§ 56-26-101 — Part definitions

Tennessee § 56-26-101

• Jurisdiction: Tennessee
• Title: 56

Text

As used in this part, unless the context otherwise requires, "accident and sickness insurance" includes any policy or contract covering insurance against loss resulting from sickness or from bodily injury or death by accident, or both. The various types of such policies are defined in the following subdivisions: (1) (A) "Blanket accident and sickness insurance" means that form of accident and sickness insurance covering special groups of persons as enumerated in one (1) of the following divisions: (i) Under a policy issued to any common carrier, which shall be deemed the policyholder covering a group defined as all persons who may become passengers on the common carrier; (ii) Under a policy issued to an employer, who shall be deemed the policyholder, covering any group of employees defined by reference to exceptional hazards incident to the employment; (iii) Under a policy issued to a college, school or other institution of learning, or to the head or principal thereof, which or who shall be deemed the policyholder, covering students or teachers; (iv) Under a policy issued in the name of any volunteer fire department or first aid or other similar volunteer group, which shall be deemed the policyholder, covering all of the members of the department or group; or (v) Under a policy issued to any other substantially similar group which, in the discretion of the commissioner, may be subject to the issuance of a blanket accident and sickness policy. (B) An individual application is not required from a person covered under a blanket accident and sickness policy, nor is it necessary for the insurer to furnish each person a certificate; (2) "Cancellable" or "renewable at option of company" refers to and may be used only in policies under which the company reserves the right to cancel or nonrenew the policy of any individual insured either on any date on which a premium becomes due, or on the policy anniversary, or at any other date subject to refund of any unearned premium; (3) "Commissioner" means the commissioner of commerce and insurance; (4) "Franchise accident and sickness insurance" means that form of accident and sickness insurance issued to either of the following: (A) Three (3) or more employees of any corporation, copartnership or individual employer or any governmental corporation, agency or department thereof; or (B) Ten (10) or more members of any trade or professional association or of a labor union or of any other association having had an active existence for at least two (2) years where the association or union has a constitution or bylaws and is formed in good faith for purposes other than that of obtaining insurance; where the employees or members, with or without their dependents, are issued the same form of an individual policy varying only as to amounts and kinds of coverage applied for by the employees or members, under an arrangement whereby the premiums on the policies may be paid to the insurer periodically by the employer, with or without payroll deductions, or by the association or union for its members, or by some designated person acting on behalf of the employer, association or union; and (5) "Individual market" has the same meaning given in § 2791(e)(1)(A) of the Public Health Service Act ( 42 U.S.C. § 300gg-91 ); (6) (A) "Noncancellable" or "noncancellable and guaranteed renewable" or synonymous terms such as "guaranteed continuable" may be used only in a policy, which the insured has the right to continue in force by the timely payment of premiums set forth in the policy: (i) Until at least age fifty (50); or (ii) In the case of a policy issued after age forty-four (44), for at least five (5) years from its date of issue, during which period the insurer has no right to make unilaterally any change in any provision of the policy while the policy is in force. (B) Except as provided in subdivision (6)(A), "guaranteed renewable" may be used only in a policy that the insured has the right to continue in force by the timely payment of premiums: (i) Until at least age fifty (50); or (ii) In the case of a policy issued after age forty-four (44), for at least five (5) years from its date of issue, during which period the insurer has no right to make unilaterally any change in any provision of the policy while the policy is in force, except that the insurer may make changes in premium rates by classes. (C) The limitation in subdivision (6)(A) on use of "noncancellable" also applies to any synonymous term such as "not cancellable," and the limitation in subdivision (6)(B) on use of "guaranteed renewable" applies to any synonymous term such as "guaranteed continuable"; (7) "Small employer" has the same meaning given in § 56-7-2203 . However, for purposes of qualifying to establish a liability pool under § 56-26-204(a) , all employees of all member employers participating in the provision of health insurance coverage must be included in the number of eligible employees; and (8) "Written approval" includes an electronic approval.

Legislative History

Amended by 2020 Tenn. Acts, ch. 515, s 2, eff. 7/1/2020. Acts 1955, ch. 4, § 1; 1976, ch. 397, § 1; T.C.A., § 56-3301; Acts 2011 , ch. 344, § 11.