reglab/statecodes huggingface dataset:
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 27 - MEDICAL SERVICE PLAN LAW, 1945 (§§ 56-27-101 — 56-27-133) › Section 56-27-121 - Orders and regulations - Rates

After the issuance of a certificate of authority, the commissioner shall have authority to issue orders or to publish regulations that may be necessary for the proper enforcement of this chapter, and as the commissioner deems are in the public interest. The published regulations of the commissioner will have the effect of statute, and shall include in particular powers of regulating the form of subscription contracts and required and prohibited provisions in the contracts, and all other matters needing further definition or clarification and coming within the requirements of this chapter. The commissioner has the authority to regulate rates as required by statute now in force or hereinafter adopted by the general assembly, as provided for by the regulation of casualty rates or as approved by the commissioner by proper legal regulation.
Acts 1945, ch. 113, § 8; C. Supp. 1950, § 4186.25; T.C.A. (orig. ed.), § 56-2921.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 27 - MEDICAL SERVICE PLAN LAW, 1945 (§§ 56-27-101 — 56-27-133) › Section 56-27-122 - Suspension or cancellation of licenses - Withdrawal of approval of documents - Amendment of certificate of authority - Revocation and amendment of certificate, order, authority or consent

(a)
The commissioner has the authority to suspend or cancel the license of any medical service corporation or any agent of the corporation for violation of this chapter or of the insurance laws that may apply that are not in conflict with this chapter, after proper legal notice and opportunity of hearing, and subject to judicial review. The commissioner has the authority, after the issuance of a certificate of authority, to withdraw approval that the commissioner may have previously granted of any document required to be filed with the department under any section of this chapter. Such authority includes the right to require a medical service plan corporation to solicit in a manner required by agents' licensing laws, and to fulfill contracts approved by the commissioner, to utilize soliciting methods provided by this chapter, or by other insurance laws, including the agents' licensing law applying to casualty companies, or to operate in a county or counties or area different from those on which the certificate of authority was based, and to comply with other orders and regulations of the commissioner or requirements of this chapter; provided, that the contracts and practices are in compliance with this chapter and are not violative of other laws of this state. The authorization shall be deemed to be an amendment to the original certificate of authority.
(b)
The commissioner has the power and authority to revoke and amend, after reasonable notice and hearing, any certificate, order, authority or consent made by the commissioner to a medical service plan corporation, and may also cancel or suspend the authority of the corporation to transact business in any particular county or counties or area if the commissioner finds that less than fifty-one percent (51%) of the eligible licensed doctors of medicine practicing in that county are participating physicians.
Acts 1945, ch. 113, § 8; C. Supp. 1950, § 4186.25; T.C.A. (orig. ed.), § 56-2922.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 27 - MEDICAL SERVICE PLAN LAW, 1945 (§§ 56-27-101 — 56-27-133) › Section 56-27-123 - Revocation of license for violation of this chapter

(a)
A medical service plan corporation that neglects to make and file its annual statement in the form and within the time provided by §
56-27-117
, or neglects to reply in writing to the inquiries of the commissioner and within a reasonable time as may be specified by the commissioner, or who otherwise violates this chapter, shall be subject to revocation of license after proper notice and right of hearing.
(b)
Any agent or solicitor who violates this chapter or any written order or official regulation of the commissioner or any other insurance law, particularly the agents' licensing law set forth in chapter 6 of this title, shall be subject to revocation of the person's license after due notice and right of hearing.
Acts 1945, ch. 113, § 18; C. Supp. 1950, § 4186.34 (Williams, § 4186.35); impl. am. Acts 1975, ch. 68, § 12; T.C.A. (orig. ed.), § 56-2923.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 27 - MEDICAL SERVICE PLAN LAW, 1945 (§§ 56-27-101 — 56-27-133) › Section 56-27-124 - Review of order of commissioner - Writ of certiorari

A review of any order made by the commissioner pursuant to this chapter may be had in the circuit court of Davidson County, upon a writ of certiorari. Application for the writ shall be made within thirty (30) days after the making of the order by the commissioner.
Acts 1945, ch. 113, § 3; C. Supp. 1950, § 4186.20; T.C.A. (orig. ed.), § 56-2924.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 27 - MEDICAL SERVICE PLAN LAW, 1945 (§§ 56-27-101 — 56-27-133) › Section 56-27-125 - Subscription contract - Duration - Renewal - Termination - Forfeiture of membership - Deferment of inception coverage

Every subscription contract made by a medical service plan corporation shall provide for the payment of medical services for a period of twelve (12) months from the date of issue of the subscription certificate. The contract may provide that it shall be subject to renewal from year to year unless there has been one (1) month's prior written notice of termination by the medical service plan corporation. A subscriber shall forfeit membership upon failure to renew the subscriber's contract, or upon the subscriber's voluntary resignation. During the first contract year, the contract may provide that the inception coverage may be deferred for not more than two (2) months from date of issue of the contract, and may exclude treatment for illness existing at the inception of the contract.
Acts 1945, ch. 113, § 11; C. Supp. 1950, § 4186.27 (Williams, § 4186.28); T.C.A. (orig. ed.), § 56-2925.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 27 - MEDICAL SERVICE PLAN LAW, 1945 (§§ 56-27-101 — 56-27-133) › Section 56-27-127 - Printed portions of subscription certificate

In the subscription certificate referred to in §
56-27-126
:
(1)
All printed portions shall be plainly printed in type of which the face is not smaller than ten (10) point;
(2)
There shall be a brief description of the subscription certificate on its first page and on its filing back in type of which the face is not smaller than fourteen (14) point. The description shall not be broader than the coverage granted in the contract;
(3)
The exceptions of the contract shall appear with the same prominence in the certificate as the benefits to which they apply, and reference to the exceptions by a paragraph section shall be specifically made in the insuring clause;
(4)
If the contract contains any provisions purporting to make any portion of the articles of incorporation or of the bylaws of the corporation a part of the contract, the portion shall be set forth in full in the subscription certificate; and
All in a manner and in compliance with published regulations of the commissioner.
Acts 1945, ch. 113, § 13; C. Supp. 1950, § 4186.29 (Williams, § 4186.30); T.C.A. (orig. ed.), § 56-2927.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 27 - MEDICAL SERVICE PLAN LAW, 1945 (§§ 56-27-101 — 56-27-133) › Section 56-27-128 - Subscriptions to provide medical care for needy - Governmental or private contributions authorized

A medical service plan corporation may, in its discretion, receive and accept from governmental or private agencies or from other persons as defined in this chapter, payments covering all or part of the costs of subscriptions to provide medical care for needy and other individuals. However, all contracts for medical care shall be between the medical service plan corporation and the person to receive the care.
Acts 1945, ch. 113, § 21; C. Supp. 1950, § 4186.37 (Williams, § 4186.38); T.C.A. (orig. ed.), § 56-2928.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 27 - MEDICAL SERVICE PLAN LAW, 1945 (§§ 56-27-101 — 56-27-133) › Section 56-27-129 - Settlement of dispute or controversy by commissioner - Review of decision

Any dispute or controversy arising between a medical service plan corporation and any participating physician or any physician desiring to become a participating physician, or any subscriber, or any other person whose subscription certificate has been cancelled, or to whom the corporation has refused to issue a certificate, may, within thirty (30) days after the dispute or controversy arises, be appealed by the person allegedly aggrieved to the commissioner, or a person or persons designated by the commissioner. After proper notice and hearing, the commissioner shall render a decision, which shall be binding on any medical service plan corporation or agent of the corporation, subject to judicial review.
Acts 1945, ch. 113, § 26; C. Supp. 1950, § 4186.42 (Williams, § 4186.43); T.C.A. (orig. ed.), § 56-2929.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 27 - MEDICAL SERVICE PLAN LAW, 1945 (§§ 56-27-101 — 56-27-133) › Section 56-27-130 - Mailing list of physicians and surgeons to subscribers

Every medical service plan corporation shall mail annually to each subscriber a list of the names and addresses of all of the physicians and surgeons in the county of the subscriber's residence, who have agreements with the corporation to act as participating physicians.
Acts 1945, ch. 113, § 20; C. Supp. 1950, § 4186.36 (Williams, § 4186.37); T.C.A. (orig. ed.), § 56-2930.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 27 - MEDICAL SERVICE PLAN LAW, 1945 (§§ 56-27-101 — 56-27-133) › Section 56-27-131 - Construction of chapter

This chapter is not to be construed as prohibiting any insurance company properly qualified in this state to write accident, health or disability insurance from making available any plan of medical service that may be approved by the commissioner under existing statutes or within the authority granted in this chapter, in the same manner and in the same means as granted to benevolent associations.
Acts 1945, ch. 113, § 25; mod. C. Supp. 1950, § 4186.41 (Williams, § 4186.42); T.C.A. (orig. ed.), § 56-2931.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 27 - MEDICAL SERVICE PLAN LAW, 1945 (§§ 56-27-101 — 56-27-133) › Section 56-27-132 - Laws relating to practice of medicine and surgery or other insurance not affected

Nothing in this chapter shall be construed so as to modify, vary or repeal any law now in force relating to the practice of medicine and surgery, or the regulation of ordinary life, accident, and health or casualty insurance, except only as the law is inconsistent with this chapter.
Acts 1945, ch. 113, § 23; C. Supp. 1950, § 4186.39 (Williams, § 4186.40); T.C.A. (orig. ed.), § 56-2932.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 27 - MEDICAL SERVICE PLAN LAW, 1945 (§§ 56-27-101 — 56-27-133) › Section 56-27-133 - Sterilization insurance provision

(a)
Any law to the contrary notwithstanding, no contract of insurance that provides coverage for sterilization operations or procedures may be entered into or renewed on or after July 1, 1971, if the contract imposes any disclaimer, restriction on, or limitation of coverage with respect to the insured's reason for sterilization. All contracts entered into or renewed on or after July 1, 1971, shall be construed to be in compliance with this section, and any provision in any contract that is in conflict with this section shall be of no force or effect.
(b)
If any contract of insurance entered into prior to July 1, 1971, provides coverage for a sterilization operation or procedure, that part of the insurance contract covering the sterilization operation or procedure shall not be cancelled by the insurer unless the cancellation coincides with cancellation of the entire policy.
Acts 1971, ch. 400, § 3; T.C.A., § 56-2933.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 28 - HOSPITAL SERVICE CORPORATIONS (§§ 56-28-101 — 56-28-118) › Section 56-28-101 - Application of chapter

Any corporation organized not for profit under the general welfare corporation laws of the state for the purpose of establishing, maintaining and operating a nonprofit hospital service corporation, whereby hospital service may be provided by a hospital or group of hospitals with which the corporation has a contract for the purpose, to such of the public as become subscribers to the corporation under a contract that entitles each subscriber to certain hospital care, shall be governed by this chapter.
Acts 1945, ch. 98, § 1; C. Supp. 1950, § 4186.1; T.C.A. (orig. ed.), § 56-3001.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 28 - HOSPITAL SERVICE CORPORATIONS (§§ 56-28-101 — 56-28-118) › Section 56-28-102 - Articles of incorporation and amendments - Approval by commissioner

The articles of incorporation of the corporation and amendments to the articles shall be submitted to the department of commerce and insurance. The approval of the articles and amendments by the commissioner of commerce and insurance shall be endorsed on the articles and amendments before the articles and amendments are filed with the secretary of state; provided, that if the articles of incorporation of the corporation have been filed with the secretary of state prior to February 24, 1945, the approval of the articles by the commissioner shall be evidenced by a separate instrument in writing, filed with the secretary of state.
Acts 1945, ch. 98, § 2; C. Supp. 1950, § 4186.2; impl. am. Acts 1971, ch. 137, §§ 1, 2; T.C.A. (orig. ed.), § 56-3002.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 28 - HOSPITAL SERVICE CORPORATIONS (§§ 56-28-101 — 56-28-118) › Section 56-28-103 - Board of directors - Composition - Compensation

(a)
The directors of the corporation shall at all times be composed of the following groups in equal numbers:
(1)
Administrators or trustees of hospitals that have contracted with the corporation to render hospital service to the subscribers;
(2)
Physicians, exclusive of group one (1); and
(3)
The general public, exclusive of groups one (1) and two (2).
(b)
Directors or board members should serve without pay for their work in this capacity; provided, that they may receive payment for particular services actually rendered, such as legal counsel, medical service, accounting or other required services, upon specific approval of the board of directors, the approval being made a part of the minutes of the board.
Acts 1945, ch. 98, § 2; C. Supp. 1950, § 4186.2; T.C.A. (orig. ed.), § 56-3003.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 28 - HOSPITAL SERVICE CORPORATIONS (§§ 56-28-101 — 56-28-118) › Section 56-28-104 - License required

A corporation, subject to this chapter, may issue contracts only when the department has, by formal license, authorized the corporation to do so.
Acts 1945, ch. 98, § 4; C. Supp. 1950, § 4186.4; impl. am. Acts 1971, ch. 137, § 1; T.C.A. (orig. ed.), § 56-3004.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 28 - HOSPITAL SERVICE CORPORATIONS (§§ 56-28-101 — 56-28-118) › Section 56-28-105 - Application for license - Form - Accompanying documents - Filing fee - Unpaid contributions reported as separate item

Application for the license shall be made on forms approved by the commissioner, containing the information the commissioner deems necessary. Each application for the license shall be accompanied by copies of the following documents:
(1)
Certificate of incorporation;
(2)
Bylaws;
(3)
Proposed contracts between the corporation and participating hospital or hospitals showing terms under which hospital service is to be furnished to subscribers;
(4)
Contracts to be issued to subscribers showing a table of the rates to be charged and the benefits to which they are entitled, showing benefits expressed in service rather than in dollars; however, with equitable arrangements to protect the interests of subscribers when it becomes impossible for the service to be provided. The contracts should make clear that the ultimate responsibility for service to subscribers rests with the member hospital or hospitals; and
(5)
A statement of its financial condition and business in such form and detail as the commissioner may require, including the amounts of contribution paid for working capital, and the name or names of each contributor and the terms of the contribution, signed and sworn to by the president and secretary or other proper officers, and shall pay for the filing of the statement the sum of thirty dollars ($30.00). Contributions not paid, but agreed to be paid, may be reported as a separate item, but shall not be admitted as assets of the corporation.
Acts 1945, ch. 98, § 4; C. Supp. 1950, § 4186.4; T.C.A. (orig. ed.), § 56-3005.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 28 - HOSPITAL SERVICE CORPORATIONS (§§ 56-28-101 — 56-28-118) › Section 56-28-106 - Issuance of license - Prerequisites

The commissioner shall issue a license upon compliance with this chapter and other proper requirements of the commissioner, and upon being satisfied that:
(1)
The applicant is established as a bona fide nonprofit hospital service corporation and the service rendered by the corporation is not an unnecessary duplication of similar service in the community served, and is desirable for public necessity and convenience, and hospital contracts have been obtained, if possible, in the finding of the commissioner, with hospitals representing a majority of the bed capacity in the area where members are enrolled, and a fair opportunity has been given to all institutions of standing in the area to be served, to become member hospitals;
(2)
A provision has been made in the subscriber's contract authorizing hospital service in hospitals other than participating hospitals, in which case money benefits shall be provided as specified in subscriber's contract and approved as fair by the commissioner;
(3)
Member hospitals of a hospital service plan agree to render service benefits of the plan of which it is a member at the agreed payment schedule to all subscribers; and
(4)
The rates charged and benefits to be provided are to be fair, reasonable and not unfairly discriminatory. Rates may differ between subscribers in recognized groups and subscribers not in groups, all subject as above to the review and approval or disapproval of the commissioner as provided in §§
56-26-102
and
56-26-202
and any rules promulgated under that section. Sections
56-26-102
and
56-26-202
and related rules shall apply to all hospital service plans in the same manner as to accident and sickness policies subject to §§
56-26-102
and
56-26-202
.
Acts 1945, ch. 98, § 5; C. Supp. 1950, § 4186.5; T.C.A. (orig. ed.), §56-3006; Acts 2011 , ch. 344, § 15.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 28 - HOSPITAL SERVICE CORPORATIONS (§§ 56-28-101 — 56-28-118) › Section 56-28-107 - Working capital

The amount provided as working capital shall only be provided by individuals or groups who have no financial interest in the activities of the hospital service corporations, or by the member hospitals. Interest charged for the capital, if any, shall not exceed six percent (6%), and payment of interest, if any, and repayment of the working capital shall be permitted only after provision has been adequately made for the operating expenses, payments to member hospitals, and the establishment of legal reserves and the other reserves as may be required by the commissioner. The amount of money actually available for working capital shall be sufficient to carry all acquisition costs and operating expense for a period of at least three (3) months from the date of the issuance of the certificate.
Acts 1945, ch. 98, § 7; C. Supp. 1950, § 4186.7; T.C.A. (orig. ed.), § 56-3007.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 28 - HOSPITAL SERVICE CORPORATIONS (§§ 56-28-101 — 56-28-118) › Section 56-28-108 - Acquisition and administrative expenses

All acquisition and administrative expenses in connection with the hospital service corporation shall at all times be limited after the first year of operation so as not to exceed twenty-five percent (25%) of the total net premium income of the corporation. All acquisition and administrative expenses shall be subject to the approval of the commissioner.
Acts 1945, ch. 98, § 12; C. Supp. 1950, § 4186.12; T.C.A. (orig. ed.), § 56-3008.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 28 - HOSPITAL SERVICE CORPORATIONS (§§ 56-28-101 — 56-28-118) › Section 56-28-109 - Reserves

The service corporation shall maintain at all times proper reserves subject to the approval of the commissioner for unearned subscription fees and unearned premiums and for unpaid hospital bills, including provision for unreported and undischarged hospital cases, and other known liabilities. In addition, a contingency or epidemic reserve shall be accumulated annually at the rate of not less than two and one half percent (2.5%) of net premium income. When the contingency or epidemic reserve equals seventy-five thousand dollars ($75,000), or fifty-five percent (55%) of the annual premium income, whichever is higher, further accumulations may be discontinued for any length of time that they are not needed to meet the requirement of this section.
Acts 1945, ch. 98, § 9; C. Supp. 1950, § 4186.9; T.C.A. (orig. ed.), § 56-3009.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 28 - HOSPITAL SERVICE CORPORATIONS (§§ 56-28-101 — 56-28-118) › Section 56-28-110 - Investments

The funds of the service corporation, subject to this chapter, shall be invested only in securities permitted by the law of this state for the investment of assets of life insurance companies.
Acts 1945, ch. 98, § 13; C. Supp. 1950, § 4186.13; T.C.A. (orig. ed.), § 56-3010.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 28 - HOSPITAL SERVICE CORPORATIONS (§§ 56-28-101 — 56-28-118) › Section 56-28-111 - Annual statement

The service corporation shall annually, on or before March 1, file in the office of the department a statement of its operations for the calendar year and showing financial condition as of December 31 then next preceding, in such form and content as the commissioner shall prescribe, signed and sworn to by its president and secretary, or other proper officers, and shall pay for the filing of the statement the sum of fifty dollars ($50.00).
Acts 1945, ch. 98, § 8; C. Supp. 1950, § 4186.8; impl. am. Acts 1971, ch. 137, § 1; Acts 1979, ch. 298, § 7; T.C.A. (orig. ed.), § 56-3011.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 28 - HOSPITAL SERVICE CORPORATIONS (§§ 56-28-101 — 56-28-118) › Section 56-28-112 - Financial and statistical records

The service corporation shall maintain adequate financial and statistical records in reasonable uniformity with accounting plans and statistical requirements of the annual statement blank required by the commissioner.
Acts 1945, ch. 98, § 10; C. Supp. 1950, § 4186.10; T.C.A. (orig. ed.), § 56-3012.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 28 - HOSPITAL SERVICE CORPORATIONS (§§ 56-28-101 — 56-28-118) › Section 56-28-113 - Examination - Rehabilitation or liquidation

The commissioner has the same authority to examine the service corporations as is granted the commissioner for the examination of life, accident and health insurance companies, and has the same authority for the correction, rehabilitation or liquidation of the service corporations as is now provided by law for life, accident and health companies.
Acts 1945, ch. 98, § 11; C. Supp. 1950, § 4186.11; T.C.A. (orig. ed.), § 56-3013.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 28 - HOSPITAL SERVICE CORPORATIONS (§§ 56-28-101 — 56-28-118) › Section 56-28-114 - Contracts for service to subscribers - Rates

The corporation may enter into contracts for the rendering of hospital service to the subscribers only with hospitals approved by the commissioner. All contracts issued by the corporation to the subscribers shall constitute individually and jointly direct obligations of the hospital or hospitals with which the corporation has contracted for hospital service. The rates charged to the subscribers for hospital service and the rates of payment by the corporation to the contracting hospital or hospitals at all times shall be subject to the approval or disapproval of the commissioner; provided, that in the case of experience-rated group insurance, premium rates and classification of risks need not be filed but shall be maintained by the hospital service corporations and made available for review by the commissioner upon the commissioner's request.
Acts 1945, ch. 98, § 3; C. Supp. 1950, § 4186.3; Acts 1978, ch. 513, § 1; T.C.A. (orig. ed.), § 56-3014.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 28 - HOSPITAL SERVICE CORPORATIONS (§§ 56-28-101 — 56-28-118) › Section 56-28-115 - Publication of regulations regulating subscribers' contracts

The commissioner is authorized to publish regulations that will have the effect of statute, regulating the form of subscribers' contracts and required and prohibited provisions in the contracts.
Acts 1945, ch. 98, § 6; C. Supp. 1950, § 4186.6; T.C.A. (orig. ed.), § 56-3015.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 28 - HOSPITAL SERVICE CORPORATIONS (§§ 56-28-101 — 56-28-118) › Section 56-28-116 - Renewal of licenses - Certificates of authority for agents

All licenses authorizing hospital service corporations to transact business in this state shall be renewable on April 1 of each year. A service corporation licensed to do business in this state under this chapter shall obtain from the commissioner a certificate of authority for every agent writing or soliciting hospital service contracts for the medical service corporation in this state, and the certificate shall be renewable January 1 of each year.
Acts 1945, ch. 98, § 14; C. Supp. 1950, § 4186.14; T.C.A. (orig. ed.), § 56-3016.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 28 - HOSPITAL SERVICE CORPORATIONS (§§ 56-28-101 — 56-28-118) › Section 56-28-117 - Fees and taxes

Every corporation or its agents, subject to this chapter, are subject to the fees and taxes prescribed for life, health and accident insurance companies and agents of the companies doing business in this state. It is not the purpose of this chapter to discriminate in favor of the service corporations.
Acts 1945, ch. 98, § 15; C. Supp. 1950, § 4186.15; T.C.A. (orig. ed.), § 56-3017.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 28 - HOSPITAL SERVICE CORPORATIONS (§§ 56-28-101 — 56-28-118) › Section 56-28-118 - Construction of chapter

This chapter is not to be construed as prohibiting any insurance company properly qualified in this state to write accident, health or disability insurance to make available any plan of hospitalization that may be approved by the commissioner under existing statutes or within the authority granted in this chapter in the same manner and in the same means as granted to benevolent associations.
Acts 1945, ch. 98, § 16; mod. C. Supp. 1950, § 4186.16; T.C.A. (orig. ed.), § 56-3018.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 29 - HOSPITAL AND MEDICAL SERVICE CORPORATIONS (§§ 56-29-101 — 56-29-119) › Section 56-29-101 - Purpose of chapter

The purpose of this chapter is as described in this section, and it is the intention of this chapter to provide for the organization and operation of nonprofit hospital service corporations. However, it is not to be construed as prohibiting any insurance company properly qualified in this state to write accident, health or disability insurance to make available any plan of hospitalization that may be approved by the commissioner under other chapters of this code or within the authority granted in this chapter in the same manner and in the same means as granted to benevolent associations. Further, nothing in this chapter shall be construed as either granting to hospitals the authority to practice medicine or the authority to collect medical fees for physicians who serve on the hospital staff.
Acts 1949, ch. 234, § 17; C. Supp. 1950, § 4186.59 (Williams, § 4186.62); T.C.A. (orig. ed.), § 56-3101.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 29 - HOSPITAL AND MEDICAL SERVICE CORPORATIONS (§§ 56-29-101 — 56-29-119) › Section 56-29-102 - Corporations covered by this chapter

Any corporation not for profit organized under the former General Welfare Corporation Act, or under former title 48, chapters 1-14 [repealed] for the purpose of establishing, maintaining and operating a nonprofit hospital service corporation and of providing medical benefits, whereby hospital service may be provided by a hospital or group of hospitals with which the corporation has a contract for that purpose and whereby the corporation may provide cash indemnity for medical expense, to such of the public as become subscribers to the corporation under a contract that entitles each subscriber to certain hospital care and to certain cash indemnity benefits for medical expense, shall be governed by this chapter.
Acts 1949, ch. 234, § 1; C. Supp. 1950, § 4186.43 (Williams, § 4186.46); impl. am. Acts 1968, ch. 523, § 1 (17.06); T.C.A. (orig. ed.), § 56-3102.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 29 - HOSPITAL AND MEDICAL SERVICE CORPORATIONS (§§ 56-29-101 — 56-29-119) › Section 56-29-103 - Existing corporations that may operate under this chapter - Prerequisites

Any corporation now organized and existing under title 48, chapter 11 [repealed] as it existed prior to July 1, 1969, or any corporation now existing and operating under chapter 28 of this title, may become a corporation with the powers of a corporation newly organized under this chapter and become subject to this chapter by amending its charter so as to provide for both medical benefits and hospital services as provided by this chapter and conforming to this chapter, but shall at all times be required before the amendment becomes effective to have the amendment approved by the commissioner, as provided in §
56-29-104
.
Acts 1949, ch. 234, § 2; C. Supp. 1950, § 4186.44 (Williams, § 4186.47); impl. am. Acts 1968, ch. 523, § 1(17.06); impl. am. Acts 1971, ch. 137, § 2; T.C.A. (orig. ed.), § 56-3103.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 29 - HOSPITAL AND MEDICAL SERVICE CORPORATIONS (§§ 56-29-101 — 56-29-119) › Section 56-29-104 - Articles of incorporation and amendments - Approval by commissioner

The articles of incorporation of the corporation and amendments to the articles shall be submitted to the department. The approval of the articles and amendments by the commissioner of commerce and insurance, referred to as the "commissioner" in this chapter, shall be endorsed on the articles and amendments before the articles and amendments are filed with the secretary of state; provided, that if the articles of incorporation of the corporation have been filed with the secretary of state prior to April 15, 1949, the approval of the articles by the commissioner shall be evidenced by a separate instrument in writing, filed with the secretary of state.
Acts 1949, ch. 234, § 3; C. Supp. 1950, § 4186.45 (Williams, §4186.48); impl. am. Acts 1971, ch. 137, §§ 1, 2; T.C.A. (orig. ed.), § 56-3104.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 29 - HOSPITAL AND MEDICAL SERVICE CORPORATIONS (§§ 56-29-101 — 56-29-119) › Section 56-29-106 - License required

A corporation, subject to this chapter, may issue contracts only when the department has, by formal license, authorized it to do so.
Acts 1949, ch. 234, § 5; C. Supp. 1950, § 4186.47 (Williams, § 4186.50); impl. am. Acts 1971, ch. 137, § 1; T.C.A. (orig. ed.), § 56-3106.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 29 - HOSPITAL AND MEDICAL SERVICE CORPORATIONS (§§ 56-29-101 — 56-29-119) › Section 56-29-107 - Application for license - Accompanying documents - Filing fee

Application for the license shall be made on a form approved by the commissioner, containing such information as the commissioner deems necessary. Each application for the license shall be accompanied by copies of the following documents:
(1)
Certificate of incorporation;
(2)
Bylaws;
(3)
Proposed contracts between the corporation and participating hospital or hospitals showing terms under which hospital service is to be furnished to subscribers;
(4)
Contracts to be issued to subscribers showing a table of the rates to be charged and the benefits to which they are entitled, showing medical expense indemnity benefits expressed in terms of dollars and showing hospital service benefits expressed in service rather than in dollars; however, with equitable arrangements to protect the interests of subscribers when it becomes impossible for the service to be provided. The contracts should make clear that the ultimate responsibility for hospital service to subscribers rests with the member hospital or hospitals; and
(5)
A statement of its financial condition and business in such form and detail as the commissioner may require, including the amounts of contribution paid for working capital, and the name or names of each contributor and the terms of the contributions, signed and sworn to by its president and secretary or other proper officers, and shall pay for the filing of the statement the sum of thirty dollars ($30.00). Contributions not paid, but agreed to be paid, may be reported as a separate item, but shall not be admitted as assets of the corporation.
Acts 1949, ch. 234, § 5; C. Supp. 1950, § 4186.47 (Williams, § 4186.50); T.C.A. (orig. ed.), § 56-3107.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 29 - HOSPITAL AND MEDICAL SERVICE CORPORATIONS (§§ 56-29-101 — 56-29-119) › Section 56-29-108 - Issuance of license by commissioner - Prerequisites

The commissioner shall issue a license upon compliance with this chapter and other proper requirements of the commissioner, and upon being satisfied that:
(1)
The applicant is established as a bona fide nonprofit hospital service corporation with or without the right to provide medical expense indemnity; the hospital service benefits provided by the corporation are not an unnecessary duplication of similar service in the community served; it is desirable for public necessity and convenience; hospital contracts have been obtained, if possible, in the findings of the commissioner, with hospitals representing a majority of the bed capacity in the area where members are to be enrolled; and a fair opportunity has been given to all institutions of standing in the area to be served, to become member hospitals;
(2)
A provision has been made in the subscriber's contract authorizing hospital service in hospitals other than participating hospitals, in which case money benefits shall be provided as specified in the subscriber's contract and approved as fair by the commissioner;
(3)
Member hospitals of a hospital service plan agree to render service benefits of the plan of which it is a member at the agreed payment schedule to all subscribers; and
(4)
The rates charged are fair, reasonable, adequate and not unfairly discriminatory. Benefits to be provided are to be fair, reasonable and not unfairly discriminatory. Rates may differ between subscribers in recognized groups and subscribers not in groups, all subject as above to the approval of the commissioner.
Acts 1949, ch. 234, § 6; C. Supp. 1950, § 4186.48 (Williams, § 4186.51); T.C.A. (orig. ed.), § 56-3108.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 29 - HOSPITAL AND MEDICAL SERVICE CORPORATIONS (§§ 56-29-101 — 56-29-119) › Section 56-29-109 - Working capital provided by disinterested groups or individuals - Repayment - Interest

The amount provided as working capital shall only be provided by individuals or groups who have no financial interest in the activities of the hospital service corporations, or by any member hospitals. Interest charged for the capital, if any, shall not exceed six percent (6%), and payment of interest, if any, and repayment of the working capital shall be permitted only after provision has been adequately made for operating expenses, payments to member hospitals and the establishment of legal reserves and other reserves that may be required by the commissioner. The amount of money actually available for working capital shall be sufficient to carry all acquisition costs and operating expenses for a period of at least three (3) months from the date of the issuance of the certificate.
Acts 1949, ch. 234, § 8; C. Supp. 1950, § 4186.50 (Williams, § 4186.53); T.C.A. (orig. ed.), § 56-3109.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 29 - HOSPITAL AND MEDICAL SERVICE CORPORATIONS (§§ 56-29-101 — 56-29-119) › Section 56-29-110 - Acquisition and administrative expenses - Limitation - Approval

All acquisition and administrative expenses in connection with the hospital service corporations shall at all times be limited after the first year of operation to not exceed twenty-five percent (25%) of the total net premium income of the corporation. All acquisition and administrative expenses shall be subject to the approval of the commissioner.
Acts 1949, ch. 234, § 13; C. Supp. 1950, § 4186.55 (Williams, § 4186.58); T.C.A. (orig. ed.), § 56-3110.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 29 - HOSPITAL AND MEDICAL SERVICE CORPORATIONS (§§ 56-29-101 — 56-29-119) › Section 56-29-111 - Reserve requirements

The service corporation shall maintain at all times proper reserves, subject to the approval of the commissioner, for unearned subscription fees and unearned premiums and for unpaid hospital bills, including provision for unreported and undischarged hospital cases and for incurred medical expense indemnity claims and other known liabilities. In addition, a contingency or epidemic reserve shall be accumulated annually at a rate not less than two and one half percent (2.5%) of net premium income. If the service corporation provides for hospital service benefits only when the contingency or epidemic reserve equals seventy-five thousand dollars ($75,000), or fifty-five percent (55%) of the annual premium income, whichever is higher, or if the service corporation provides for hospital service and medical expense indemnity benefits when the contingency or epidemic reserve equals one hundred fifty thousand dollars ($150,000), or fifty-five percent (55%) of the annual premium income, whichever is higher, further accumulations may be discontinued for any length of time that they are not required to meet the contingency or epidemic reserve requirement. If the service corporation is unable to meet the requirements of this section, then the commissioner is empowered to require that the corporation either increase rates or reduce benefits to the extent necessary in order that the corporation may be able to meet the requirements.
Acts 1949, ch. 234, § 10; C. Supp. 1950, § 4186.52 (Williams, § 4186.55); impl. am. Acts 1971, ch. 137, § 2; T.C.A. (orig. ed.), § 56-3111.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 29 - HOSPITAL AND MEDICAL SERVICE CORPORATIONS (§§ 56-29-101 — 56-29-119) › Section 56-29-112 - Investment of corporation funds

The funds of the service corporations, subject to this chapter, shall be invested only in securities permitted by the law of this state for the investment of assets of life insurance companies.
Acts 1949, ch. 234, § 14; C. Supp. 1950, § 4186.56 (Williams, § 4186.59); T.C.A. (orig. ed.), § 56-3112.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 29 - HOSPITAL AND MEDICAL SERVICE CORPORATIONS (§§ 56-29-101 — 56-29-119) › Section 56-29-113 - Annual statement - Contents - Filing fee

Every service corporation shall annually, on or before March 1, file in the office of the department a statement of its operation for the calendar year and showing financial condition as of December 31 then next preceding, in such form and content as the commissioner prescribes, signed and sworn to by its president and secretary, or other proper officers, and shall pay for the filing of the statement the sum of fifty dollars ($50.00).
Acts 1949, ch. 234, § 9; C. Supp. 1950, § 4186.51 (Williams, § 4186.54); impl. am. Acts 1971, ch. 137, § 1; Acts 1979, ch. 298, § 8; T.C.A. (orig. ed.), § 56-3113.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 29 - HOSPITAL AND MEDICAL SERVICE CORPORATIONS (§§ 56-29-101 — 56-29-119) › Section 56-29-114 - Keeping of adequate financial and statistical records

The service corporation shall maintain adequate financial and statistical records in reasonable uniformity with accounting plans and statistical requirements of the annual statement blank required by the commissioner.
Acts 1949, ch. 234, § 11; C. Supp. 1950, § 4186.53 (Williams, § 4186.56); T.C.A. (orig. ed.), § 56-3114.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 29 - HOSPITAL AND MEDICAL SERVICE CORPORATIONS (§§ 56-29-101 — 56-29-119) › Section 56-29-115 - Examination - Rehabilitation or liquidation

The commissioner has the same authority to examine such service corporations as granted to the commissioner for the examination of life, accident and health insurance companies, and has the same authority for the correction, rehabilitation or liquidation of such service corporations as now provided by law for life, accident and health companies.
Acts 1949, ch. 234, § 12; C. Supp. 1950, § 4186.54 (Williams, § 4186.57); T.C.A. (orig. ed.), § 56-3115.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 29 - HOSPITAL AND MEDICAL SERVICE CORPORATIONS (§§ 56-29-101 — 56-29-119) › Section 56-29-116 - [Repealed]

Acts 1949, ch. 234, § 4; C. Supp. 1950, § 4186.46 (Williams, § 4186.49); Acts 1978, ch. 513, § 2; T.C.A. (orig. ed.), §56-3116, repealed by Acts 2011 , ch. 344, § 16, effective 7/1/2011.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 29 - HOSPITAL AND MEDICAL SERVICE CORPORATIONS (§§ 56-29-101 — 56-29-119) › Section 56-29-117 - Submission of contracts and schedule of rates to commissioner - Disapproval

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.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 29 - HOSPITAL AND MEDICAL SERVICE CORPORATIONS (§§ 56-29-101 — 56-29-119) › Section 56-29-118 - Licenses renewable annually - Agents to have certificate of authority

(a)
All licenses authorizing hospital service corporations to transact business in this state shall be renewable on July 1 of each year.
(b)
A hospital service corporation licensed to do business in this state under this chapter shall obtain from the commissioner a certificate of authority for every agent writing or soliciting contracts for the service corporation in this state, and the certificates shall be renewable January 1 of each year.
Acts 1949, ch. 234, § 15; C. Supp. 1950, § 4186.57 (Williams, § 4186.60); T.C.A. (orig. ed.), § 56-3118.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 29 - HOSPITAL AND MEDICAL SERVICE CORPORATIONS (§§ 56-29-101 — 56-29-119) › Section 56-29-119 - Fees and taxes of corporations and agents

Every corporation or its agents, subject to this chapter, shall be subject to the fees and taxes as prescribed for life, health and accident insurance companies and agents of the companies doing business in this state. It is not the purpose of this chapter to discriminate in favor of the service corporations.
Acts 1949, ch. 234, § 17; C. Supp. 1950, § 4186.58 (Williams, § 4186.61); T.C.A. (orig. ed.), § 56-3119.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 30 - DENTAL SERVICE PLAN LAW, 1961 (§§ 56-30-101 — 56-30-135) › Section 56-30-101 - Short title

This chapter shall be known and may be cited as the "Dental Service Plan Law, 1961."
Acts 1961, ch. 340, § 1; T.C.A., § 56-3501.
2023 Tennessee Code › Title 56 - INSURANCE (§§ 56-1-101 — 56-61-125) › Chapter 30 - DENTAL SERVICE PLAN LAW, 1961 (§§ 56-30-101 — 56-30-135) › Section 56-30-102 - Chapter definitions

As used in this chapter, unless the context otherwise requires:
(1)
"Beneficiary" means a person designated in the subscription certificate referred to in subdivision (10), as entitled to the dental services referred to in subdivision (10);
(2)
"Commissioner" means the commissioner of commerce and insurance;
(3)
"Covered dependent" is the spouse, an adult dependent or child of a subscriber who is named in the subscription certificate issued to the subscriber, and with respect to whom appropriate premium is specified in the certificate;
(4)
"Dental service" means professional services rendered by persons duly licensed under the laws of this state to practice dentistry and all services defined as constituting the practice of dentistry as set out in title 63, chapter 5;
(5)
"Nonprofit dental service corporation" means any corporation organized pursuant to this chapter for the purpose of establishing, maintaining and operating a nonprofit dental service plan, and that employs the service benefit concept in the majority of the programs it administers;
(6)
"Nonprofit dental service plan" means a plan whereby specified dental service is provided by a nonprofit dental service corporation to subscribers to the plan;
(7)
"Participating dentist" means a dentist licensed to practice dentistry in this state under title 63, chapter 5, who contracts in writing with a dental service plan corporation to perform the dental services specified in the subscription certificates issued by the corporation, and at the rates of compensation determined by the board of directors of the corporation, and who agrees to abide by the bylaws, rules and regulations of the corporation applicable to participating dentists;
(8)
"Person" includes a natural person, a corporation, an association, a common law trust or corporation;
(9)
"Service benefit concept" means a type of dental benefit contract between a beneficiary and a third party payer, whereby the beneficiary is guaranteed no out-of-pocket expenses for covered services beyond any agreed on cost sharing stipulated in the contract; and
(10)
"Subscriber" means a person to whom a subscription certificate is issued by a dental care service plan corporation that sets forth the beneficiaries and the kind and extent of dental service for which the corporation is liable to make payment.
Acts 1961, ch. 340, § 2; impl. am. Acts 1971, ch. 137, § 2; T.C.A., § 56-3502; Acts 1989, ch. 152, § 1.