§ 56-7-2801. Short Title
This part shall be known and may be cited as the “Tennessee Health Insurance Portability, Availability and Renewability Act.”
§ 56-7-2802. Part Definitions
As used in this part, unless the context otherwise requires: “Affiliation period”: Means a period that, under the terms of the health insurance coverage offered by the health maintenance organization, must expire before the health insurance coverage becomes effective. The organization is not required to provide health care services or benefits during the affiliation period […]
§ 56-7-2803. Preexisting Condition Exclusions — Period of Creditable Coverage — Special Enrollment Periods
A group health plan, and a health insurance issuer offering group health insurance coverage, may, with respect to a participant or beneficiary, impose a preexisting condition exclusion only if: The exclusion relates to a condition, whether physical or mental, regardless of the cause of the condition, for which medical advice, diagnosis, care, or treatment was […]
§ 56-7-2804. Rules for Eligibility — Factors Not to Be Considered
Subject to subdivision (a)(2), a group health plan, and a health insurance issuer offering group health insurance coverage in connection with a group health plan, may not establish rules for eligibility, including continued eligibility, of any individual to enroll under the terms of the plan based on any of the following health status-related factors in […]
§ 56-7-2805. Small Group Market — Network Plans — Financial Capacity Limits — Applicability
Issuance of Coverage in the Small Group Market. Subject to subsections (b)-(e), each health insurance issuer that offers health insurance coverage in the small group market in this state must accept: Every small employer in the state that applies for the coverage; and For enrollment under the coverage every eligible individual who applies for enrollment […]
§ 56-7-2806. Guaranteed Renewability of Coverage for Employers in the Group Market
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. General Exceptions. A health insurance issuer […]
§ 56-7-2807. Exclusion of Certain Plans
Limitation on application of provisions relating to group health plans. The requirements of this part shall apply with respect to group health plans only: Subject to subdivision (a)(2), in the case of a plan that is a nonfederal governmental plan; and With respect to health insurance coverage offered in connection with a group health plan, […]
§ 56-7-2808. Applicability — Determination of Creditable Service
Except as modified in this section, this part shall apply with respect to group health plans, and health insurance coverage offered in connection with group health plans, for plan years beginning after June 30, 1997. Determination of creditable coverage. Period of coverage. Subject to subdivision (b)(1)(B), no period before July 1, 1996, shall be taken […]
§ 56-7-2809. Coverage Without Preexisting Condition Exclusion Required — Alternative Coverage — Network Plans — Financial Capacity Limit
On and after July 1, 1997, each health insurance issuer that offers individual health insurance coverage in this state must offer to and accept for enrollment every eligible individual who applies for coverage without imposing any preexisting condition exclusion with respect to the coverage. As used in this section, “eligible individual” means an individual: For […]
§ 56-7-2810. Guaranteed Renewability of Coverage for Individuals
A health insurance issuer that provides individual health insurance coverage to an individual shall renew or continue in force the coverage at the option of the individual for all such coverage in effect on or after July 1, 1997, except as provided in this section. A health insurance issuer may nonrenew or discontinue health insurance […]
§ 56-7-2811. Provisions Applicable to Individual as Well as Group Markets
The provisions for certification and disclosure of coverage shall apply to health insurance coverage offered by a health insurance issuer in the individual market in the same manner as it applies to health insurance coverage offered by a health insurance issuer in connection with a group health plan in the small or large group market.
§ 56-7-2812. Applicability of Individual Market Requirements to Excepted Benefits Under § 56-7-2802(10)
The individual market requirements of this part shall not apply to any health insurance coverage in relation to its provision of excepted benefits described in § 56-7-2802(10)(A) or to those described in § 56-7-2802(10)(B), (C), or (D) if the benefits are provided under a separate policy, certificate or contract of insurance. A health insurance issuer […]
§ 56-7-2813. Construction With Other Laws — Enforcement Actions
This part is supplemental to any other laws of this state; however, to the extent that this part is in conflict with other insurance law, this part shall control. No enforcement action shall be taken, pursuant to this part, against a group health plan or health insurance issuer with respect to a violation of a […]
§ 56-7-2814. Legislative Intent — Rules and Regulations
It is the intent of this part to meet the minimum standards established by the federal Health Insurance Portability and Accountability Act of 1996 (HIPAA) (42 U.S.C. § 1320d et seq.), and the rules and regulations to be promulgated by federal authorities in connection with HIPAA. The commissioner is, therefore, authorized to promulgate rules and […]