(a) Each employer, public or private, except any public entity that has a metropolitan form of government and a population of not less than four hundred thousand (400,000), according to the 1980 federal census or any subsequent federal census, in this state that offers its employees a health benefit plan and employs not less than twenty-five (25) employees, shall afford at least two (2) qualified HMOs the opportunity to bid or to provide health care services. This dual offering is contingent upon written requests being received from the HMOs for inclusion in the employer’s health benefit plan, and provided the HMOs are different types or models, such as medical group or staff and individual practice association. Where there is a prevailing collective bargaining agreement, the selection of the HMO or organizations to be made available to the employees shall be made under the agreement.
lawyer at desk

Ask an insurance law question, get an answer ASAP!
Click here to chat with a lawyer about your rights.

Terms Used In Tennessee Code 56-32-123

  • Commissioner: means the commissioner of commerce and insurance. See Tennessee Code 56-32-102
  • Contract: A legal written agreement that becomes binding when signed.
  • Health care services: means any services included in the furnishing to any individual of medical or dental care, or hospitalization, or incidental to the furnishing of the care or hospitalization, as well as the furnishing to any person of any and all other services for the purpose of preventing, alleviating, curing, or healing human illness, injury or physical disability. See Tennessee Code 56-32-102
  • State: when applied to the different parts of the United States, includes the District of Columbia and the several territories of the United States. See Tennessee Code 1-3-105
  • written: includes printing, typewriting, engraving, lithography, and any other mode of representing words and letters. See Tennessee Code 1-3-105
(b) No employer in this state shall be required to pay more for health benefits as a result of the application of this section than would otherwise be required by any prevailing collective bargaining agreement or other contract for the provision of health benefits to its employees; provided, that the employer or benefits fund shall pay to the HMO chosen by each employee or member an amount equal to the lesser of:

(1) The amount paid on behalf of its other employees or members for health benefits; or
(2) The HMO’s charge for coverage approved by the commissioner pursuant to § 56-32-107.
  Previous section
Next section  
 Chapter 32 Contents