Title 56, Insurance

Notwithstanding any other law to the contrary, subject to approval by the commissioner, a nonprofit dental service corporation only providing dental plans and policies in this state has the authority to provide plans and polices for vision services in this state in the same manne…

This chapter is known and may be cited as the “Vision Service Plan Law.”

(1) As used in this chapter, unless the context otherwise requires:(1) “Beneficiary” means a person designated in the subscription certificate referred to in subdivision (8) as entitled to the vision services referred to in subdivision (8);(2) “Commissioner” means the commissione…

(a) Five (5) or more optometrists duly licensed to practice under the laws of this state may associate themselves by written articles of association for the incorporation of a nonprofit vision service corporation. (b) A majority of the directors of each nonprofit vision service c…

The articles of incorporation of the corporation, or 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, before filing with the secretary of state.

A vision service plan corporation shall consist of a board of directors of such number, grouped in such reasonable classes, as the bylaws of the corporation, as approved by the commissioner, provide.

It is unlawful for any person except a vision service plan corporation, incorporated in accordance with this chapter, and operating in accordance with authority from the commissioner, or a nonprofit corporation organized under chapter 27, 28, 29, or 30 of this title, or an insura…

Every optometrist licensed to practice in this state under title 63, chapter 8, has the right to become a participating optometrist in the vision service plan corporation operating in the county in which the optometrist resides or practices. A vision service plan corporation shal…

A vision service plan corporation may enter into agreements with optometrists qualified as set out in this chapter, under the terms of which the optometrists may become participating optometrists in a plan operated by the corporation, and may make payments to the optometrists tha…

No corporation subject to this chapter may issue contracts until the commissioner has, by formal license, authorized it to do so.

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

(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 vision 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.

All acquisition and administrative expenses incurred in connection with the vision service corporation shall at all times be limited to a percentage of its total net premiums as set and approved by the commissioner.

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

Every vision service plan 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.

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

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

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

All licenses authorizing vision 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. The vision service plan corporations licensed to do business in this state under this chapter shal…

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

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

A vision service plan corporation that neglects to make and file its annual statement in the form and within the time provided by this chapter, or neglects to reply in writing to the inquiries of the commissioner within a reasonable time as specified by the commissioner, or who o…

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 entry of the order by the commissioner.

Each nonprofit vision service corporation may contract with its subscribers for vision services that may be from time to time provided under the nonprofit vision service plan adopted by the corporation. The rates charged by the nonprofit vision service corporation to its subscrib…

Every subscription contract made by a vision service plan corporation shall provide for the payment of vision services for a minimum 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 t…

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

(1) In every subscription certificate or descriptive brochure referred to in this chapter:(1) All printed portions shall be plainly printed in type of which the face is not smaller than ten-point type;(2) There shall be a brief description of the subscription certificate on its f…

A vision service plan corporation may, in its discretion, receive and accept from governmental or private agencies or from other persons payments covering all or part of the costs of subscriptions to provide vision care for needy and other individuals.

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

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

Nothing in this chapter shall be construed to modify or repeal any law, or parts of law, now in force relating to the practice of medicine or surgery, or to the practice of optometry, or to the regulation of life, accident, health or casualty insurance, except as it is inconsiste…

This chapter is known and may be cited as the “Health Maintenance Organization Act of 1986.”

(1) As used in this chapter, unless the context otherwise requires:(1) For the purposes of regulating an HMO that participates in the TennCare program under Title XIX of the Social Security Act (42 U.S.C. § 1396 et seq.), or any successor to the TennCare program, “affiliate” mean…

(a) Notwithstanding any law of this state to the contrary, any person may apply to the commissioner for and obtain a certificate of authority to establish and operate an HMO in compliance with this chapter. No person shall establish or operate an HMO in this state without obtaini…

(a) Issuance of a certificate of authority shall be granted upon payment of the application fee prescribed in § 56-32-119, if the commissioner is satisfied that the following conditions are met:(1) Persons responsible for the conduct of the affairs of the applicant are competent,…

(a) The powers of an HMO include, but are not limited to, the following:(1) The purchase, lease, construction, renovation, operation or maintenance of hospitals or medical facilities, or both, and their ancillary equipment, and property reasonably required for its principal offic…

(a) Any director, officer, employee or partner of an HMO who receives, collects, disburses or invests funds in connection with the activities of the organization shall be responsible for the funds in a fiduciary relationship to the organization. (b) An HMO shall maintain in force…

(a) (1) Every enrollee residing in this state is entitled to evidence of coverage.(2) No evidence of coverage, or amendment to the evidence of coverage, shall be issued or delivered to any person in this state until a copy of the form of the evidence of coverage, or amendment to …

Every HMO shall annually, on or before March 1, file with the commissioner a report on the blank prescribed by the National Association of Insurance Commissioners for HMOs. The commissioner may require additional reports deemed reasonably necessary and appropriate to enable the c…

Every HMO shall provide promptly to its enrollees notice of any material change in the operation of the organization that will affect them directly.

With the exception of investments made in accordance with § 56-32-105, the funds of an HMO shall be invested only in securities or other investments permitted by the laws of this state for the investment of assets constituting the legal reserves of life insurance companies or oth…

(a) To ensure the public's interest in the delivery of health care services by fiscally sound HMOs, each HMO must provide the commissioner evidence of compliance with the following minimum net worth requirements:(1) Before issuing any certificate of authority, the commissioner sh…

(a) No HMO or representative of the HMO may cause or knowingly permit the use of advertising that is untrue or misleading, solicitation that is untrue or misleading, or any form of evidence of coverage that is deceptive. For the purpose of this chapter:(1) A statement or item of …

(a) The commissioner may, after notice and hearing, promulgate reasonable rules and regulations necessary to provide for the licensing of agents. “Agent” means a person who is appointed or employed by an HMO and who engages in solicitation or membership in the organization. “Agen…

(a) The commissioner of commerce and insurance, in cooperation with the commissioner of health, shall coordinate the regulation of any HMO holding a certificate of authority to ensure the financial viability of the HMO and that the HMO is currently providing and shall in the futu…