(a) A health benefit plan is subject to this part if it provides health benefits for small employers and if either of the following conditions is met:

Terms Used In Tennessee Code 56-7-2206

  • Code: includes the Tennessee Code and all amendments and revisions to the code and all additions and supplements to the code. See Tennessee Code 1-3-105
  • Health benefit plan: means :
    (i) Any accident and health insurance policy or certificate. See Tennessee Code 56-7-2203
  • Premium: includes insurance premiums or other fees charged for a health benefit plan, including the costs of benefits paid or reimbursements made to or on behalf of persons covered by the plan. See Tennessee Code 56-7-2203
  • small employer: includes any person that, during the preceding year, employed no less than two (2) and no more than fifty (50) eligible employees and otherwise qualifies as a small employer pursuant to this subdivision (18). See Tennessee Code 56-7-2203
(1) Any part of the premiums or benefits is paid by a small employer, or any covered individual is reimbursed, whether through wage adjustments or otherwise, by a small employer for any portion of the premium, or for which the small employer has permitted payroll deduction for the covered individual, whether or not the coverage is issued through a group or individual policy of insurance, and whether or not the small employer pays any part of the premium; or
(2) The health benefit plan is treated by the employer or any of the covered individuals as part of a plan or program for the purpose of § 106 or § 162 of the Internal Revenue Code ( 26 U.S.C. §§ 106 and 162 ).
(b) Chapter 5, part 3 of this title does not apply to individual accident and health insurance policies or contracts to the extent they are subject to this part.
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