(a) The rates charged by any prepaid limited health service organization to its subscribers shall not be excessive, inadequate, or unfairly discriminatory. The department may require whatever information it deems necessary to determine that a rate or proposed rate meets the requirements of this section.

Terms Used In Tennessee Code 56-51-113

  • Department: means the department of commerce and insurance. See Tennessee Code 56-51-102
  • Limited health service: means dental care services, vision care services, mental health services, substance abuse services, and pharmaceutical services. See Tennessee Code 56-51-102
  • Provider: means , but is not limited to, any physician, dentist, health facility, or other person or institution that is duly licensed in this state to deliver limited health services. See Tennessee Code 56-51-102
(b) In determining whether a rate is in compliance with subsection (a), the department must take into consideration the limited services provided, the method in which the services are provided, and the method of provider payment. This section may not be construed as authorizing the department to establish by rule minimum loss ratios for prepaid limited health service organizations’ rates.
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