Upon the occurrence of any of the following events the health organization shall have the right to a confidential departmental hearing, on the record, at which the health organization may challenge any determination or action by the commissioner. The health organization shall notify the commissioner of its request for a hearing within five (5) days after the notification by the commissioner under subdivision (1), (2), (3) or (4). Upon receipt of the health organization’s request for a hearing, the commissioner shall set a date for the hearing, which shall be no less than ten (10) nor more than thirty (30) days after the date of the health organization’s request. The events include:

(1) Notification to a health organization by the commissioner of an adjusted RBC report;

Terms Used In Tennessee Code 56-46-207

  • Commissioner: means the commissioner of commerce and insurance. See Tennessee Code 56-1-102
  • Corrective order: means an order issued by the commissioner specifying corrective actions which the commissioner has determined are required. See Tennessee Code 56-46-201
  • Health organization: means a health maintenance organization, limited health service organization, dental or vision plan, hospital, medical and dental indemnity or service corporation, or other managed care organization licensed pursuant to chapters 27, 28, 30, 31, 32 and 51 of this title. See Tennessee Code 56-46-201
  • RBC plan: means a comprehensive financial plan containing the elements specified in §. See Tennessee Code 56-46-201
  • RBC report: means the report required in §. See Tennessee Code 56-46-201
  • Record: means information that is inscribed on a tangible medium or that is stored in an electronic or other medium and is retrievable in a perceivable form. See Tennessee Code 1-3-105
(2) Notification to a health organization by the commissioner that:

(A) The health organization’s RBC plan or revised RBC plan is unsatisfactory; and
(B) Notification constitutes a Regulatory Action Level Event with respect to the health organization;
(3) Notification to a health organization by the commissioner that the health organization has failed to adhere to its RBC plan or revised RBC plan and that the failure has a substantial adverse effect on the ability of the health organization to eliminate the Company Action Level Event with respect to the health organization in accordance with its RBC plan or revised RBC plan; or
(4) Notification to a health organization by the commissioner of a corrective order with respect to the health organization.
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