Tennessee Code Annotated

Title 56: Insurance

Chapter 51: Tennessee Prepaid Limited Health Service Organization Act of 2000

TCA 56-51-117: Restrictions upon expulsion or refusal to issue or renew contract.

(a)  A prepaid limited health service organization may not expel or refuse to renew the coverage of or refuse to enroll any individual member of a subscriber group through a health maintenance organization or a state or federal agency on the basis of the race, color, creed, handicap, marital status, sex, or national origin of the subscriber or individual.

(b)  A prepaid limited health service organization may not expel or refuse to renew the coverage of any individual member of a subscriber group through a health maintenance organization or a state or federal agency on the basis of the age or health status of the subscriber or individual.

(c)  For group solicitations through a contract with a health maintenance organization, a prepaid limited health service organization may pre-underwrite to determine group acceptability. However, once a contract is issued, a prepaid limited health service organization must provide coverage to all existing enrollees and their dependents, and newly employed enrollees and their dependents who have enrolled within thirty (30) days of eligibility or membership.

(d)  Nothing in this section prohibits a prepaid limited health service organization from requiring in its contracts with health maintenance organizations that, as a condition of continued eligibility for membership, dependents of a subscriber upon reaching a specified age convert to a converted contract. Coverage must continue to be provided to handicapped children who are incapable of self- sustaining employment by reason of mental or physical handicap, and substantially dependent upon the enrollee for support and maintenance.

History: [Acts 2000, ch. 948, § 17.]