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Current as of January 02, 2024 | Updated by Findlaw Staff
(a) As used in this section:
(1) “Department” means the department of commerce and insurance;
(2) “Health insurance entity” 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 an insurance company, a health maintenance organization, or a nonprofit hospital and medical service corporation;
(3) “Hospital indemnity coverage” means coverage that provides benefits on an independent, noncoordinated basis and that pays a fixed amount for specified events without regard to other insurance;
(4) “Marketplace” means the federally facilitated marketplace for health insurance policies sold in accordance with the federal Patient Protection and Affordable Care Act (42 U.S.C. § 18011 et seq.) for this state; and
(5) “Per term” means the applicable duration or period of time for a specific policy provision in a health insurance plan offered in accordance with this section, including the timeframe during which a deductible or maximum allotted benefit accumulates and is calculated.
(b) A health insurance entity may offer hospital indemnity coverage on the marketplace if the coverage allows an individual to choose from five (5) tiers that provide at least the following coverage:
(1) For the first tier, a deductible of no more than two thousand five hundred dollars ($2,500);
(2) For the second tier, a deductible of no more than five thousand dollars ($5,000);
(3) For the third tier, a deductible of no more than seven thousand five hundred dollars ($7,500);
(4) For the fourth tier, a deductible of no more than ten thousand dollars ($10,000); and
(5) For the fifth tier, a deductible of no more than fifteen thousand dollars ($15,000).
(c) Except as provided under subsection (d):
(1) A health insurance entity offering coverage pursuant to this section may require an individual to meet eligibility requirements to enroll in the coverage;
(2) Coverage offered pursuant to this section must comply with § 56-7-2356; and
(3) A health insurance entity may offer benefits or coverage under a hospital indemnity policy on the marketplace that exceed the minimum requirements of subsection (b).
(d) If this section conflicts with federal law, then the federal law controls to the extent of the conflict.
(e) The department shall promulgate rules to effectuate this section. The rules must be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
Cite this article: FindLaw.com - Tennessee Code Title 56. Insurance § 56-7-1023 - last updated January 02, 2024 | https://codes.findlaw.com/tn/title-56-insurance/tn-code-sect-56-7-1023/
FindLaw Codes may not reflect the most recent version of the law in your jurisdiction. Please verify the status of the code you are researching with the state legislature before relying on it for your legal needs.
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