Tennessee Code 56-7-2812 – Applicability of individual market requirements to excepted benefits under sections 56-7-2802(10)
Current as of: 2024 | Check for updates
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Terms Used In Tennessee Code 56-7-2812
- Contract: A legal written agreement that becomes binding when signed.
- Excepted benefits: means benefits under one (1) or more, or any combination, of the following:
(A) Benefits not subject to requirements: (i) Coverage only for accident or disability income insurance, or any combination of accident and disability income insurance. See Tennessee Code 56-7-2802 - Health insurance coverage: means benefits consisting of medical care, provided directly, through insurance or reimbursement, or otherwise and including items and services paid for as medical care, under any policy, certificate, or agreement offered by a health insurance issuer. See Tennessee Code 56-7-2802
- 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. See Tennessee Code 56-7-2802
- Individual health insurance coverage: means health insurance coverage offered to individuals in the individual market, but does not include short-term limited duration insurance. See Tennessee Code 56-7-2802
- Individual market: means the market for health insurance coverage offered to individuals other than in connection with a group health plan. See Tennessee Code 56-7-2802
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 offering health insurance coverage in connection with group health plans shall not be deemed to be a health insurance issuer offering individual health insurance coverage solely because the issuer offers a conversion policy.