Tennessee 2025-2026 Regular Session

Tennessee Senate Bill SB1270 Compare Versions

Only one version of the bill is available at this time.

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2	2	<BillNo> <Sponsor>
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4	4	SENATE BILL 1270
5	5	By Johnson
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7	7
8	8	SB1270
9	9	001434
10	10	- 1 -
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12	12	AN ACT to amend Tennessee Code Annotated, Title 56
13	13	and Section 68-1-115, relative to insurance.
14	14
15	15	BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF TENNESSEE:
16	16	SECTION 1. Tennessee Code Annotated, Title 56, Chapter 2, Part 1, is amended by
17	17	adding the following as a new section:
18	18	56-2-1__. Claims experience report.
19	19	(a) As used in this section, unless the context otherwise requires:
20	20	(1) "Group health plan" or "plan" means an employee welfare benefit
21	21	plan, as that term is defined in § 3(1) of the Employee Retirement Income and
22	22	Security Act of 1974 (ERISA), 29 U.S.C. § 1002(1), including insured and self-
23	23	insured plans, to the extent that the plan provides medical care, as that term is
24	24	defined in § 2791(a)(2) of the Public Health Service Act (PHS Act), 42 U.S.C.
25	25	300gg–91(a)(2), including items and services paid for as medical care, to
26	26	employees or their dependents directly or through insurance, reimbursement, or
27	27	otherwise, that:
28	28	(A) Has twenty-five (25) or more participants as defined in section
29	29	3(7) of ERISA, 29 U.S.C. § 1002(7); or
30	30	(B) Is administered by an entity other than the employer that
31	31	established and maintains the plan;
32	32	(2) "Health benefit plan issuer" means a company or insurance company,
33	33	as those terms are defined in § 56-1-102, or a health maintenance organization,
34	34	as that term is defined in § 56-32-102, that qualifies as a health insurance entity
35	35	as that term is defined in § 56-7-109;
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40	40	(3) "Plan administrator" means an administrator, as that term is defined in
41	41	29 U.S.C. § 1002(16)(A); and
42	42	(4) "Plan sponsor" has the same meaning as defined in 29 U.S.C. §
43	43	1002(16)(B).
44	44	(b) No later than thirty (30) days after a health benefit plan issuer receives a
45	45	written request for a claims experience report from a plan, plan sponsor, or plan
46	46	administrator, the health benefit plan issuer shall provide the report to the requesting
47	47	party.
48	48	(c) To the extent such information is available to the health benefit plan issuer
49	49	and is relevant to the request made under subsection (b), a report provided pursuant to
50	50	subsection (b) must include the following information for the thirty-six-month period
51	51	preceding the date of the request or for the entire period of coverage, whichever is
52	52	shorter:
53	53	(1) Aggregate paid claims experience by month, including claims
54	54	experience for medical, dental, and pharmacy benefits, as applicable;
55	55	(2) Total premiums paid by month;
56	56	(3) Total number of covered employees on a monthly basis by coverage
57	57	tier, including whether coverage was for:
58	58	(A) An employee only;
59	59	(B) An employee with dependents only;
60	60	(C) An employee with a spouse only; or
61	61	(D) An employee with spouse and dependents;
62	62	(4) An aggregate report of all claims exceeding ten thousand dollars
63	63	($10,000); and
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68	68	(5) Total dollar amount of claims pending as of the date of the request for
69	69	the report.
70	70	(d) In the case of a request made under subsection (b) after the date of
71	71	termination of coverage, the report provided under subsection (b) must contain the
72	72	information outlined in subsection (c) that is available to the health benefit plan issuer as
73	73	of the date of the request and is relevant to the request for the thirty-six-month period
74	74	preceding the date of termination of coverage or for the entire policy period, whichever
75	75	period is shorter.
76	76	(e) No later than thirty (30) days after the date of termination of coverage under
77	77	a group health plan, a health benefit plan issuer shall provide to a plan, plan sponsor, or
78	78	plan administrator who made a request under subsection (b) before the date of
79	79	termination of coverage a supplemental written report of the information described in
80	80	subsection (c) to update the claims experience report with information that was not
81	81	included in the original report.
82	82	(f) A plan, plan sponsor, or plan administrator may use information in a written
83	83	claims experience report provided under this section only as necessary to perform
84	84	treatment, payment, or health care operations as those activities are described by 45
85	85	C.F.R. § 164.501.
86	86	(g) Except where the release of information is otherwise prohibited by law, a
87	87	health benefit plan issuer that releases information in accordance with this section has
88	88	not violated a standard of care and is not liable for civil damages resulting from, and is
89	89	not subject to criminal prosecution for, releasing such information.
90	90	SECTION 2. Tennessee Code Annotated, Section 56-2-208(b)(6)(F)(vi)(c), is amended
91	91	by deleting the language "active" and substituting "inactive".
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96	96	SECTION 3. Tennessee Code Annotated, Section 56-2-208(b)(8)(C)(iii), is amended by
97	97	adding the language "; provided, that the commissioner shall not remove from the list a
98	98	reciprocal jurisdiction as defined under subdivisions (b)(8)(A)(ii)(a) or (b)" immediately preceding
99	99	the period of the first sentence.
100	100	SECTION 4. Tennessee Code Annotated, Section 56-2-208(b)(8)(D), is amended by
101	101	deleting the language "subdivision (b)(8)(B)(iv)" and substituting "subdivision (b)(8)(B)(i)(d)".
102	102	SECTION 5. Tennessee Code Annotated, Section 56-2-208(b)(10), is amended by
103	103	deleting the language "subdivision (b)(2), (b)(3), or (b)(4)" and substituting "subdivision (b)(2),
104	104	(b)(3), (b)(4), or (b)(8)".
105	105	SECTION 6. Tennessee Code Annotated, Section 56-2-208(b)(11)(B)(ii), is amended by
106	106	deleting "subdivision (b)(6)(F)" and substituting "subdivision (b)(6)(G)".
107	107	SECTION 7. Tennessee Code Annotated, Section 56-2-208(b)(11)(C), is amended by
108	108	deleting "subdivision (b)(6)(E)" and substituting "subdivision (b)(6)(F)".
109	109	SECTION 8. Tennessee Code Annotated, Section 56-2-209(a)(2), is amended by
110	110	adding the language ", as defined in subsection (d)" immediately preceding the period of the first
111	111	sentence.
112	112	SECTION 9. Tennessee Code Annotated, Section 56-2-209(a)(2)(C), is amended by
113	113	deleting the subdivision and substituting:
114	114	(C) Clean, irrevocable, unconditional letters of credit, issued or confirmed by a
115	115	qualified United States financial institution no later than December 31 of the year for
116	116	which filing is being made, and in the possession of, or in trust for, the ceding company
117	117	on or before the filing date of its annual statement; or
118	118	SECTION 10. Tennessee Code Annotated, Section 56-2-209(b), is amended by
119	119	deleting the subsection and substituting:
120	120
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124	124	(b) Letters of credit meeting applicable standards of issuer acceptability as of the
125	125	dates of their issuance, or confirmation, must, notwithstanding the issuing or confirming
126	126	qualified United States financial institution's subsequent failure to meet applicable
127	127	standards of issuer acceptability, continue to be acceptable as security until their
128	128	expiration, extension, renewal, modification, or amendment, whichever first occurs.
129	129	SECTION 11. Tennessee Code Annotated, Section 56-2-209(c), is amended by
130	130	deleting the language "subdivision (a)(3)" and substituting "subdivision (a)(2)(C) and subsection
131	131	(b)".
132	132	SECTION 12. Tennessee Code Annotated, Section 56-2-209(g)(4), is amended by
133	133	adding the following as a new subdivision (A) and redesignating the existing subdivisions
134	134	accordingly:
135	135	(A) Meets the conditions set forth in § 56-2-208(b)(8);
136	136	SECTION 13. Tennessee Code Annotated, Section 56-5-102(7), is amended by
137	137	deleting the subdivision and substituting:
138	138	(7) "Personal risk insurance" means property and casualty insurance that
139	139	provides:
140	140	(A) Insurance on one (1) to four (4) family dwelling units, including mobile
141	141	homes;
142	142	(B) Individual insurance on household goods in dwellings, mobile homes,
143	143	apartments, or other residential facilities;
144	144	(C) Insurance on private passenger nonfleet motor-driven vehicles, not
145	145	used for hire, that are used for personal or family needs, including pickups,
146	146	station wagons, vans, and vehicles with fewer than four (4) wheels;
147	147	(D) Insurance on pleasure watercraft that are used for personal or family
148	148	needs; and
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153	153	(E) Insurance sold in connection with and incidental to rental agreements
154	154	for a period not to exceed ninety (90) days;
155	155	SECTION 14. Tennessee Code Annotated, Title 56, Chapter 5, Part 1, is amended by
156	156	adding the following new section:
157	157	56-5-1__. Coverage of farm risks and property used in farming.
158	158	Coverage by a commercial risk insurance policy of farm risks or real or personal
159	159	property used in farming must not be considered in determining whether property is
160	160	classified as farm or agricultural property under another law or rule in this state.
161	161	SECTION 15. Tennessee Code Annotated, Section 56-7-1605(a), is amended by
162	162	deleting the subsection and substituting:
163	163	(a) In addition to any other requirements of law, policy forms, except as stated in
164	164	§ 56-7-1604, must not be delivered or issued for delivery in this state on or after the
165	165	dates the forms are subject to this part, unless:
166	166	(1) The text achieves a minimum score of forty (40) on the Flesch
167	167	reading ease test or an equivalent score on another comparable test as provided
168	168	in subsection (d);
169	169	(2) The style, arrangement, and overall appearance of the policy give no
170	170	undue prominence to any portion of the text of the policy or to any endorsements
171	171	or riders; and
172	172	(3) The policy form contains a table of contents or an index of the
173	173	principal sections of the policy, if the policy has more than three thousand (3,000)
174	174	words.
175	175	SECTION 16. Tennessee Code Annotated, Section 56-7-1605(b)(1), is amended by
176	176	deleting the language "printed".
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181	181	SECTION 17. Tennessee Code Annotated, Section 56-7-1605(c), is amended by
182	182	deleting the subsection and substituting:
183	183	(c) As used in this section, "text" includes all matter contained in a policy form
184	184	except the following:
185	185	(1) The name and address of the insurer; the name, number, or title of
186	186	the policy; the table of contents or index; captions and subcaptions; specification
187	187	pages, schedules, or tables; and
188	188	(2) Any policy language that is drafted to conform to the requirements of
189	189	any federal law, regulation, or agency interpretation; any policy language
190	190	required by any collectively bargained agreement; any medical terminology; any
191	191	words which are defined in the policy; and any policy language required by law
192	192	or regulation; provided, that the insurer identifies the language or terminology
193	193	excepted by this subsection (c) and certifies, in writing, that the language or
194	194	terminology is entitled to be excepted by this subsection (c).
195	195	SECTION 18. Tennessee Code Annotated, Title 56, Chapter 7, Part 23, is amended by
196	196	deleting Sections 56-7-2312 – 56-7-2322.
197	197	SECTION 19. Tennessee Code Annotated, Section 68-1-115, is amended by deleting
198	198	the language ", § 56-7-2312,".
199	199	SECTION 20. The headings in this act are for reference purposes only and do not
200	200	constitute a part of the law enacted by this act. However, the Tennessee Code Commission is
201	201	requested to include the headings in any compilation or publication containing this act.
202	202	SECTION 21. Section 1 and Sections 15 through 19 take effect upon becoming law, the
203	203	public welfare requiring it. Sections 2 through 12 take effect July 1, 2025, the public welfare
204	204	requiring it. Sections 13 and 14 take effect January 1, 2026, and apply to plans, policies, and
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209	209	agreements issued, delivered, amended, or renewed to take effect on or after January 1, 2026,
210	210	the public welfare requiring it.