Title 56, Insurance

The articles of incorporation of the corporation and amendments to the articles shall be submitted to the commissioner, and shall be subject to the commissioner's approval, which shall be endorsed on the articles or the amendments before they are filed with the secretary of state…

A medical service plan corporation shall consist of a board of directors and of members, grouped in reasonable classes as the bylaws of the corporation as approved by the commissioner shall provide. The business of the corporation shall be managed by a board of directors of nine …

It is unlawful for any person except a medical service plan corporation, incorporated in accordance with this chapter, and operating in accordance with this chapter, and operating in accordance with authority from the commissioner or an insurance company properly qualified in thi…

A medical service plan corporation shall be authorized to provide either or both general and special medical and surgical care benefits, including service that may be necessarily incident to medical care. The extent and scope of a medical service plan shall be clearly shown in th…

(a) Every doctor of medicine licensed to practice in this state under title 63, chapter 6, and who is reputable and in good standing, has the right to become a participating physician in the medical service plan corporation operating in the county in which the doctor resides or p…

A medical service plan corporation may enter into agreements with physicians qualified as set out in § 56-27-108, under which the physicians become participating physicians of a plan operated by the corporation, and may make to the physicians payments that have accrued to them by…

A corporation subject to this chapter may issue contracts only when the commissioner has by formal license authorized it to do so.

(1) Application for the license shall be made on forms approved by the commissioner, containing information the commissioner deems necessary. Every application for the license shall be accompanied by copies of the following documents:(1) A certified copy of its charter or certifi…

(1) The commissioner shall issue a license upon compliance with this chapter, and other proper requirements of the commissioner, and upon being satisfied that:(1) All items required to be filed are in proper form, as required by this chapter, and meet the approval of the commissi…

The funds of the medical service corporations subject to this chapter shall be invested only in securities permitted by the laws of this state for the investment of assets of life insurance companies.

(a) All acquisition and administrative expenses incurred in connection with the medical service corporation shall at all times be limited after the second year of operation to not exceed twenty-five percent (25%) of the total net premium income of the corporation. The expenses, d…

A medical service plan corporation is authorized to purchase a contract of insurance protecting the corporation or any officer or employee of the corporation, or any physician from liability for injuries resulting from negligence, misfeasance, malfeasance, nonfeasance or health c…

The medical service corporation shall maintain adequate financial and statistical records in reasonable uniformity with accounting plans and statistical requirements of the annual statement blank required by the commissioner.

The service corporation shall annually, on or before March 1, file in the office of the department a statement of its operations for the calendar year, and showing financial condition as of December 31, then next preceding, in the form and content the commissioner shall prescribe…

The commissioner has the same authority to examine the service corporation as is granted to the commissioner for the examination of life, accident and health insurance companies, and has the same authority for the correction, rehabilitation or liquidation of the service corporati…

Every medical service corporation, or its agents, subject to this chapter, is subject to the fees and taxes as prescribed for life, health and accident insurance companies and agents of the companies doing business in this state. It is not the purpose of this chapter to discrimin…

All licenses authorizing medical service plan corporations to transact business in this state shall be renewable on April 1 of each year, subject to the approval of the commissioner. Every medical service corporation licensed to do business in this state under this chapter shall …

After the issuance of a certificate of authority, the commissioner shall have authority to issue orders or to publish regulations that may be necessary for the proper enforcement of this chapter, and as the commissioner deems are in the public interest. The published regulations …

(a) The commissioner has the authority to suspend or cancel the license of any medical service corporation or any agent of the corporation for violation of this chapter or of the insurance laws that may apply that are not in conflict with this chapter, after proper legal notice a…

(a) A medical service plan corporation that neglects to make and file its annual statement in the form and within the time provided by § 56-27-117, or neglects to reply in writing to the inquiries of the commissioner and within a reasonable time as may be specified by the commiss…

A review of any order made by the commissioner pursuant to this chapter may be had in the circuit court of Davidson County, upon a writ of certiorari. Application for the writ shall be made within thirty (30) days after the making of the order by the commissioner.

Every subscription contract made by a medical service plan corporation shall provide for the payment of medical services for a period of twelve (12) months from the date of issue of the subscription certificate. The contract may provide that it shall be subject to renewal from ye…

(1) Every contract entered into by a medical service plan corporation and a subscriber shall be in writing, and a certificate stating the terms and conditions of the contract shall be furnished the subscriber. No such subscription certificate shall be issued unless it contains th…

(1) In the subscription certificate referred to in § 56-27-126:(1) All printed portions shall be plainly printed in type of which the face is not smaller than ten (10) point;(2) There shall be a brief description of the subscription certificate on its first page and on its filing…

A medical service plan corporation may, in its discretion, receive and accept from governmental or private agencies or from other persons as defined in this chapter, payments covering all or part of the costs of subscriptions to provide medical care for needy and other individual…

Any dispute or controversy arising between a medical service plan corporation and any participating physician or any physician desiring to become a participating physician, or any subscriber, or any other person whose subscription certificate has been cancelled, or to whom the co…

Every medical service plan corporation shall mail annually to each subscriber a list of the names and addresses of all of the physicians and surgeons in the county of the subscriber's residence, who have agreements with the corporation to act as participating physicians.

This chapter is not to be construed as prohibiting any insurance company properly qualified in this state to write accident, health or disability insurance from making available any plan of medical service that may be approved by the commissioner under existing statutes or within…

Nothing in this chapter shall be construed so as to modify, vary or repeal any law now in force relating to the practice of medicine and surgery, or the regulation of ordinary life, accident, and health or casualty insurance, except only as the law is inconsistent with this chapt…

(a) Any law to the contrary notwithstanding, no contract of insurance that provides coverage for sterilization operations or procedures may be entered into or renewed on or after July 1, 1971, if the contract imposes any disclaimer, restriction on, or limitation of coverage with …

Any corporation organized not for profit under the general welfare corporation laws of the state for the purpose of establishing, maintaining and operating a nonprofit hospital service corporation, whereby hospital service may be provided by a hospital or group of hospitals with …

The articles of incorporation of the corporation and amendments to the articles shall be submitted to the department of commerce and insurance. The approval of the articles and amendments by the commissioner of commerce and insurance shall be endorsed on the articles and amendmen…

(a) The directors of the corporation shall at all times be composed of the following groups in equal numbers:(1) Administrators or trustees of hospitals that have contracted with the corporation to render hospital service to the subscribers;(2) Physicians, exclusive of group one …

A corporation, subject to this chapter, may issue contracts only when the department has, by formal license, authorized the corporation to do so.

(1) Application for the license shall be made on forms approved by the commissioner, containing the information the commissioner deems necessary. Each application for the license shall be accompanied by copies of the following documents:(1) Certificate of incorporation;(2) Bylaws…

(1) The commissioner shall issue a license upon compliance with this chapter and other proper requirements of the commissioner, and upon being satisfied that:(1) The applicant is established as a bona fide nonprofit hospital service corporation and the service rendered by the cor…

The amount provided as working capital shall only be provided by individuals or groups who have no financial interest in the activities of the hospital service corporations, or by the member hospitals. Interest charged for the capital, if any, shall not exceed six percent (6%), a…

All acquisition and administrative expenses in connection with the hospital service corporation shall at all times be limited after the first year of operation so as not to exceed twenty-five percent (25%) of the total net premium income of the corporation. All acquisition and ad…

The service corporation shall maintain at all times proper reserves subject to the approval of the commissioner for unearned subscription fees and unearned premiums and for unpaid hospital bills, including provision for unreported and undischarged hospital cases, and other known …

The funds of the service corporation, subject to this chapter, shall be invested only in securities permitted by the law of this state for the investment of assets of life insurance companies.

The service corporation shall annually, on or before March 1, file in the office of the department a statement of its operations for the calendar year and showing financial condition as of December 31 then next preceding, in such form and content as the commissioner shall prescri…

The service corporation shall maintain adequate financial and statistical records in reasonable uniformity with accounting plans and statistical requirements of the annual statement blank required by the commissioner.

The commissioner has the same authority to examine the service corporations as is granted the commissioner for the examination of life, accident and health insurance companies, and has the same authority for the correction, rehabilitation or liquidation of the service corporation…

The corporation may enter into contracts for the rendering of hospital service to the subscribers only with hospitals approved by the commissioner. All contracts issued by the corporation to the subscribers shall constitute individually and jointly direct obligations of the hospi…

The commissioner is authorized to publish regulations that will have the effect of statute, regulating the form of subscribers' contracts and required and prohibited provisions in the contracts.

All licenses authorizing hospital service corporations to transact business in this state shall be renewable on April 1 of each year. A service corporation licensed to do business in this state under this chapter shall obtain from the commissioner a certificate of authority for e…