (orig. ed.), § 56-2011.
When computing reinsurance reserve, policy fees, membership and endorsement fees, all agents' commissions and salaries of all agents required to have a certificate of authority from the department of commerce and insurance shall be excluded as a part of the premium receipts. The unpaid premiums in the course of collection and the unpaid premium notes of the policyholders not over twelve (12) months due shall be treated as ledger assets.
Acts 1907, ch. 461, § 4; Shan., § 3369a13; Acts 1921, ch. 160, § 4; Code 1932, § 6264; T.C.A. (orig. ed.), § 56-2011.
Tenn. Code Ann. § 56-2-125 — TN Code / Title 56 / Chapter 2 / Section 56-2-125
Establishment and maintenance of an all payer claims database - Establishment of Tennessee health information committee
Status: in_force

(a) As used in this section, unless the context otherwise requires: (1) "All payer claims database" means a database comprised of health insurance issuer and group health plan claims information that excludes the data elements in 45 CFR 164.514(e)(2) ; (2) "Commissioner" means the commissioner of commerce and insurance; (3) "Department" means the department of commerce and insurance; (4) "Group health plan" means an employee welfare benefit plan, as defined in § 3(1) of the Employee Retirement Income Security Act of 1974 (ERISA) ( 29 U.S.C. § 1002(1) ), to the extent that the plan provides medical care to employees or their dependents, as defined under the terms of the plan, or an administrator of the plan. For purposes of this section, "group health plan" shall not mean any plan that is offered through a health insurance issuer; (5) "Health insurance coverage" means health insurance coverage as defined in § 56-7-2902 , as well as medicare supplemental health insurance; and (6) "Health insurance issuer" means an entity subject to the insurance laws of this state, or subject to the jurisdiction of the commissioner, that contracts or offers to contract to provide health insurance coverage, including, but not limited to, an insurance company, a health maintenance organization and a nonprofit hospital and medical service corporation. "Health insurance issuer" also means a pharmacy benefits manager, a third party administrator and an entity described in § 56-2-121 . (b) (1) The commissioner shall establish and maintain an all payer claims database to enable the commissioner of finance and administration to carry out the following duties: (A) Improving the accessibility, adequacy and affordability of patient health care and health care coverage; (B) Identifying health and health care needs and informing health and health care policy; (C) Determining the capacity and distribution of existing health care resources; (D) Evaluating the effectiveness of intervention programs on improving patient outcomes; (E) Reviewing costs among various treatment settings, providers and approaches; and (F) Providing publicly available information on health care providers' quality of care. (2) Nothing in this section shall preclude a health insurance issuer from providing information on health care providers' quality of care in accordance with § 56-32-130(e) . (c) [Deleted by 2018 amendment.] (d) (1) As required by HIPAA, the all payer claims database shall not publicly disclose any individually identifiable health information as defined in 45 CFR 160.103 . Use of the all payer claims database shall be subject to restrictions required by HIPAA and other applicable privacy laws and policies. The all payer claims database shall be accessed only by staff or a designated entity authorized in writing by the commissioner of finance and administration to perform the analyses contemplated by this section. The commissioner shall develop procedures and safeguards to protect the integrity and confidentiality of any data contained in the all payer claims database. (2) (A) (i) The all payer claims database, summaries, source, or draft information used to construct or populate the all payer claims database, patient level claims data, reports derived from the all payer claims database, and other information submitted under this section, whether in electronic or paper form, shall not be considered a public record and shall not be open for inspection by members of the public under § 10-7-503(a)(1) . The information contained in the all payer claims database shall be considered confidential and not subject to subpoena. (ii) The commissioner may promulgate rules to authorize the public release of reports derived from the information. Any release of reports shall not result in such information losing its confidentiality or cause it to be admissible, except in administrative proceedings authorized under the rules adopted by the commissioner. (B) The commissioner shall, through memoranda of understanding, allow the use of the all payer claims database by the department of finance and administration, the department of health, the department of mental health and substance abuse services, the department of disability and aging, and other departments of state government for the purposes listed in subdivision (b)(1). (C) Except for officials of the state or those officials' designees as permitted by subdivision (d)(1), nothing in this section shall be construed as permitting access to or discovery of the source or draft information used to construct or populate the all payer claims database. (e) The all payer claims database shall contain unique health care provider identifiers that may be used in public reports; provided, however, that no information that could reveal the identity of any patient from the all payer claims database shall be made available to the public. To ensure that individual patients are not identified, the following data shall not be included in any transmission by a group health plan or health insurance issuer to the state or designated entity for the all payer claims database or in any source or draft information used to construct or populate the all payer claims database: (1) Patient names; (2) Patient street addresses; (3) All elements of patient birth dates, except year of birth; (4) Patient telephone numbers; (5) Patient facsimile numbers; (6) Patient electronic mail addresses; (7) Patient social security numbers; (8) Medical record numbers; (9) Health plan beneficiary numbers; (10) Patient account numbers; (11) Patient certificate/license numbers; (12) Vehicle identifiers and serial numbers including license plate numbers; (13) Device identifiers and serial numbers; (14) Web universal resource locators (URLs); (15) Internet protocol (IP) address numbers; (16) Biometric identifiers including fingerprints, voiceprints, and genetic code; (17) Full-face photographic images and any comparable images; or (18) Any other unique patient identifying number, characteristic or code, except encrypted index numbers assigned prior to the transmission by group health plans or health insurance issuers to the state or designated entity for the purpose of linking procedures by patient; provided, that a patient's identity cannot be known from the encrypted index number. (f) (1) (A) No later than January 1, 2010, and every month thereafter, all group health plans and health insurance issuers shall provide electronic health insurance claims data for state residents to the commissioner or a designated entity authorized by the commissioner, in accordance with standards and procedures recommended by the Tennessee health information committee pursuant to subdivision (c)(2) and adopted by the commissioner by rule. (B) All group health plans and health insurance issuers shall provide additional information as the Tennessee health information committee recommends and the commissioner subsequently establishes by rule for the purpose of creating and maintaining an all payer claims database. (C) The Tennessee health information committee and the commissioner shall strive for standards and procedures that are the least burdensome for data submitters. (2) The collection, storage and release of health and health care data and statistical information that is subject to the federal requirements of HIPAA shall be governed by the rules adopted in 45 CFR parts 160 and 164. (3) All group health plans and health insurance issuers that collect the health employer data and information set (HEDIS) shall annually submit the HEDIS information to the commissioner in a form and in a manner prescribed by the National Committee for Quality Assurance (NCQA). (4) If any group health plan or health insurance issuer fails to submit required data to the commissioner on a timely basis, the commissioner may impose a civil penalty of up to one hundred dollars ($100) for each day of delay. (g) The commissioner, in the commissioner's discretion, may allow some group health plans and health insurance issuers to submit data on a quarterly basis. The commissioner may also establish by rule exceptions to the reporting requirements of this section for entities based upon an entity's size or amount of claims or other relevant factors deemed appropriate. (h) (1) The commissioner may, subject to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, promulgate rules and regulations for purposes of implementing this section. The commissioner is authorized to promulgate the initial rules as emergency rules pursuant to the Uniform Administrative Procedures Act prior to January 1, 2010, for the purpose of creating the all payer claims database. (2) The commissioner of finance and administration may, subject to the Uniform Administrative Procedures Act, promulgate rules and regulations concerning the operation of the all payer claims database and the distribution and use of information maintained or created thereby. The commissioner of finance and administration is authorized to promulgate the initial rules as emergency rules pursuant to the Uniform Administrative Procedures Act prior to January 1, 2010, for the purpose of creating the all payer claims database. Amended by 2024 Tenn. Acts, ch. 688,s 143, eff. 7/1/2024. Amended by 2018 Tenn. Acts, ch. 968, Secs.s 2, s 3 eff. 5/16/2018. Amended by 2015 Tenn. Acts, ch. 65, s 3, Sec.s 4 eff. 4/6/2015. Acts 2009 , ch. 611, § 3; 2010 , ch. 1100, §§ 90-92; 2011 , ch. 15, § 3; 2012 , ch. 575, §§ 1, 2.
(a) As used in this section, unless the context otherwise requires: (1) "All payer claims database" means a database comprised of health insurance issuer and group health plan claims information that excludes the data elements in 45 CFR 164.514(e)(2) ; (2) "Commissioner" means the commissioner of commerce and insurance; (3) "Department" means the department of commerce and insurance; (4) "Group health plan" means an employee welfare benefit plan, as defined in § 3(1) of the Employee Retirement Income Security Act of 1974 (ERISA) ( 29 U.S.C. § 1002(1) ), to the extent that the plan provides medical care to employees or their dependents, as defined under the terms of the plan, or an administrator of the plan. For purposes of this section, "group health plan" shall not mean any plan that is offered through a health insurance issuer; (5) "Health insurance coverage" means health insurance coverage as defined in § 56-7-2902 , as well as medicare supplemental health insurance; and (6) "Health insurance issuer" means an entity subject to the insurance laws of this state, or subject to the jurisdiction of the commissioner, that contracts or offers to contract to provide health insurance coverage, including, but not limited to, an insurance company, a health maintenance organization and a nonprofit hospital and medical service corporation. "Health insurance issuer" also means a pharmacy benefits manager, a third party administrator and an entity described in § 56-2-121 .
(1) "All payer claims database" means a database comprised of health insurance issuer and group health plan claims information that excludes the data elements in 45 CFR 164.514(e)(2) ;
(2) "Commissioner" means the commissioner of commerce and insurance;
(3) "Department" means the department of commerce and insurance;
(4) "Group health plan" means an employee welfare benefit plan, as defined in § 3(1) of the Employee Retirement Income Security Act of 1974 (ERISA) ( 29 U.S.C. § 1002(1) ), to the extent that the plan provides medical care to employees or their dependents, as defined under the terms of the plan, or an administrator of the plan. For purposes of this section, "group health plan" shall not mean any plan that is offered through a health insurance issuer;
(5) "Health insurance coverage" means health insurance coverage as defined in § 56-7-2902 , as well as medicare supplemental health insurance; and
(6) "Health insurance issuer" means an entity subject to the insurance laws of this state, or subject to the jurisdiction of the commissioner, that contracts or offers to contract to provide health insurance coverage, including, but not limited to, an insurance company, a health maintenance organization and a nonprofit hospital and medical service corporation. "Health insurance issuer" also means a pharmacy benefits manager, a third party administrator and an entity described in § 56-2-121 .
(b) (1) The commissioner shall establish and maintain an all payer claims database to enable the commissioner of finance and administration to carry out the following duties: (A) Improving the accessibility, adequacy and affordability of patient health care and health care coverage; (B) Identifying health and health care needs and informing health and health care policy; (C) Determining the capacity and distribution of existing health care resources; (D) Evaluating the effectiveness of intervention programs on improving patient outcomes; (E) Reviewing costs among various treatment settings, providers and approaches; and (F) Providing publicly available information on health care providers' quality of care. (2) Nothing in this section shall preclude a health insurance issuer from providing information on health care providers' quality of care in accordance with § 56-32-130(e) .
(1) The commissioner shall establish and maintain an all payer claims database to enable the commissioner of finance and administration to carry out the following duties: (A) Improving the accessibility, adequacy and affordability of patient health care and health care coverage; (B) Identifying health and health care needs and informing health and health care policy; (C) Determining the capacity and distribution of existing health care resources; (D) Evaluating the effectiveness of intervention programs on improving patient outcomes; (E) Reviewing costs among various treatment settings, providers and approaches; and (F) Providing publicly available information on health care providers' quality of care.
(A) Improving the accessibility, adequacy and affordability of patient health care and health care coverage;
(B) Identifying health and health care needs and informing health and health care policy;
(C) Determining the capacity and distribution of existing health care resources;
(D) Evaluating the effectiveness of intervention programs on improving patient outcomes;
(E) Reviewing costs among various treatment settings, providers and approaches; and
(F) Providing publicly available information on health care providers' quality of care.
(2) Nothing in this section shall preclude a health insurance issuer from providing information on health care providers' quality of care in accordance with § 56-32-130(e) .
(c) [Deleted by 2018 amendment.]
(d) (1) As required by HIPAA, the all payer claims database shall not publicly disclose any individually identifiable health information as defined in 45 CFR 160.103 . Use of the all payer claims database shall be subject to restrictions required by HIPAA and other applicable privacy laws and policies. The all payer claims database shall be accessed only by staff or a designated entity authorized in writing by the commissioner of finance and administration to perform the analyses contemplated by this section. The commissioner shall develop procedures and safeguards to protect the integrity and confidentiality of any data contained in the all payer claims database. (2) (A) (i) The all payer claims database, summaries, source, or draft information used to construct or populate the all payer claims database, patient level claims data, reports derived from the all payer claims database, and other information submitted under this section, whether in electronic or paper form, shall not be considered a public record and shall not be open for inspection by members of the public under § 10-7-503(a)(1) . The information contained in the all payer claims database shall be considered confidential and not subject to subpoena. (ii) The commissioner may promulgate rules to authorize the public release of reports derived from the information. Any release of reports shall not result in such information losing its confidentiality or cause it to be admissible, except in administrative proceedings authorized under the rules adopted by the commissioner. (B) The commissioner shall, through memoranda of understanding, allow the use of the all payer claims database by the department of finance and administration, the department of health, the department of mental health and substance abuse services, the department of disability and aging, and other departments of state government for the purposes listed in subdivision (b)(1). (C) Except for officials of the state or those officials' designees as permitted by subdivision (d)(1), nothing in this section shall be construed as permitting access to or discovery of the source or draft information used to construct or populate the all payer claims database.
(1) As required by HIPAA, the all payer claims database shall not publicly disclose any individually identifiable health information as defined in 45 CFR 160.103 . Use of the all payer claims database shall be subject to restrictions required by HIPAA and other applicable privacy laws and policies. The all payer claims database shall be accessed only by staff or a designated entity authorized in writing by the commissioner of finance and administration to perform the analyses contemplated by this section. The commissioner shall develop procedures and safeguards to protect the integrity and confidentiality of any data contained in the all payer claims database.
(2) (A) (i) The all payer claims database, summaries, source, or draft information used to construct or populate the all payer claims database, patient level claims data, reports derived from the all payer claims database, and other information submitted under this section, whether in electronic or paper form, shall not be considered a public record and shall not be open for inspection by members of the public under § 10-7-503(a)(1) . The information contained in the all payer claims database shall be considered confidential and not subject to subpoena. (ii) The commissioner may promulgate rules to authorize the public release of reports derived from the information. Any release of reports shall not result in such information losing its confidentiality or cause it to be admissible, except in administrative proceedings authorized under the rules adopted by the commissioner. (B) The commissioner shall, through memoranda of understanding, allow the use of the all payer claims database by the department of finance and administration, the department of health, the department of mental health and substance abuse services, the department of disability and aging, and other departments of state government for the purposes listed in subdivision (b)(1). (C) Except for officials of the state or those officials' designees as permitted by subdivision (d)(1), nothing in this section shall be construed as permitting access to or discovery of the source or draft information used to construct or populate the all payer claims database.
(A) (i) The all payer claims database, summaries, source, or draft information used to construct or populate the all payer claims database, patient level claims data, reports derived from the all payer claims database, and other information submitted under this section, whether in electronic or paper form, shall not be considered a public record and shall not be open for inspection by members of the public under § 10-7-503(a)(1) . The information contained in the all payer claims database shall be considered confidential and not subject to subpoena. (ii) The commissioner may promulgate rules to authorize the public release of reports derived from the information. Any release of reports shall not result in such information losing its confidentiality or cause it to be admissible, except in administrative proceedings authorized under the rules adopted by the commissioner.
(i) The all payer claims database, summaries, source, or draft information used to construct or populate the all payer claims database, patient level claims data, reports derived from the all payer claims database, and other information submitted under this section, whether in electronic or paper form, shall not be considered a public record and shall not be open for inspection by members of the public under § 10-7-503(a)(1) . The information contained in the all payer claims database shall be considered confidential and not subject to subpoena.
(ii) The commissioner may promulgate rules to authorize the public release of reports derived from the information. Any release of reports shall not result in such information losing its confidentiality or cause it to be admissible, except in administrative proceedings authorized under the rules adopted by the commissioner.
(B) The commissioner shall, through memoranda of understanding, allow the use of the all payer claims database by the department of finance and administration, the department of health, the department of mental health and substance abuse services, the department of disability and aging, and other departments of state government for the purposes listed in subdivision (b)(1).
(C) Except for officials of the state or those officials' designees as permitted by subdivision (d)(1), nothing in this section shall be construed as permitting access to or discovery of the source or draft information used to construct or populate the all payer claims database.
(e) The all payer claims database shall contain unique health care provider identifiers that may be used in public reports; provided, however, that no information that could reveal the identity of any patient from the all payer claims database shall be made available to the public. To ensure that individual patients are not identified, the following data shall not be included in any transmission by a group health plan or health insurance issuer to the state or designated entity for the all payer claims database or in any source or draft information used to construct or populate the all payer claims database: (1) Patient names; (2) Patient street addresses; (3) All elements of patient birth dates, except year of birth; (4) Patient telephone numbers; (5) Patient facsimile numbers; (6) Patient electronic mail addresses; (7) Patient social security numbers; (8) Medical record numbers; (9) Health plan beneficiary numbers; (10) Patient account numbers; (11) Patient certificate/license numbers; (12) Vehicle identifiers and serial numbers including license plate numbers; (13) Device identifiers and serial numbers; (14) Web universal resource locators (URLs); (15) Internet protocol (IP) address numbers; (16) Biometric identifiers including fingerprints, voiceprints, and genetic code; (17) Full-face photographic images and any comparable images; or (18) Any other unique patient identifying number, characteristic or code, except encrypted index numbers assigned prior to the transmission by group health plans or health insurance issuers to the state or designated entity for the purpose of linking procedures by patient; provided, that a patient's identity cannot be known from the encrypted index number.
(1) Patient names;
(2) Patient street addresses;
(3) All elements of patient birth dates, except year of birth;
(4) Patient telephone numbers;
(5) Patient facsimile numbers;
(6) Patient electronic mail addresses;
(7) Patient social security numbers;
(8) Medical record numbers;
(9) Health plan beneficiary numbers;
(10) Patient account numbers;
(11) Patient certificate/license numbers;
(12) Vehicle identifiers and serial numbers including license plate numbers;
(13) Device identifiers and serial numbers;
(14) Web universal resource locators (URLs);
(15) Internet protocol (IP) address numbers;
(16) Biometric identifiers including fingerprints, voiceprints, and genetic code;
(17) Full-face photographic images and any comparable images; or
(18) Any other unique patient identifying number, characteristic or code, except encrypted index numbers assigned prior to the transmission by group health plans or health insurance issuers to the state or designated entity for the purpose of linking procedures by patient; provided, that a patient's identity cannot be known from the encrypted index number.
(f) (1) (A) No later than January 1, 2010, and every month thereafter, all group health plans and health insurance issuers shall provide electronic health insurance claims data for state residents to the commissioner or a designated entity authorized by the commissioner, in accordance with standards and procedures recommended by the Tennessee health information committee pursuant to subdivision (c)(2) and adopted by the commissioner by rule. (B) All group health plans and health insurance issuers shall provide additional information as the Tennessee health information committee recommends and the commissioner subsequently establishes by rule for the purpose of creating and maintaining an all payer claims database. (C) The Tennessee health information committee and the commissioner shall strive for standards and procedures that are the least burdensome for data submitters. (2) The collection, storage and release of health and health care data and statistical information that is subject to the federal requirements of HIPAA shall be governed by the rules adopted in 45 CFR parts 160 and 164. (3) All group health plans and health insurance issuers that collect the health employer data and information set (HEDIS) shall annually submit the HEDIS information to the commissioner in a form and in a manner prescribed by the National Committee for Quality Assurance (NCQA). (4) If any group health plan or health insurance issuer fails to submit required data to the commissioner on a timely basis, the commissioner may impose a civil penalty of up to one hundred dollars ($100) for each day of delay.
(1) (A) No later than January 1, 2010, and every month thereafter, all group health plans and health insurance issuers shall provide electronic health insurance claims data for state residents to the commissioner or a designated entity authorized by the commissioner, in accordance with standards and procedures recommended by the Tennessee health information committee pursuant to subdivision (c)(2) and adopted by the commissioner by rule. (B) All group health plans and health insurance issuers shall provide additional information as the Tennessee health information committee recommends and the commissioner subsequently establishes by rule for the purpose of creating and maintaining an all payer claims database. (C) The Tennessee health information committee and the commissioner shall strive for standards and procedures that are the least burdensome for data submitters.
(A) No later than January 1, 2010, and every month thereafter, all group health plans and health insurance issuers shall provide electronic health insurance claims data for state residents to the commissioner or a designated entity authorized by the commissioner, in accordance with standards and procedures recommended by the Tennessee health information committee pursuant to subdivision (c)(2) and adopted by the commissioner by rule.
(B) All group health plans and health insurance issuers shall provide additional information as the Tennessee health information committee recommends and the commissioner subsequently establishes by rule for the purpose of creating and maintaining an all payer claims database.
(C) The Tennessee health information committee and the commissioner shall strive for standards and procedures that are the least burdensome for data submitters.
(2) The collection, storage and release of health and health care data and statistical information that is subject to the federal requirements of HIPAA shall be governed by the rules adopted in 45 CFR parts 160 and 164.
(3) All group health plans and health insurance issuers that collect the health employer data and information set (HEDIS) shall annually submit the HEDIS information to the commissioner in a form and in a manner prescribed by the National Committee for Quality Assurance (NCQA).
(4) If any group health plan or health insurance issuer fails to submit required data to the commissioner on a timely basis, the commissioner may impose a civil penalty of up to one hundred dollars ($100) for each day of delay.
(g) The commissioner, in the commissioner's discretion, may allow some group health plans and health insurance issuers to submit data on a quarterly basis. The commissioner may also establish by rule exceptions to the reporting requirements of this section for entities based upon an entity's size or amount of claims or other relevant factors deemed appropriate.
(h) (1) The commissioner may, subject to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, promulgate rules and regulations for purposes of implementing this section. The commissioner is authorized to promulgate the initial rules as emergency rules pursuant to the Uniform Administrative Procedures Act prior to January 1, 2010, for the purpose of creating the all payer claims database. (2) The commissioner of finance and administration may, subject to the Uniform Administrative Procedures Act, promulgate rules and regulations concerning the operation of the all payer claims database and the distribution and use of information maintained or created thereby. The commissioner of finance and administration is authorized to promulgate the initial rules as emergency rules pursuant to the Uniform Administrative Procedures Act prior to January 1, 2010, for the purpose of creating the all payer claims database.
(1) The commissioner may, subject to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, promulgate rules and regulations for purposes of implementing this section. The commissioner is authorized to promulgate the initial rules as emergency rules pursuant to the Uniform Administrative Procedures Act prior to January 1, 2010, for the purpose of creating the all payer claims database.
(2) The commissioner of finance and administration may, subject to the Uniform Administrative Procedures Act, promulgate rules and regulations concerning the operation of the all payer claims database and the distribution and use of information maintained or created thereby. The commissioner of finance and administration is authorized to promulgate the initial rules as emergency rules pursuant to the Uniform Administrative Procedures Act prior to January 1, 2010, for the purpose of creating the all payer claims database.
Amended by 2024 Tenn. Acts, ch. 688,s 143, eff. 7/1/2024.
Amended by 2018 Tenn. Acts, ch. 968, Secs.s 2, s 3 eff. 5/16/2018.
Amended by 2015 Tenn. Acts, ch. 65, s 3, Sec.s 4 eff. 4/6/2015.
Acts 2009 , ch. 611, § 3; 2010 , ch. 1100, §§ 90-92; 2011 , ch. 15, § 3; 2012 , ch. 575, §§ 1, 2.
Tenn. Code Ann. § 56-3-408 — TN Code / Title 56 / Chapter 3 / Section 56-3-408
Prohibited actions and transactions
Status: in_force

(a) No domestic insurance company, whether incorporated by special act or under a general law of this state, shall underwrite or participate in the underwriting of an offering of securities or property by any other person; nor shall the company enter into any agreement to withhold from sale any of its property, but the disposition of its property shall be at all times within the control of its board of directors. (b) (1) No investment or loan, except premium finance loans, shall be made by any such insurance company, unless the investment or loan has first been authorized by the board of directors or by a committee appointed by the board and charged with the duty of supervising the investment or loan. (2) Membership on the board of directors shall not be a requirement for eligibility to membership on the committee. Acts 1979, ch. 305, § 8; T.C.A., § 56-368.
(a) No domestic insurance company, whether incorporated by special act or under a general law of this state, shall underwrite or participate in the underwriting of an offering of securities or property by any other person; nor shall the company enter into any agreement to withhold from sale any of its property, but the disposition of its property shall be at all times within the control of its board of directors.
(b) (1) No investment or loan, except premium finance loans, shall be made by any such insurance company, unless the investment or loan has first been authorized by the board of directors or by a committee appointed by the board and charged with the duty of supervising the investment or loan. (2) Membership on the board of directors shall not be a requirement for eligibility to membership on the committee.
(1) No investment or loan, except premium finance loans, shall be made by any such insurance company, unless the investment or loan has first been authorized by the board of directors or by a committee appointed by the board and charged with the duty of supervising the investment or loan.
(2) Membership on the board of directors shall not be a requirement for eligibility to membership on the committee.
Acts 1979, ch. 305, § 8; T.C.A., § 56-368.
Tenn. Code Ann. § 56-7-2910 — TN Code / Title 56 / Chapter 7 / Section 56-7-2910
[For postponed repeal effective 6/30/2025, see T.C.A. 56-7-2916] Offering of coverage options - Exclusion of charges and expenses - Availability of third party payment - Recovery of ineligible benefits paid
Status: in_force

(a) The program shall offer at least one (1) form of coverage to each eligible person. Coverage may be modeled after one (1) of the healthcare options offered to state employees pursuant to § 8-27-201 , [repealed and reenacted; See Compiler's Notes.] or may combine a health savings account with a high deductible health plan. Coverage may also be obtained through the commercial market. The board may adopt other coverage options as appropriate. (b) The board, with the approval of the commissioner, shall establish: (1) The coverage to be provided by each option; (2) The applicable schedule of benefits; and (3) Any exclusions to coverage and other limitations. (c) In establishing subsection (b), the board shall take into consideration the levels of health insurance coverage provided in the state and medical economic factors as may be deemed appropriate, and shall promulgate benefit levels, deductibles, coinsurance factors, exclusions, and limitations determined to be generally reflective of and commensurate with health insurance coverage provided through a representative number of large employers in Tennessee. (d) The coverage options offered by the program shall not be required to provide the mandated coverage or the mandated offers of coverage required pursuant to part 23, 24, 25 or 26 of this chapter. (e) Program coverage may exclude charges or expenses incurred during a period of time not to exceed twelve (12) months following the effective date of coverage, as to any condition that, during a period not to exceed six (6) months immediately preceding the effective date of coverage, had manifested itself in such a manner as would cause an ordinarily prudent person to seek diagnosis, care or treatment or for which medical advice, care or treatment was recommended or received as to the condition. The preexisting condition exclusion shall be waived to the extent to which similar exclusions, if any, have been satisfied under any prior health insurance coverage that was involuntarily terminated, if the application for program coverage is made not later than sixty-three (63) days following the involuntary termination. In that case, coverage in the program shall be effective from the date on which the prior coverage was terminated. The exclusions may not be applied to a federally defined eligible individual. (f) Access Tennessee shall have a cause of action against an eligible person for the recovery of the amount of benefits paid that are not for covered expenses. Benefits due from the program may be reduced or refused as a set-off against any amount recoverable under this subsection (f). (g) Nothing in this part shall be construed to prohibit Access Tennessee from issuing additional types of health insurance policies with different types of benefits that, in the opinion of the board, may be of benefit to those individuals otherwise eligible for coverage. (h) Notwithstanding this part to the contrary, no person shall be eligible for coverage through the program who is not already enrolled in the program prior to April 22, 2015. Amended by 2015 Tenn. Acts, ch. 185, Secs.s 7, s 8, s 11 eff. 4/22/2015. Acts 2006, ch. 867, §§ 3, 14.
(a) The program shall offer at least one (1) form of coverage to each eligible person. Coverage may be modeled after one (1) of the healthcare options offered to state employees pursuant to § 8-27-201 , [repealed and reenacted; See Compiler's Notes.] or may combine a health savings account with a high deductible health plan. Coverage may also be obtained through the commercial market. The board may adopt other coverage options as appropriate.
(b) The board, with the approval of the commissioner, shall establish: (1) The coverage to be provided by each option; (2) The applicable schedule of benefits; and (3) Any exclusions to coverage and other limitations.
(1) The coverage to be provided by each option;
(2) The applicable schedule of benefits; and
(3) Any exclusions to coverage and other limitations.
(c) In establishing subsection (b), the board shall take into consideration the levels of health insurance coverage provided in the state and medical economic factors as may be deemed appropriate, and shall promulgate benefit levels, deductibles, coinsurance factors, exclusions, and limitations determined to be generally reflective of and commensurate with health insurance coverage provided through a representative number of large employers in Tennessee.
(d) The coverage options offered by the program shall not be required to provide the mandated coverage or the mandated offers of coverage required pursuant to part 23, 24, 25 or 26 of this chapter.
(e) Program coverage may exclude charges or expenses incurred during a period of time not to exceed twelve (12) months following the effective date of coverage, as to any condition that, during a period not to exceed six (6) months immediately preceding the effective date of coverage, had manifested itself in such a manner as would cause an ordinarily prudent person to seek diagnosis, care or treatment or for which medical advice, care or treatment was recommended or received as to the condition. The preexisting condition exclusion shall be waived to the extent to which similar exclusions, if any, have been satisfied under any prior health insurance coverage that was involuntarily terminated, if the application for program coverage is made not later than sixty-three (63) days following the involuntary termination. In that case, coverage in the program shall be effective from the date on which the prior coverage was terminated. The exclusions may not be applied to a federally defined eligible individual.
(f) Access Tennessee shall have a cause of action against an eligible person for the recovery of the amount of benefits paid that are not for covered expenses. Benefits due from the program may be reduced or refused as a set-off against any amount recoverable under this subsection (f).
(g) Nothing in this part shall be construed to prohibit Access Tennessee from issuing additional types of health insurance policies with different types of benefits that, in the opinion of the board, may be of benefit to those individuals otherwise eligible for coverage.
(h) Notwithstanding this part to the contrary, no person shall be eligible for coverage through the program who is not already enrolled in the program prior to April 22, 2015.
Amended by 2015 Tenn. Acts, ch. 185, Secs.s 7, s 8, s 11 eff. 4/22/2015.
Acts 2006, ch. 867, §§ 3, 14.
Tenn. Code Ann. § 56-57-101 — TN Code / Title 56 / Chapter 57 / Section 56-57-101
Chapter definitions
Status: in_force

As used in this chapter, unless the context otherwise requires: (1) "Commissioner" means the commissioner of commerce and insurance; (2) "Department" means the department of commerce and insurance; (3) "Member" means any person who enrolls at no cost, or who pays fees, dues, charges or other consideration for the right to enroll to receive the purported benefits of a prescription drug discount plan; (4) "Operator" means any person that engages as principal in the business of offering, selling, marketing, advertising or otherwise distributing a prescription drug discount plan within this state. Operator does not include discount cards offered by a nonprofit association to its members as an incidental benefit to membership in the association; provided, that membership in the association entitles members to apply for insurance or other health benefits that are available only to members of the association; (5) "Person" means an individual, corporation, partnership, association, joint venture, joint stock company, trust, unincorporated organization, limited liability company, any similar entity, or any combination of these entities; (6) "Prescription drug" has the same meaning as the term is defined in § 63-10-204 ; and (7) "Prescription drug discount plan" means any card or other purchasing mechanism or device, that is not insurance, that purports to offer discounts or access to discounts to any person for the retail purchase of prescription drugs from licensed pharmacies. A prescription drug discount plan does not include any drug discount card or drug benefit plan provided by a self-insured employer's group health benefits plan, or any prescription drug discount plan offered by an insurer licensed under this title in conjunction with health insurance. Acts 2005, ch. 474, § 2.
As used in this chapter, unless the context otherwise requires:
(1) "Commissioner" means the commissioner of commerce and insurance;
(2) "Department" means the department of commerce and insurance;
(3) "Member" means any person who enrolls at no cost, or who pays fees, dues, charges or other consideration for the right to enroll to receive the purported benefits of a prescription drug discount plan;
(4) "Operator" means any person that engages as principal in the business of offering, selling, marketing, advertising or otherwise distributing a prescription drug discount plan within this state. Operator does not include discount cards offered by a nonprofit association to its members as an incidental benefit to membership in the association; provided, that membership in the association entitles members to apply for insurance or other health benefits that are available only to members of the association;
(5) "Person" means an individual, corporation, partnership, association, joint venture, joint stock company, trust, unincorporated organization, limited liability company, any similar entity, or any combination of these entities;
(6) "Prescription drug" has the same meaning as the term is defined in § 63-10-204 ; and
(7) "Prescription drug discount plan" means any card or other purchasing mechanism or device, that is not insurance, that purports to offer discounts or access to discounts to any person for the retail purchase of prescription drugs from licensed pharmacies. A prescription drug discount plan does not include any drug discount card or drug benefit plan provided by a self-insured employer's group health benefits plan, or any prescription drug discount plan offered by an insurer licensed under this title in conjunction with health insurance.
Acts 2005, ch. 474, § 2.