Terms Used In Tennessee Code > Title 33 > Chapter 2 - Services and Facilities

• Abuse: means the occurrence of one (1) or more of the following acts:
  (A) Attempting to cause or intentionally, knowingly or recklessly causing another person, including a minor child, bodily injury, physical harm, severe emotional distress, psychological trauma, rape, sexual assault or involuntary sexual intercourse. See Tennessee Code 56-8-202
• Abuse: means the knowing infliction of injury, unreasonable confinement, intimidation, or punishment with resulting physical harm, pain, or mental anguish. See Tennessee Code 33-2-402
• Abuse status: means the fact or perception that a person is, has been, or may be a subject of abuse, regardless of whether the person has sustained abuse-related medical conditions or has incurred abuse-related claims. See Tennessee Code 56-8-202
• Abuse-related medical condition: means a medical condition sustained by a subject of abuse that arises in whole or part out of an act or pattern of abuse. See Tennessee Code 56-8-202
• Access Tennessee: means the nonprofit entity created pursuant to §. See Tennessee Code 56-7-2902
• Account: means any one (1) of the accounts created by §. See Tennessee Code 56-12-104
• Account: means any of the accounts created under §. See Tennessee Code 56-12-203
• Account owner: means the owner of a retained asset account who is a resident of this state. See Tennessee Code 56-7-3403
• Actual reimbursement: means the total amount that a covered entity or pharmacy benefits manager determines that a pharmacy or other dispenser will receive consistent with the provider agreement, and is the sum of the amount the covered entity or pharmacy benefits manager will pay directly to the pharmacy or other dispenser plus any applicable patient out-of-pocket cost paid directly by the patient to the pharmacy or other dispenser, for dispensing of a particular prescription or providing a covered service. See Tennessee Code 56-7-3201
• Actuarial certification: means a written statement by a member of the American Academy of Actuaries or other individual acceptable to the commissioner that a small employer carrier is in compliance with §. See Tennessee Code 56-7-2203
• Actuary: means a person who is a member in good standing of the American Academy of Actuaries. See Tennessee Code 56-6-502
• Actuary: means a person who is a member in good standing of the American Academy of Actuaries. See Tennessee Code 56-6-802
• Additional business day: means the first weekday not designated as a state or federal holiday. See Tennessee Code 56-7-3702
• ADTF: means an institution, treatment resource, group residence (boarding home, sheltered workshop, activity center), rehabilitation center, hospital, community mental health center, nonresidential office-based opiate treatment facility, nonresidential substitution-based treatment center for opiate addiction, DUI school, counseling center, clinic, halfway house, recovery residence, or other entity, by these or other names, providing alcohol and drug services. See Tennessee Code 33-2-1401
• Affidavit: A written statement of facts confirmed by the oath of the party making it, before a notary or officer having authority to administer oaths.
• Affiliate: means a person who directly, or indirectly, through one (1) or more intermediaries, controls, is controlled by, or is under common control with an insolvent insurer on December 31 of the year next preceding the date the insurer becomes an insolvent insurer. See Tennessee Code 56-12-104
• Affiliated company: means any company in the same corporate system as a parent, an industrial insured, or a member organization by virtue of common ownership, control, operation, or management. See Tennessee Code 56-13-102
• Affiliated group: means a group of entities in which each entity, with respect to an insured, controls the insured, is controlled by the insured, or is under common control with the insured. See Tennessee Code 56-14-102
• Affirmed: In the practice of the appellate courts, the decree or order is declared valid and will stand as rendered in the lower court.
• Agency captive insurance company: means a company or protected cell formed under this chapter that is owned by an insurance agency or brokerage and that only reinsures risks of policies that are placed by or through the agency or brokerage. See Tennessee Code 56-13-102
• Alcohol and drug services: includes evaluation, treatment, residential personal care, habilitation, rehabilitation, counseling, or supervision of persons with substance use disorder, or services to persons designed to prevent substance use disorder that either receive funds from the department of health or assess fees for services provided. See Tennessee Code 33-2-402
• Alcohol and drug services: includes evaluation, treatment, residential personal care, habilitation, rehabilitation, counseling, or supervision of persons with substance use disorder, or services to persons designed to prevent substance use disorder that either receive funds from the department of health or assess fees for services provided. See Tennessee Code 33-2-1401
• Alien: means a company formed according to the legal requirements of a foreign country. See Tennessee Code 56-13-102
• Alien captive insurance company: means any insurance company formed to write insurance business for its parents and affiliates and licensed pursuant to the laws of an alien jurisdiction which imposes statutory or regulatory standards in a form acceptable to the commissioner on companies transacting the business of insurance in such jurisdiction. See Tennessee Code 56-13-302
• Allowed amount: means the contractually agreed upon payment amount between a carrier and a healthcare entity participating in the carrier's network, excluding any member deductible, co-pay, or other obligation. See Tennessee Code 56-7-602
• Ambulance: means any privately or publicly owned land or air vehicle that is especially designed, constructed or modified and equipped and is intended to be used for and is maintained or operated for transportation upon the streets, highways or airways in this state for persons who are sick, injured, wounded, otherwise incapacitated, helpless, or in need of medical care. See Tennessee Code 68-140-302
• Ambulance service: means the principal use of any privately or publicly owned ambulance for the transportation of injured or infirm persons. See Tennessee Code 68-140-302
• Amendment: A proposal to alter the text of a pending bill or other measure by striking out some of it, by inserting new language, or both. Before an amendment becomes part of the measure, thelegislature must agree to it.
• Annuity: A periodic (usually annual) payment of a fixed sum of money for either the life of the recipient or for a fixed number of years. A series of payments under a contract from an insurance company, a trust company, or an individual. Annuity payments are made at regular intervals over a period of more than one full year.
• Annuity: means any active annuity contract issued in this state other than an annuity used to fund an employment-based retirement plan or program where the insurer is not committed by terms of the annuity contract to pay death benefits to the beneficiaries of specific plan participants or that is used to fund a pre-need funeral contract as defined in §. See Tennessee Code 56-7-3403
• Answer: The formal written statement by a defendant responding to a civil complaint and setting forth the grounds for defense.
• Appeal: A request made after a trial, asking another court (usually the court of appeals) to decide whether the trial was conducted properly. To make such a request is "to appeal" or "to take an appeal." One who appeals is called the appellant.
• Applicant: means :
  (A) In the case of an individual medicare supplement policy, the person who seeks to contract for insurance benefits. See Tennessee Code 56-7-1501
• Appraisal: A determination of property value.
• Appropriation: The provision of funds, through an annual appropriations act or a permanent law, for federal agencies to make payments out of the Treasury for specified purposes. The formal federal spending process consists of two sequential steps: authorization
• Arraignment: A proceeding in which an individual who is accused of committing a crime is brought into court, told of the charges, and asked to plead guilty or not guilty.
• Association: means the Tennessee insurance guaranty association created under §. See Tennessee Code 56-12-104
• Association: means any legal association of individuals, corporations, limited liability companies, partnerships, associations, or other entities, whereby:
  (A) The member organizations of such or the association itself, whether or not in conjunction with some or all of the member organizations:

  (i) Own, control, or hold with power to vote all of the outstanding voting securities of an association captive insurance company incorporated as a stock insurer. See Tennessee Code 56-13-102
• Association: means the Tennessee life and health insurance guaranty association created under §. See Tennessee Code 56-12-203
• Association captive insurance company: means any company that insures risks of the member organizations of an association, and that also may insure the risks of affiliated companies of the member organizations and the risks of the association itself. See Tennessee Code 56-13-102
• Asymmetric conduct: means an insurer's use of the DMF prior to July 1, 2015, in connection with searching for information regarding whether annuitants under the insurer's annuities might be deceased, but not in connection with whether the insureds under its policies might be deceased. See Tennessee Code 56-7-3403
• Attachment: A procedure by which a person's property is seized to pay judgments levied by the court.
• Attorney: means the person designated and authorized by subscribers as the attorney-in-fact having authority to obligate them on reciprocal insurance contracts. See Tennessee Code 56-16-102
• Attorney: means the person designated and authorized by subscribers as the attorney-in-fact having authority to obligate them on reciprocal insurance contracts. See Tennessee Code 56-16-102
• Attorney general: means the attorney general and reporter and any assistant thereto by whatever name known, any district attorney general and any assistant thereto by whatever name called, and any officer or full-time employee of the general assembly or any committee thereof established by statute, who is duly licensed to practice law in Tennessee, whose duty it is to provide facilities for drafting bills or to assist individual legislators in drafting bills or who renders legal advice and services to the members of the general assembly or committees thereof. See Tennessee Code 8-34-101
• Attorney-in-fact: A person who, acting as an agent, is given written authorization by another person to transact business for him (her) out of court.
• Authorization: means any and all forms of official permission required by this part, including licenses, permits and certificates. See Tennessee Code 68-140-302
• Bail: Security given for the release of a criminal defendant or witness from legal custody (usually in the form of money) to secure his/her appearance on the day and time appointed.
• Bankruptcy: Refers to statutes and judicial proceedings involving persons or businesses that cannot pay their debts and seek the assistance of the court in getting a fresh start. Under the protection of the bankruptcy court, debtors may discharge their debts, perhaps by paying a portion of each debt. Bankruptcy judges preside over these proceedings.
• Base premium rate: means , for each class of business as to a rating period, the lowest premium rate charged or that could have been charged under a rating system for that class of business, by the small employer carrier to small employers with similar case characteristics for health benefit plans with the same or similar coverage. See Tennessee Code 56-7-2203
• Baseline: Projection of the receipts, outlays, and other budget amounts that would ensue in the future without any change in existing policy. Baseline projections are used to gauge the extent to which proposed legislation, if enacted into law, would alter current spending and revenue levels.
• Beneficiary: A person who is entitled to receive the benefits or proceeds of a will, trust, insurance policy, retirement plan, annuity, or other contract. ^{Source: OCC}
• Beneficiary: has the meaning given such term under §. See Tennessee Code 56-7-2802
• Beneficiary: means an individual or other entity entitled to benefits under a policy or annuity. See Tennessee Code 56-7-3403
• Board: means the Tennessee emergency medical services board. See Tennessee Code 68-140-302
• board: means the board provided for in part 3 of this chapter. See Tennessee Code 8-34-101
• Board: means the board of directors of the pool. See Tennessee Code 56-7-2203
• Board: means the Access Tennessee board of directors established pursuant to §. See Tennessee Code 56-7-2902
• Bona fide association: means an association that satisfies the requirements of §. See Tennessee Code 56-7-2802
• Branch business: means any insurance business transacted by a branch captive insurance company in this state. See Tennessee Code 56-13-302
• Branch captive insurance company: means any alien captive insurance company licensed by the commissioner to transact the business of insurance in this state through a business unit with a principal place of business in this state. See Tennessee Code 56-13-302
• Branch operations: means any business operations of a branch captive insurance company in this state. See Tennessee Code 56-13-302
• Captive insurance company: means any pure captive insurance company, association captive insurance company, agency captive insurance company, industrial insured captive insurance company, risk retention group, protected cell captive insurance company, incorporated cell captive insurance company, or special purpose financial captive insurance company formed or licensed under this chapter. See Tennessee Code 56-13-102
• carrier: means a health insurance entity as defined in §. See Tennessee Code 56-7-602
• Carrier: means any person that provides one (1) or more health benefit plans in this state, including a licensed insurance company, a prepaid hospital or medical service plan, a health maintenance organization (HMO) and a multiple employer welfare arrangement (MEWA). See Tennessee Code 56-7-2203
• Case characteristics: means demographic or other objective characteristics of a small employer, as determined by a small employer carrier, that are considered by the small employer carrier in the determination of premium rates for the small employer, but does not mean claim experience, health status and duration of coverage since issue. See Tennessee Code 56-7-2203
• Catastrophic disaster: means an event that results in large numbers of deaths and injuries, causes extensive damage or destruction of facilities that provide and sustain human needs, produces an overwhelming demand on state and local response resources and mechanisms, causes a severe long-term effect on general economic activity, and severely affects state, local and private sector capabilities to begin and sustain response activities. See Tennessee Code 56-6-902
• Certificate: means official acknowledgment that an individual has successfully complied with all requirements to practice and has completed a training program accredited or recognized by the board. See Tennessee Code 68-140-302
• Certificate: means , any certificate delivered or issued for delivery in this state under a group medicare supplement policy. See Tennessee Code 56-7-1501
• Chambers: A judge's office.
• Chief officer: means the person with overall authority for a public or private hospital or treatment resource, or the person's designee. See Tennessee Code 33-1-101
• Child: means a biological, adopted, or foster son or daughter. See Tennessee Code 56-7-3603
• Child: means a person who is under eighteen (18) years of age. See Tennessee Code 33-1-101
• Chronic condition: means a condition that has an expected duration of one (1) year or more and requires ongoing medical attention or limits activities of daily living, or both. See Tennessee Code 56-7-3702
• Church plan: has the meaning given the term under §. See Tennessee Code 56-7-2802
• Church plan: has the meaning given the term under ERISA, in 29 U. See Tennessee Code 56-7-2902
• Civil forfeiture: The loss of ownership of property used to conduct illegal activity.
• Claimant: means any insured making a first-party claim or any person instituting a liability claim. See Tennessee Code 56-12-104
• Class of business: means all or a distinct grouping of small employers as shown on the records of a small employer carrier. See Tennessee Code 56-7-2203
• Clinical criteria: means the written policies, screening procedures, decision rules, decision abstracts, clinical protocols, practice guidelines, and medical protocols used by the utilization review agent to determine the necessity and appropriateness of health care services. See Tennessee Code 56-6-703
• COBRA continuation coverage: refers to continuation of coverage offered pursuant to the Consolidated Omnibus Budget Reconciliation Act of 1985 (42 U. See Tennessee Code 56-7-2902
• COBRA continuation provision: means any of the following:
  (A) Section 4980B of the Internal Revenue Code of 1986 (26 U. See Tennessee Code 56-7-2802
• 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
• Commercial risk insurance: means insurance within the scope of this part that is not "personal risk insurance" as defined in §. See Tennessee Code 56-7-1802
• Commissioner: means the commissioner of health, the commissioner's duly authorized representative, or in the event of the commissioner's absence or a vacancy in the office of commissioner, the deputy commissioner. See Tennessee Code 68-140-302
• Commissioner: means the commissioner of commerce and insurance. See Tennessee Code 56-9-501
• Commissioner: means the commissioner of commerce and insurance. See Tennessee Code 56-10-201
• Commissioner: means the commissioner of commerce and insurance. See Tennessee Code 56-9-103
• Commissioner: means the commissioner of commerce and insurance. See Tennessee Code 56-11-101
• Commissioner: means the commissioner of commerce and insurance. See Tennessee Code 56-12-104
• Commissioner: means the commissioner of the department, or the commissioner's designee. See Tennessee Code 56-13-102
• Commissioner: means the commissioner of commerce and insurance. See Tennessee Code 56-12-203
• Commissioner: means the commissioner of commerce and insurance. See Tennessee Code 56-6-703
• Commissioner: means the commissioner of mental health and substance abuse services. See Tennessee Code 33-1-101
• Commissioner: means the commissioner of commerce and insurance. See Tennessee Code 56-14-102
• Commissioner: means the commissioner of commerce and insurance. See Tennessee Code 56-6-902
• Commissioner: means the commissioner of commerce and insurance. See Tennessee Code 56-16-102
• Commissioner: means the commissioner of commerce and insurance. See Tennessee Code 56-6-1001
• Commissioner: means the commissioner of commerce and insurance. See Tennessee Code 56-6-1402
• Commissioner: means the commissioner of commerce and insurance. See Tennessee Code 56-7-602
• Commissioner: means the commissioner of finance and administration. See Tennessee Code 56-7-2902
• Commissioner: means the commissioner of commerce and insurance. See Tennessee Code 56-1-102
• Commissioner: means the commissioner of mental health and substance abuse services, the commissioner's authorized representative, or in the event of the commissioner's absence or a vacancy in the office of commissioner, the deputy commissioner of mental health and substance abuse services. See Tennessee Code 33-2-402
• commodity contract: means :
  (i) A contract for the purchase or sale of a commodity for future delivery on, or subject to the rules of, a board of trade or contract market under the Commodity Exchange Act ( 7 U. See Tennessee Code 56-9-103
• Common law: The legal system that originated in England and is now in use in the United States. It is based on judicial decisions rather than legislative action.
• Community mental health center: includes for profit corporations and private entities qualified as tax exempt organizations under Internal Revenue Code, §. See Tennessee Code 33-1-101
• Community mental health center: includes any parent or corporate affiliate of a community mental health center as defined in §. See Tennessee Code 33-2-703
• Comparable healthcare service: includes , but is not limited to:
  (A) Physical and occupational therapy services. See Tennessee Code 56-7-602
• Complaint: A written statement by the plaintiff stating the wrongs allegedly committed by the defendant.
• Consent: means agreement to administrative supervision by the insurer. See Tennessee Code 56-9-501
• Consent: means voluntary agreement to what is reasonably well understood regardless of how the agreement is expressed. See Tennessee Code 33-1-101
• Continuance: Putting off of a hearing ot trial until a later time.
• Contract: A legal written agreement that becomes binding when signed.
• Contractual obligation: means an obligation under a policy or contract or certificate under a group policy or contract, or a portion thereof, for which coverage is provided under §. See Tennessee Code 56-12-203
• Control: means actual working control, in whatever manner exercised. See Tennessee Code 56-10-201
• Control: means the possession, direct or indirect, of the power to direct or cause the direction of the management and policies of a person, whether through the ownership of voting securities, by contract other than a commercial contract for goods or nonmanagement services, or otherwise, unless the power is the result of an official position with or corporate office held by the person. See Tennessee Code 56-12-104
• Control: means :
  (A) To own, control, or have the power of an entity directly, indirectly, or acting through one or more other persons to vote twenty-five percent (25%) or more of any class of voting securities of another entity. See Tennessee Code 56-14-102
• controlled: means the possession, direct or indirect, of the power to direct or cause the direction of the management and policies of a person, whether through the ownership of voting securities, by contract other than a contract for goods or nonmanagement services, or otherwise. See Tennessee Code 56-6-602
• Controlled unaffiliated business: means any person:
  (A) That is not in the corporate system of a parent and its affiliated companies in the case of a pure captive insurance company, or that is not in the corporate system of an industrial insured and its affiliated companies in the case of an industrial insured captive insurance company. See Tennessee Code 56-13-102
• Controlling person: means any person, firm, association or corporation who directly or indirectly has the power to direct, or cause to be directed, the management, control or activities of the reinsurance intermediary. See Tennessee Code 56-6-802
• Conviction: A judgement of guilt against a criminal defendant.
• cooperative: means a private purchasing cooperative composed of small employers formed under this part. See Tennessee Code 56-7-2203
• Cooperative agreement: means an agreement among two (2) or more community mental health centers for the offering, provision, operation, coordination, planning, funding, pricing, contracting, utilization review, or management of mental health and related services under programs funded or administered by departments or agencies of state government, including, but not limited to, the TennCare program, or the sharing, allocation, or referral of service recipients, personnel, instructional programs, support services, ancillary services, and facilities, or other services traditionally offered by community mental health centers for the programs. See Tennessee Code 33-2-703
• Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
• Cost sharing requirement: means a copayment, coinsurance, deductible, or annual limitation on cost sharing, including, but not limited to, a limitation subject to 42 U. See Tennessee Code 56-7-3201
• Counterclaim: A claim that a defendant makes against a plaintiff.
• Covered claim: means an unpaid claim, including one for unearned premiums, submitted by a claimant, which arises out of and is within the coverage and is subject to the applicable limits of an insurance policy to which this part applies and was issued by an insurer that is insolvent, if the insurer becomes an insolvent insurer after March 31, 1999, and:
  (i) The claimant or insured is a resident of this state when the insured event occurs. See Tennessee Code 56-12-104
• Covered entity: means a covered entity as defined in §. See Tennessee Code 56-7-3201
• Covered person: means a person on whose behalf a health insurance entity offering health insurance coverage is obligated to pay benefits or provide services. See Tennessee Code 56-7-110
• covered policy: means a contract or policy, or a portion of a contract or policy, for which coverage is provided under §. See Tennessee Code 56-12-203
• Creditable coverage: means , with respect to an individual, coverage of the individual under any of the following:
  (i) A group health plan. See Tennessee Code 56-7-2802
• Creditable coverage: means , with respect to an individual, coverage of the individual that provides the minimum essential coverage required under 26 U. See Tennessee Code 56-7-2902
• Creditor: is a person having any claim, whether matured or unmatured, liquidated or unliquidated, secured or unsecured, absolute, fixed or contingent. See Tennessee Code 56-9-103
• Crop: means and includes any agricultural product, including livestock, nursery product, tree and product from a tree, as well as anything insured by the Federal Crop Insurance Corporation under a crop insurance program. See Tennessee Code 56-6-1001
• Damages: Money paid by defendants to successful plaintiffs in civil cases to compensate the plaintiffs for their injuries.
• Decedent: A deceased person.
• Deed: The legal instrument used to transfer title in real property from one person to another.
• Defendant: In a civil suit, the person complained against; in a criminal case, the person accused of the crime.
• Delinquency proceeding: means any proceeding instituted against an insurer for the purpose of liquidating, rehabilitating, reorganizing or conserving the insurer, and any summary proceeding under §. See Tennessee Code 56-9-103
• Department: means the department of health. See Tennessee Code 68-140-302
• Department: means the department of commerce and insurance. See Tennessee Code 56-9-501
• Department: means the department of commerce and insurance. See Tennessee Code 56-13-102
• Department: means the department of commerce and insurance. See Tennessee Code 56-14-102
• Department: means the department of mental health and substance abuse services. See Tennessee Code 33-1-101
• Department: means the department of commerce and insurance. See Tennessee Code 56-16-102
• Department: means the department of commerce and insurance. See Tennessee Code 56-6-1001
• Department: means the department of commerce and insurance. See Tennessee Code 56-7-602
• Department: means the department of finance and administration. See Tennessee Code 56-7-2902
• Department: means the department of commerce and insurance. See Tennessee Code 56-1-102
• Department: means the department of mental health and substance abuse services. See Tennessee Code 33-2-402
• Dependent: A person dependent for support upon another.
• Dependent: means the spouse or child of an eligible employee, subject to applicable terms of the health care plan covering the employee. See Tennessee Code 56-7-2203
• Director: means the director of the division of emergency medical services of the department. See Tennessee Code 68-140-302
• Discovery: Lawyers' examination, before trial, of facts and documents in possession of the opponents to help the lawyers prepare for trial.
• Dismissal: The dropping of a case by the judge without further consideration or hearing. ^Source:
• DMF: means the death master file from the United States social security administration or any other database or service that an insurer may determine is substantially as inclusive as the death master file for determining that a person has reportedly died. See Tennessee Code 56-7-3403
• DMF match: means a search of a DMF that results in a match of a person's social security number or name and date of birth. See Tennessee Code 56-7-3403
• Doing business: includes any of the following acts, whether effected by mail or otherwise:
  (A) The issuance or delivery of contracts of insurance to persons resident in this state. See Tennessee Code 56-9-103
• Domestic insurance company: means :
  (A) An insurance company incorporated under the laws of this state. See Tennessee Code 56-10-201
• Domiciliary state: means the state in which an insurer is incorporated or organized, or, in the case of an alien insurer, its state of entry. See Tennessee Code 56-9-103
• Donor: The person who makes a gift.
• DRP: means a person designated by a travel insurance supervising entity pursuant to §. See Tennessee Code 56-6-1402
• Drug abuse: means a condition characterized by the continuous or episodic use of a drug or drugs resulting in social impairment, vocational impairment, psychological dependence or pathological patterns of use. See Tennessee Code 33-1-101
• Electronic funds transfer: The transfer of money between accounts by consumer electronic systems-such as automated teller machines (ATMs) and electronic payment of bills-rather than by check or cash. (Wire transfers, checks, drafts, and paper instruments do not fall into this category.) ^{Source: OCC}
• Eligible employee: means an employee who works for a small employer on a full-time basis, with a normal work week of thirty (30) or more hours, including a sole proprietor, a partner or a partnership, or an independent contractor, if included as an employee under a health care plan of a small employer. See Tennessee Code 56-7-2203
• Embezzlement: In most states, embezzlement is defined as theft/larceny of assets (money or property) by a person in a position of trust or responsibility over those assets. Embezzlement typically occurs in the employment and corporate settings. ^{Source: OCC}
• Emergency healthcare services: means emergency services as defined in §. See Tennessee Code 56-7-3702
• Emergency medical service: means the service used in responding to the perceived individual need for immediate medical care in order to prevent loss of life or aggravation of physiological or psychological illness or injury. See Tennessee Code 56-7-602
• Emergency medical services personnel: means individuals certified or licensed by the emergency medical services board in accordance with various categories and classifications of licenses or certificates that the board establishes. See Tennessee Code 68-140-302
• Employee: means an individual for whom an employer must complete a Form I-9 pursuant to federal law and regulations, and does not include an independent contractor. See Tennessee Code 56-7-3603
• Employee: has the meaning given the term under §. See Tennessee Code 56-7-2802
• Employer: means :
  (A) The state or any department, commission, institution, board or agency of the state government by which a member is paid, with respect to members in its employ. See Tennessee Code 8-34-101
• Employer: has the meaning given the term under §. See Tennessee Code 56-7-2802
• Enrollee: means an individual who has contracted for or who participates in coverage under an insurance policy, a health maintenance organization contract, a health service corporation contract, an employee welfare benefit plan, a hospital or medical services plan, or any other benefit program providing payment, reimbursement, or indemnification for health care costs for the individual or the individual's eligible dependents. See Tennessee Code 56-6-703
• Enrollment date: means , with respect to an individual covered under a group health plan or health insurance coverage, the date of enrollment of the individual in the plan or coverage or, if earlier, the first day of the waiting period for the enrollment. See Tennessee Code 56-7-2802
• Enterprise Risk: means any activity, circumstance, event or series of events involving one (1) or more affiliates of an insurer that, if not remedied promptly, is likely to have a material adverse effect upon the financial condition or liquidity of the insurer or its insurance holding company system as a whole, including, but not limited to, anything that would cause the insurer's Risk-Based Capital to fall into company action level as set forth in §. See Tennessee Code 56-11-101
• Equitable: Pertaining to civil suits in "equity" rather than in "law." In English legal history, the courts of "law" could order the payment of damages and could afford no other remedy. See damages. A separate court of "equity" could order someone to do something or to cease to do something. See, e.g., injunction. In American jurisprudence, the federal courts have both legal and equitable power, but the distinction is still an important one. For example, a trial by jury is normally available in "law" cases but not in "equity" cases. ^{Source: U.S. Courts}
• ERISA: means the Employee Retirement Income Security Act of 1974 (29 U. See Tennessee Code 56-7-2902
• Escheat: Reversion of real or personal property to the state when 1) a person dies without leaving a will and has no heirs, or 2) when the property (such as a bank account) has been inactive for a certain period of time. ^{Source: OCC}
• Escrow: Money given to a third party to be held for payment until certain conditions are met.
• Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
• Ex officio: Literally, by virtue of one's office.
• Exceeded its powers: means the following conditions:
  (A) The insurer has refused to permit examination of its books, papers, accounts, records or affairs by the commissioner, the commissioner's deputies, employees or duly commissioned examiners. See Tennessee Code 56-9-501
• Excepted benefits: means benefits under one (1) or more, or any combination, of the following:
  (A) Benefits not subject to requirements:

  (i) Coverage only for accident or disability income insurance, or any combination of accident and disability income insurance. See Tennessee Code 56-7-2802
• Exempt commercial purchaser: means any person purchasing commercial insurance that, at the time of placement, meets the following requirements:
  (i) The person employs or retains a qualified risk manager to negotiate insurance coverage. See Tennessee Code 56-14-102
• Extra-contractual claims: includes , for example, claims relating to bad faith in the payment of claims, punitive or exemplary damages, or attorneys' fees and costs. See Tennessee Code 56-12-203
• Facility: means an institution licensed under title 33 or 68. See Tennessee Code 56-7-3702
• Facility: means a treatment resource, rehabilitation center, hospital, community mental health center, counseling center, clinic, group home, halfway house or any other entity that provides a mental health, service or an alcohol and drug abuse prevention and/or treatment facility. See Tennessee Code 33-2-402
• Fair market value: The price at which an asset would change hands in a transaction between a willing, informed buyer and a willing, informed seller.
• Family leave insurance: means an insurance policy issued to an employer related to a benefit program provided to an employee to pay for a percentage or portion of the employee's income loss due to:
  (A) The birth or adoption of a child by the employee. See Tennessee Code 56-7-3603
• Family member: means :
  (A) A child, spouse, or parent. See Tennessee Code 56-7-3603
• Federal governmental plan: means a governmental plan established or maintained for its employees by the federal government or by any agency or instrumentality of the federal government. See Tennessee Code 56-7-2802
• Federal home loan bank: means an institution chartered under the Federal Home Loan Bank Act ( 12 U. See Tennessee Code 56-9-103
• Federal Reserve System: The central bank of the United States. The Fed, as it is commonly called, regulates the U.S. monetary and financial system. The Federal Reserve System is composed of a central governmental agency in Washington, D.C. (the Board of Governors) and twelve regional Federal Reserve Banks in major cities throughout the United States. ^{Source: OCC}
• Federally defined eligible individual: means an individual:
  (A) For whom, as of the date on which the individual seeks coverage under this part, the aggregate of the periods of creditable coverage is eighteen (18) or more months. See Tennessee Code 56-7-2902
• Fiduciary: A trustee, executor, or administrator.
• Fingerprints: means an impression of the lines on the finger taken for purpose of identification. See Tennessee Code 56-6-902
• Foreclosure: A legal process in which property that is collateral or security for a loan may be sold to help repay the loan when the loan is in default. ^{Source: OCC}
• Foreign: when used without limitation, includes all companies formed by authority of any other state or government. See Tennessee Code 56-1-102
• Foreign country: means any other jurisdiction not in any state. See Tennessee Code 56-9-103
• Foreign guaranty association: means any entities similar to a guaranty association now in existence in or hereafter created by the legislature of any other state. See Tennessee Code 56-9-103
• Forgery: The fraudulent signing or alteration of another's name to an instrument such as a deed, mortgage, or check. The intent of the forgery is to deceive or defraud. ^{Source: OCC}
• Formal delinquency proceeding: means any liquidation or rehabilitation proceeding. See Tennessee Code 56-9-103
• Fraud: Intentional deception resulting in injury to another.
• Fund: means the Access Tennessee health insurance program fund established by §. See Tennessee Code 56-7-2902
• Garnishment: Generally, garnishment is a court proceeding in which a creditor asks a court to order a third party who owes money to the debtor or otherwise holds assets belonging to the debtor to turn over to the creditor any of the debtor
• General account: means all assets and liabilities of a protected cell captive insurance company not attributable to a protected cell. See Tennessee Code 56-13-202
• general assets: includes all the property or its proceeds in excess of the amount necessary to discharge the sum or sums secured thereby. See Tennessee Code 56-9-103
• Generic alternative: means a drug that is designated to be therapeutically equivalent by the United States food and drug administration's Approved Drug Products with Therapeutic Equivalence Evaluations. See Tennessee Code 56-7-3201
• Germane: On the subject of the pending bill or other business; a strict standard of relevance.
• Gift: A voluntary transfer or conveyance of property without consideration, or for less than full and adequate consideration based on fair market value.
• Governmental plan: has the meaning given the term under ERISA, §. See Tennessee Code 56-7-2802
• Governmental plan: has the meaning under ERISA, in 29 U. See Tennessee Code 56-7-2902
• Grace period: The number of days you'll have to pay your bill for purchases in full without triggering a finance charge. ^{Source: Federal Reserve}
• Group capital calculation instructions: means the group capital calculation instructions as adopted by the NAIC and as amended by the NAIC from time to time in accordance with the procedures adopted by the NAIC. See Tennessee Code 56-11-101
• Group health insurance coverage: means , in connection with a group health plan, health insurance coverage offered in connection with the plan. See Tennessee Code 56-7-2802
• Group health plan: means an employee welfare benefit plan, as defined in ERISA, §. See Tennessee Code 56-7-2802
• Group health plan: means an employee welfare benefit plan as defined in ERISA, in 29 U. See Tennessee Code 56-7-2902
• Group-wide supervisor: means the regulatory official authorized to engage in conducting and coordinating group-wide supervision activities who is determined or acknowledged by the commissioner under §. See Tennessee Code 56-11-101
• Guarantor: A party who agrees to be responsible for the payment of another party's debts should that party default. ^{Source: OCC}
• Guaranty association: means the Tennessee insurance guaranty association created by chapter 12, part 1 of this title, the life and health insurance guaranty association created by chapter 12, part 2 of this title, and any other similar entity now or hereafter created by the general assembly of this state for the payment of claims of insolvent insurers. See Tennessee Code 56-9-103
• Guardian: A person legally empowered and charged with the duty of taking care of and managing the property of another person who because of age, intellect, or health, is incapable of managing his (her) own affairs.
• Health benefit plan: includes accident only, credit health, dental, vision, medicare supplement, or long-term care coverage issued as a supplement to liability insurance, automobile medical payment insurance, short-term and catastrophic health insurance policies, and a policy that pays on a cost-incurred basis. See Tennessee Code 56-8-202
• Health benefit plan: means :
  (i) Any accident and health insurance policy or certificate. See Tennessee Code 56-7-2203
• Health care provider: means any person or entity performing services regulated pursuant to title 63 or title 68, chapter 11. See Tennessee Code 56-7-110
• Health care service: means health care procedures, treatments, or services provided by a facility licensed in this state or provided by a doctor of medicine, a doctor of osteopathy, or a health care professional licensed in this state. See Tennessee Code 56-6-703
• Health carrier: means an entity subject to the insurance laws and regulations of this state, or subject to the jurisdiction of the commissioner, that contracts or offers to contract to provide, deliver, arrange for, pay for or reimburse any of the cost of health care services, including a sickness and accident insurance company, a health maintenance organization, a nonprofit hospital and health service corporation, or any other entity providing a plan of health insurance, health benefits or health services. See Tennessee Code 56-8-202
• Health insurance coverage: means benefits consisting of medical care, provided directly, through insurance or reimbursement, or otherwise and including items and services paid for as medical care, under any policy, certificate, or agreement offered by a health insurance issuer. See Tennessee Code 56-7-2802
• Health insurance coverage: means any hospital and medical expense incurred policy, nonprofit health care service plan contract, health maintenance organization subscriber contract, or any other health care plan or arrangement that pays for or furnishes medical or health care services, whether by insurance or otherwise. See Tennessee Code 56-7-2902
• Health insurance issuer: means an entity subject to the insurance laws of this state, or subject to the jurisdiction of the commissioner, that contracts or offers to contract to provide health insurance coverage, including, but not limited to, an insurance company, a health maintenance organization and a nonprofit hospital and medical service corporation. See Tennessee Code 56-7-2802
• Health maintenance organization: means a health maintenance organization as defined at §. See Tennessee Code 56-11-101
• Health maintenance organization: means :
  (A) A federally qualified health maintenance organization, as defined under federal law. See Tennessee Code 56-7-2802
• Health maintenance organization: means an organization as defined in §. See Tennessee Code 56-7-2902
• Health maintenance organization holding company system: means two (2) or more affiliated persons, one (1) of which is a health maintenance organization. See Tennessee Code 56-11-101
• Health plan: means health insurance coverage as defined in §. See Tennessee Code 56-7-602
• Health status-related factor: means any of the following factors:
  (A) Health status. See Tennessee Code 56-7-2802
• Healthcare entity: means :
  (A) Any healthcare facility licensed under title 33 or 68. See Tennessee Code 56-7-602
• Healthcare facility: means an institution, place, or building providing healthcare services that is required to be licensed under title 68, chapter 11, or title 33. See Tennessee Code 56-6-703
• Healthcare service: means a service rendered by a healthcare provider or at a practice that provides testing, monitoring, diagnosis, or treatment of a human disease or condition, or dispenses medical devices, medical appliances, or medical goods for the treatment of a human disease or condition. See Tennessee Code 56-7-3702
• home state: means the home state, as determined pursuant to subdivision (9)(A), of the member of the affiliated group that has the largest percentage of premium attributed to it under such insurance contract. See Tennessee Code 56-14-102
• Home state: means the District of Columbia and any state or territory of the United States in which the public adjuster's principal place of residence or principal place of business is located. See Tennessee Code 56-6-902
• Hospital: means a public or private hospital or facility or part of a hospital or facility equipped to provide inpatient care and treatment for persons with mental illness or serious emotional disturbance. See Tennessee Code 33-1-101
• Hospital: means a licensed public or private institution as defined in §. See Tennessee Code 56-7-2902
• Impaired insurer: means a member insurer which, after July 1, 1989, is not an insolvent insurer, and is placed under an order of rehabilitation or conservation by a court of competent jurisdiction. See Tennessee Code 56-12-203
• Incorporated cell: means a protected cell of an incorporated cell captive insurance company that is organized as a corporation or other legal entity separate from the incorporated cell captive insurance company. See Tennessee Code 56-13-102
• Incorporated cell captive insurance company: means a protected cell captive insurance company that is established as a corporation or other legal entity separate from its incorporated cells that are also organized as separate legal entities. See Tennessee Code 56-13-102
• Indemnification: In general, a collateral contract or assurance under which one person agrees to secure another person against either anticipated financial losses or potential adverse legal consequences. ^{Source: FDIC}
• Independent casualty actuary: means a casualty actuary who is a member of the American Academy of Actuaries and who is not affiliated with, nor an employee, principal, nor the direct or indirect owner of, or in any way controlled by, the insurer or producer. See Tennessee Code 56-6-602
• Index rate: means , for each class of business as to a rating period for small employers with similar case characteristics, the arithmetic average of the applicable base premium rate and the corresponding highest premium rate. See Tennessee Code 56-7-2203
• Individual: means a natural person. See Tennessee Code 56-6-902
• Individual health insurance coverage: means health insurance coverage offered to individuals in the individual market, but does not include short-term limited duration insurance. See Tennessee Code 56-7-2802
• Individual market: means the market for health insurance coverage offered to individuals other than in connection with a group health plan. See Tennessee Code 56-7-2802
• Industrial insured: means an insured:
  (A) Who procures the insurance of any risk or risks by use of the services of a full-time employee acting as an insurance manager or buyer. See Tennessee Code 56-13-102
• Industrial insured captive insurance company: means any company that insures risks of the industrial insureds that comprise the industrial insured group, and that may insure the risks of the affiliated companies of the industrial insureds and the risks of the controlled unaffiliated business of an industrial insured or its affiliated companies. See Tennessee Code 56-13-102
• Industrial insured group: means any group of industrial insureds that collectively:
  (A) Own, control, or hold with power to vote all of the outstanding voting securities of an industrial insured captive insurance company incorporated as a stock insurer. See Tennessee Code 56-13-102
• Injunction: An order of the court prohibiting (or compelling) the performance of a specific act to prevent irreparable damage or injury.
• Insane: includes all persons of unsound mind. See Tennessee Code 1-3-105
• insolvent: means :
  (A) For an insurer issuing only assessable fire insurance policies:

  (i) The inability to pay any obligation within thirty (30) days after it becomes payable. See Tennessee Code 56-9-103
• Insolvent insurer: means an insurer authorized to transact insurance in this state, either when the policy was issued or when the insured event occurred, and against whom a final order of liquidation has been entered after March 31, 1999, with a finding of insolvency by a court of competent jurisdiction in the insurer's state of domicile. See Tennessee Code 56-12-104
• Insolvent insurer: means a member insurer which, after July 1, 1989, is placed under an order of liquidation by a court of competent jurisdiction with a finding of insolvency. See Tennessee Code 56-12-203
• Insurance: means life, annuity, and health benefits provided under a contract issued by a member insurer. See Tennessee Code 56-12-203
• Insurance arrangement: means , to the extent permitted by ERISA, any plan, program, contract or other arrangement under which one (1) or more employers, unions or other organizations provide to their employees or members, either directly or indirectly through a trust or third party administration, health care services or benefits other than through an insurer, and shall include any plan described in §. See Tennessee Code 56-7-2902
• Insurance holding company system: means two (2) or more affiliated persons, one (1) or more of which is an insurer. See Tennessee Code 56-11-101
• insured: includes a person who is a beneficiary covered by a group policy, certificate, or health benefit plan. See Tennessee Code 56-8-202
• Insurer: means and includes every person engaged as indemnitor, surety or contractor in the business of entering into contracts of insurance or of annuities, as limited to:
  (A) Any insurer who is doing an insurer business, or has transacted insurance in this state, and against whom claims arising from that transaction may exist now or in the future. See Tennessee Code 56-9-501
• Insurer: means any person who has done, purports to do, is doing or is licensed to do an insurance business, and is or has been subject to the authority of, or to liquidation, rehabilitation, reorganization, supervision, or conservation by, any insurance commissioner. See Tennessee Code 56-9-103
• Insurer: means any person, firm, association or corporation duly licensed in this state as an insurance company pursuant to §. See Tennessee Code 56-6-502
• insurer: means a person, firm, association or corporation duly licensed to transact a property/casualty insurance business in this state. See Tennessee Code 56-6-602
• Insurer: means any person, firm, association or corporation duly licensed in this state pursuant to the applicable provisions of this title as an insurer. See Tennessee Code 56-6-802
• insurer: means any life or health insurance company, fraternal benefit society, nonprofit health service corporation, nonprofit hospital service corporation, nonprofit medical service corporation, prepaid health plan, dental care plan, vision care plan, pharmaceutical plan, health maintenance organization, and all similar type organizations. See Tennessee Code 56-7-1603
• Insurer: means any entity that provides health insurance coverage in this state. See Tennessee Code 56-7-2902
• Insurer: means any insurance company authorized to transact life insurance business in this state. See Tennessee Code 56-7-3403
• Interchangeable biological product: means a biological product licensed by the federal food and drug administration and determined to meet the safety standards for determining interchangeability pursuant to 42 U. See Tennessee Code 56-7-3501
• Interest rate: The amount paid by a borrower to a lender in exchange for the use of the lender's money for a certain period of time. Interest is paid on loans or on debt instruments, such as notes or bonds, either at regular intervals or as part of a lump sum payment when the issue matures. ^{Source: OCC}
• Internal Revenue Code: means the Internal Revenue Code of 1986, codified in United States Code, title 26, as amended. See Tennessee Code 8-34-101
• Internationally active insurance group: means an insurance holding company system that includes an insurer registered under §. See Tennessee Code 56-11-101
• Intervenor: means any hospital, physician, allied health professional, health care provider or other person furnishing goods or services to, or in competition with, community mental health center, insurer, hospital service corporation, medical service corporation, hospital and medical services corporation, preferred provider organization, health maintenance organization, behavioral health organization, or any employer or association that directly or indirectly provides health care benefits to its employees or members. See Tennessee Code 33-2-703
• Intestate: Dying without leaving a will.
• Invalid vehicle: means any privately or publicly owned vehicle that is maintained, operated and intended to be used to transport persons who are convalescent, or otherwise nonambulatory, and do not require medical treatment while in transit. See Tennessee Code 68-140-302
• Issuer: includes insurance companies, fraternal benefit societies, health care service plans, health maintenance organizations, and any other entity delivering or issuing for delivery in this state medicare supplement policies or certificates. See Tennessee Code 56-7-1501
• Joint committee: Committees including membership from both houses of teh legislature. Joint committees are usually established with narrow jurisdictions and normally lack authority to report legislation.
• Jurisdiction: (1) The legal authority of a court to hear and decide a case. Concurrent jurisdiction exists when two courts have simultaneous responsibility for the same case. (2) The geographic area over which the court has authority to decide cases.
• Large employer: means , in connection with a group health plan with respect to a calendar year and a plan year, an employer who employed an average of at least fifty-one (51) employees on business days during the preceding calendar year and who employs at least two (2) employees on the first day of the plan year. See Tennessee Code 56-7-2802
• Large group market: means the health insurance market under which individuals obtain health insurance coverage, directly or through any arrangement, on behalf of themselves and their dependents, through a group health plan maintained by a large employer. See Tennessee Code 56-7-2802
• Late enrollee: means an eligible employee or dependent who requests enrollment in a health benefit plan of a small employer following the initial enrollment period provided under the terms of the health benefit plan. See Tennessee Code 56-7-2203
• Late enrollee: means , with respect to coverage under a group health plan, a participant or beneficiary who enrolls under the plan other than during:
  (A) The first period in which the individual is eligible to enroll under the plan. See Tennessee Code 56-7-2802
• Levels of care: means the continuum of support ranging from nonclinical recovery housing to clinical and licensed treatment. See Tennessee Code 33-2-1401
• liabilities: include , but are not limited to, reserves required by statute or by department general regulations or specific requirements imposed by the commissioner upon a subject company at the time of admission or subsequent thereto. See Tennessee Code 56-9-103
• License: means an authorization to a person to provide ambulance services. See Tennessee Code 68-140-302
• Licensed producer: means an agent, broker or reinsurance intermediary licensed pursuant to the applicable provisions of this title. See Tennessee Code 56-6-802
• Licensee: means a proprietorship, a partnership, an association, a governmental agency, or corporation, that operates a facility or a service and has obtained a license under this part. See Tennessee Code 33-2-402
• Lien: A claim against real or personal property in satisfaction of a debt.
• Limited lines travel insurance producer: means an individual or business entity that has met the requirements of §. See Tennessee Code 56-6-1402
• Litigation: A case, controversy, or lawsuit. Participants (plaintiffs and defendants) in lawsuits are called litigants.
• Livestock: means all equine as well as animals that are being raised primarily for use as food or fiber for human utilization or consumption including, but not limited to, cattle, sheep, swine, goats, and poultry. See Tennessee Code 1-3-105
• Markup: The process by which congressional committees and subcommittees debate, amend, and rewrite proposed legislation.
• Maximum allowable cost: means the maximum amount that a pharmacy benefits manager or covered entity will reimburse a pharmacy for the cost of a drug or a medical product or device. See Tennessee Code 56-7-3102
• Maximum allowable cost list: means a list of drugs, medical products or devices, or both medical products and devices, for which a maximum allowable cost has been established by a pharmacy benefits manager or covered entity. See Tennessee Code 56-7-3102
• Medicaid: means the federal- and state-financed, state-run program of medical assistance established pursuant to Title XIX of the Social Security Act (42 U. See Tennessee Code 56-7-2902
• Medical care: means amounts paid for:
  (A) The diagnosis, cure, mitigation, treatment, or prevention of disease, or amounts paid for the purpose of affecting any structure or function of the body. See Tennessee Code 56-7-2802
• Medical care: means :
  (A) The diagnosis, care, mitigation, treatment, or prevention of disease. See Tennessee Code 56-7-2902
• Medical direction: means the supervision by a physician licensed to practice in the state of Tennessee of all medical aspects of patient care within EMS. See Tennessee Code 68-140-302
• Medicare: means the Health Insurance for the Aged Act, Title XVIII of the Social Security Amendments of 1965. See Tennessee Code 56-7-1501
• Medicare: means coverage under Parts A and/or B of Title XVIII of the Social Security Act (42 U. See Tennessee Code 56-7-2902
• Medicare supplement policy: means a group or individual policy of accident and sickness insurance or a subscriber contract of hospital and medical service associations or health maintenance organizations other than a policy issued pursuant to a contract under §. See Tennessee Code 56-7-1501
• Member insurer: means any person who:
  (i) Writes any kind of insurance to which this part applies under §. See Tennessee Code 56-12-104
• Member insurer: means an insurer, health maintenance organization, or nonprofit hospital and medical service organization licensed or that holds a certificate of authority to transact in this state any kind of insurance or health maintenance organization business for which coverage is provided under §. See Tennessee Code 56-12-203
• Member organization: means any individual, corporation, limited liability company, partnership, association, or other entity that belongs to an association. See Tennessee Code 56-13-102
• Mental illness: means a psychiatric disorder, alcohol dependence, or drug dependence, but does not include intellectual disability or other developmental disabilities as defined in title 52. See Tennessee Code 33-1-101
• MGA: means any person who:
  (i) Manages all or part of the insurance business of an insurer, including the management of a separate division, department, or underwriting office. See Tennessee Code 56-6-502
• Minor: means any person who has not attained eighteen (18) years of age. See Tennessee Code 1-3-105
• Misappropriation of property: means the deliberate misplacement, exploitation, or wrongful, temporary or permanent use of belongings or money without consent. See Tennessee Code 33-2-402
• Month: means a calendar month. See Tennessee Code 1-3-105
• Mortgagee: The person to whom property is mortgaged and who has loaned the money.
• Mortgagor: The person who pledges property to a creditor as collateral for a loan and who receives the money.
• Mutual corporation: means a corporation organized without stockholders and includes a nonprofit corporation with members. See Tennessee Code 56-13-102
• Mutual insurer: means a company owned by its policyholders where no stock is available for purchase on the stock exchanges. See Tennessee Code 56-13-102
• NAIC: means the National Association of Insurance Commissioners. See Tennessee Code 56-11-101
• NAIC: means the National Association of Insurance Commissioners. See Tennessee Code 56-6-902
• NAIC liquidity stress test framework: means a separate NAIC publication which includes a history of the NAIC's development of regulatory liquidity stress testing, the scope criteria applicable for a specific data year, and the liquidity stress test instructions and reporting templates for a specific data year, such scope criteria, instructions, and reporting templates as adopted by the NAIC and as amended by the NAIC from time to time in accordance with the procedures adopted by the NAIC. See Tennessee Code 56-11-101
• Neglect: means failure to provide goods or services necessary to avoid physical harm, mental anguish, or mental illness, which results in injury or probable risk of serious harm. See Tennessee Code 33-2-402
• Net direct written premiums: means direct gross premiums written in this state on insurance policies to which this part applies, less return premiums and dividends paid or credited to policyholders on this direct business. See Tennessee Code 56-12-104
• Netting agreement: means :
  (A) A contract or agreement, including terms and conditions incorporated by reference in it, including a master agreement, which master agreement, together with all schedules, confirmations, definitions, and addenda to it and transactions under any of them, shall be treated as one (1) netting agreement, that documents one (1) or more transactions between the parties to the agreement for or involving one (1) or more qualified financial contracts and that provides for the netting, liquidation, setoff, termination, acceleration, or close-out, under or in connection with one (1) or more qualified financial contracts or present or future payment or delivery obligations or payment or delivery entitlements under one (1) or more qualified financial contracts, including liquidation or close-out values relating to those obligations or entitlements, among the parties to the netting agreement. See Tennessee Code 56-9-103
• Network plan: means health insurance coverage of a health insurance issuer under which the financing and delivery of medical care, including items and services paid for as medical care, are provided, in whole or in part, through a defined set of providers under contract with the issuer. See Tennessee Code 56-7-2802
• New business premium rate: means , for each class of business as to a rating period, the lowest premium rate charged, offered or that could have been charged by a small employer carrier to small employers with similar case characteristics for newly issued health benefit plans with the same or similar coverage. See Tennessee Code 56-7-2203
• Nonadmitted insurer: means , with respect to a state, an insurer not licensed to engage in the business of insurance in such state. See Tennessee Code 56-14-102
• Nonfederal governmental plan: means a governmental plan that is not a federal governmental plan. See Tennessee Code 56-7-2802
• Nonpayment of premium: means failure of the named insured to discharge when due any obligations in connection with the payment of premiums on a policy of automobile liability insurance or any installment of the premium, whether the premium is payable directly to the insurer or its agent or indirectly under any premium finance plan or extension of credit. See Tennessee Code 56-7-1301
• Nonpayment of premium: means failure of the named insured to discharge when due any of its obligations in connection with the payment of premiums on a policy of commercial risk insurance or any installment of the premium, whether the premium is payable directly to the insurer or its agents or indirectly under any premium finance plan or extension of credit. See Tennessee Code 56-7-1802
• Nonresidential office-based opiate treatment facility: includes , but is not limited to, stand-alone clinics, treatment resources, individual physical locations occupied as the professional practice of a prescriber or prescribers licensed pursuant to title 63, or other entities prescribing products containing buprenorphine, or products containing any other controlled substance designed to treat opiate addiction by preventing symptoms of withdrawal to twenty-five percent (25%) or more of its patients or to one hundred fifty (150) or more patients. See Tennessee Code 33-2-402
• Oath: includes affirmation. See Tennessee Code 1-3-105
• Oath: A promise to tell the truth.
• Offer and disseminate: means providing general information, including a description of the coverage and price, as well as processing the application, collecting premiums, and performing other lawful nonlicensable activities. See Tennessee Code 56-6-1402
• Organization: means any nationally recognized recovery residence standards organization, any affiliate of any nationally recognized recovery residence standards organization, or grantees of any state or federal department or agency. See Tennessee Code 33-2-1401
• Organizational documents: means the documents that must be submitted pursuant to title 48 and title 61 in order to legally form a business in this state or to obtain a certificate of authority to transact business in this state. See Tennessee Code 56-13-102
• Oversight: Committee review of the activities of a Federal agency or program.
• Parametric insurance: means a type of insurance that does not indemnify the pure loss, but ex ante agrees to make a payment upon the occurrence of a triggering event. See Tennessee Code 56-13-102
• Parent: means an individual, corporation, limited liability company, partnership, association, or other entity, or individual that directly or indirectly owns, controls, or holds with power to vote more than fifty percent (50%) of the outstanding voting:
  (A) Securities of a pure captive insurance company organized as a stock corporation. See Tennessee Code 56-13-102
• Participant: means a person or an entity, authorized to be a participant by §. See Tennessee Code 56-13-202
• Participant: has the meaning given the term under ERISA, §. See Tennessee Code 56-7-2802
• Participant contract: means a contract by which a protected cell captive insurance company insures the risks of a participant and limits the losses of each such participant to its pro rata share of the assets of one (1) or more protected cells identified in such participant contract. See Tennessee Code 56-13-202
• Partnership: A voluntary contract between two or more persons to pool some or all of their assets into a business, with the agreement that there will be a proportional sharing of profits and losses.
• Patient: means an individual who, as a result of physical or mental condition, needs medical attention. See Tennessee Code 68-140-302
• Peer: means an individual with lived experience in recovery and the appropriate skills to support a recovery community. See Tennessee Code 33-2-1401
• Permit: means an authorization issued for an ambulance vehicle as meeting the standards adopted pursuant to this part. See Tennessee Code 68-140-302
• Person: means any individual, association, organization or any other business entity, either profit or nonprofit, any state or local governmental entity, and federal agencies to the extent permitted by federal law. See Tennessee Code 68-140-302
• Person: means an individual, a corporation, a limited liability company, a partnership, an association, a joint stock company, a trust, an unincorporated organization, any similar entity or any combination of the foregoing acting in concert, but does not include any joint venture partnership exclusively engaged in owning, managing, leasing or developing real or tangible personal property. See Tennessee Code 56-11-101
• Person: means any individual, corporation, partnership, governmental entity, association, voluntary organization or any other legal entity. See Tennessee Code 56-12-104
• Person: means an individual, corporation, limited liability company, partnership, association, governmental body or entity, or voluntary organization. See Tennessee Code 56-12-203
• Person: includes a corporation, firm, company or association. See Tennessee Code 1-3-105
• Person: means an individual or a business entity. See Tennessee Code 56-6-902
• Person: means any association, aggregate of individuals, business, company, corporation, individual, joint-stock company, Lloyds-type organization, organization, partnership, receiver, reciprocal or interinsurance exchange, trustee or society. See Tennessee Code 56-16-102
• Person: means a natural person. See Tennessee Code 56-6-1001
• Person: means a business entity or a natural person. See Tennessee Code 56-6-1402
• Person: means any association, aggregate of individuals, business, company, corporation, individual, joint-stock company, Lloyds-type organization, organization, partnership, receiver, reciprocal or interinsurance exchange, trustee or society. See Tennessee Code 56-16-102
• Person: means the policy insured, annuity owner, annuitant, or account owner, as applicable under the policy, annuity, or retained asset account subject to this part. See Tennessee Code 56-7-3403
• Personal property: includes money, goods, chattels, things in action, and evidences of debt. See Tennessee Code 1-3-105
• Personal property: All property that is not real property.
• Personal representative: when applied to those who represent a decedent, includes executors and administrators, unless the context implies heirs and distributees. See Tennessee Code 1-3-105
• Personal support services: means nursing consultation, education services, and other personal assistance services as defined by rule, which are provided to individuals with substantial limitation in two (2) or more major life activities in either their regular or temporary residences, but does not mean direct nursing services provided in connection with an acute episode of illness or injury. See Tennessee Code 33-2-402
• Pharmacy benefits manager: includes , but is not limited to, a health insurance issuer, managed health insurance issuer as defined in §. See Tennessee Code 56-7-3102
• Pharmacy benefits manager: means a pharmacy benefits manager as defined in §. See Tennessee Code 56-7-3201
• Pharmacy services administrative organization: means an entity that provides contracting and other administrative services to pharmacies to assist them in their interaction with third-party payers, pharmacy benefits managers, drug wholesalers, and other entities. See Tennessee Code 56-7-3102
• Physician: means a medical doctor or osteopathic physician with a valid state medical license issued pursuant to title 63, chapter 6 or 9. See Tennessee Code 56-7-3702
• Plaintiff: The person who files the complaint in a civil lawsuit.
• plan: means a policy, contract, certificate or agreement offered by a carrier to provide, deliver, arrange for, pay for or reimburse any of the costs of health care services. See Tennessee Code 56-8-202
• Plan of operation: means the articles, bylaws, and operating rules and procedures adopted by the board pursuant to §. See Tennessee Code 56-7-2902
• Plan sponsor: has the meaning given the term under §. See Tennessee Code 56-7-2802
• Plea: In a criminal case, the defendant's statement pleading "guilty" or "not guilty" in answer to the charges, a declaration made in open court.
• Pleadings: Written statements of the parties in a civil case of their positions. In the federal courts, the principal pleadings are the complaint and the answer.
• Policy: means a contract of insurance, certificate, indemnity, suretyship, or annuity issued, proposed for issuance, or intended for issuance by an insurer, including endorsements or riders to an insurance policy or contract. See Tennessee Code 56-8-202
• Policy: means any policy or certificate of life insurance issued in this state, but does not include any policy or certificate of life insurance that provides a death benefit under:
  (A) An employee benefit plan subject to the Employee Retirement Income Security Act of 1974, as periodically amended, compiled at 29 U. See Tennessee Code 56-7-3403
• policy form: means :
  (A) Any policy, contract, plan or agreement of life or health insurance, including credit life insurance and credit health insurance, delivered or issued for delivery in this state by any company subject to this part. See Tennessee Code 56-7-1603
• Power of attorney: A written instrument which authorizes one person to act as another's agent or attorney. The power of attorney may be for a definite, specific act, or it may be general in nature. The terms of the written power of attorney may specify when it will expire. If not, the power of attorney usually expires when the person granting it dies. ^{Source: OCC}
• Practice: means an entity formed with at least one (1) healthcare provider to provide healthcare services. See Tennessee Code 56-7-3702
• Practice: means the exercise of principles and skills for effective emergency medical care under medical direction recognized as acts and responsibilities within the discipline of emergency medical services. See Tennessee Code 68-140-302
• Preauthorization: means the process by which the utilization review agent determines the medical necessity of otherwise covered health care services prior to the rendering of such health care services including, but not limited to, preadmission review, pretreatment review, utilization, and case management. See Tennessee Code 56-6-703
• Precedent: A court decision in an earlier case with facts and law similar to a dispute currently before a court. Precedent will ordinarily govern the decision of a later similar case, unless a party can show that it was wrongly decided or that it differed in some significant way.
• Preexisting condition exclusion: means , with respect to coverage, a limitation or exclusion of benefits relating to a condition based on the fact that the condition was present before the date of enrollment for the coverage, whether or not any medical advice, diagnosis, care, or treatment was recommended or received before that date. See Tennessee Code 56-7-2802
• Preexisting conditions provision: means a policy provision that limits or excludes coverage for charges or expenses incurred during a specified period following the insured's effective date of coverage, for a condition that, during a specified period immediately preceding the effective date of coverage, had manifested itself in a manner that would cause an ordinarily prudent person to seek diagnosis, care or treatment, or for which medical advice, diagnosis, care or treatment was recommended or received as to that condition or as to pregnancy existing on the effective date of coverage. 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
• Premiums: means amounts or considerations, by whatever name called, received on covered policies or contracts less returned premiums, considerations, and deposits and less dividends and experience credits. See Tennessee Code 56-12-203
• Prescription drug: means a drug that under federal or state law is required to be dispensed only pursuant to a prescription order or is restricted to use by individuals authorized by law to prescribe drugs. See Tennessee Code 56-7-3201
• Prescription drug: means a drug that under federal or state law is required to be dispensed only pursuant to a prescription order or is restricted to use by individuals authorized by law to prescribe drugs. See Tennessee Code 56-7-3501
• Prior authorization: means a written or oral determination made by a health carrier or utilization review organization, or an agent of such carrier or organization, that an enrollee's receipt of a healthcare service is a covered benefit under the applicable plan and that a requirement of medical necessity or other requirements imposed by such utilization review organization as prerequisites for payment for such services have been satisfied. See Tennessee Code 56-7-3702
• Private passenger automobile liability insurance policy: means a policy delivered or issued for delivery in this state, insuring a natural person as named insured, or one (1) or more related individuals resident of the same household, and under which the insured vehicles therein designated are of the following types only:
  (A) A motor vehicle of the private passenger or station wagon type that is not used as a public or livery conveyance for passengers, nor rented to others. See Tennessee Code 56-7-1301
• Probable cause: A reasonable ground for belief that the offender violated a specific law.
• Probation: A sentencing alternative to imprisonment in which the court releases convicted defendants under supervision as long as certain conditions are observed.
• Producer: means an insurance broker or brokers or any other person, firm, association or corporation, when, for any compensation, commission or other thing of value, the person, firm, association or corporation acts or aids in any manner in soliciting, negotiating or procuring the making of any insurance contract on behalf of an insured other than the person, firm, association or corporation. See Tennessee Code 56-6-602
• Program: means the Access Tennessee health insurance program, created in §. See Tennessee Code 56-7-2902
• Property: includes both personal and real property. See Tennessee Code 1-3-105
• Prosecute: To charge someone with a crime. A prosecutor tries a criminal case on behalf of the government.
• Protected cell: means a separate account established by a protected cell captive insurance company formed or licensed under this chapter, in which an identified pool of assets and liabilities are segregated and insulated by means of this chapter from the remainder of the protected cell captive insurance company's assets and liabilities in accordance with the terms of one (1) or more participant contracts to fund the liability of the protected cell captive insurance company with respect to the participants as set forth in the participant contracts. See Tennessee Code 56-13-202
• Protected cell assets: means all assets, contract rights, and general intangibles identified with and attributable to a specific protected cell of a protected cell captive insurance company. See Tennessee Code 56-13-202
• Protected cell captive insurance company: means any captive insurance company:
  (A) In which the minimum capital and surplus required by this chapter are provided by one (1) or more sponsors. See Tennessee Code 56-13-202
• Protected cell liabilities: means all liabilities and other obligations identified with and attributed to a specific protected cell of a protected cell captive insurance company. See Tennessee Code 56-13-202
• provider: means any person or entity performing services regulated pursuant to title 63 or title 68, chapter 11, with whom the health insurance entity has an express and valid network provider agreement or contract. See Tennessee Code 56-7-3301
• Provider of record: means the physician or other licensed practitioner identified to the utilization review agent as having primary responsibility for the care, treatment, and services rendered to an individual. See Tennessee Code 56-6-703
• Public adjuster: means any person, other than someone who is employed by an insurance carrier, who, for compensation or any other thing of value, on behalf of the insured:
  (i) Acts or aids, solely in relation to first party claims arising under insurance contracts that insure the real or personal property of the insured on behalf of an insured, in investigating, verifying, substaining, estimating, appraising, determining, presenting, and discussing the value of the claim, and effectuating the resolution of a claim for loss or damage covered by an insurance contract. See Tennessee Code 56-6-902
• Public law: A public bill or joint resolution that has passed both chambers and been enacted into law. Public laws have general applicability nationwide.
• Pure captive insurance company: means any company that insures risks of its parent and affiliated companies or a controlled unaffiliated business or businesses. See Tennessee Code 56-13-102
• Qualified financial contract: means any commodity contract, forward contract, repurchase agreement, securities contract, swap agreement, and any similar agreement that the commissioner determines to be a qualified financial contract for the purposes of this chapter. See Tennessee Code 56-9-103
• Qualified risk manager: means , with respect to a policyholder of commercial insurance, a person who meets the following requirements:
  (A) The person is an employee of, or third-party consultant retained by, the commercial policyholder. See Tennessee Code 56-14-102
• Quorum: The number of legislators that must be present to do business.
• Rating period: means the calendar period for which premium rates established by a small employer carrier are assumed to be in effect, as determined by the small employer carrier. See Tennessee Code 56-7-2203
• Real property: Land, and all immovable fixtures erected on, growing on, or affixed to the land.
• real property: include lands, tenements and hereditaments, and all rights thereto and interests therein, equitable as well as legal. See Tennessee Code 1-3-105
• Reasonably accurate: means information determined through application by the health insurance entity of contract rates, fee schedules and reimbursement rules and policies in effect as of the date inquiry is made by the provider. See Tennessee Code 56-7-3301
• Receiver: means receiver, liquidator, rehabilitator or conservator as the context requires. See Tennessee Code 56-9-103
• Receivership court: means the court in the insolvent or impaired insurer's state having jurisdiction over the conservation, rehabilitation, or liquidation of the member insurer. See Tennessee Code 56-12-203
• Reciprocal: means the aggregation of subscribers under a common name. See Tennessee Code 56-16-102
• Reciprocal: means the aggregation of subscribers under a common name. See Tennessee Code 56-16-102
• Reciprocal insurance: means insurance resulting from the mutual exchange of insurance contracts among persons in an unincorporated association under a common name through an attorney-in-fact having authority to obligate each person both as insured and insurer. See Tennessee Code 56-16-102
• Reciprocal insurance: means insurance resulting from the mutual exchange of insurance contracts among persons in an unincorporated association under a common name through an attorney-in-fact having authority to obligate each person both as insured and insurer. See Tennessee Code 56-16-102
• Reciprocal state: means any state other than this state in which in substance and effect §. See Tennessee Code 56-9-103
• 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
• Record keeping services: means those circumstances under which the insurer has agreed with a group life insurance policyholder to be responsible for obtaining, maintaining, and administering in its own systems information about each individual insured under the policyholder's group life insurance contract at least the following information:
  (A) Individual insured's social security number or name and date of birth. See Tennessee Code 56-7-3403
• Recoupment: means the action by a health insurance entity to recover amounts previously paid to a health care provider by withholding or setting off the amounts against current payments to the health care provider. See Tennessee Code 56-7-110
• Recourse: An arrangement in which a bank retains, in form or in substance, any credit risk directly or indirectly associated with an asset it has sold (in accordance with generally accepted accounting principles) that exceeds a pro rata share of the bank's claim on the asset. If a bank has no claim on an asset it has sold, then the retention of any credit risk is recourse. ^{Source: FDIC}
• Recovery residence: means any ADTF, including any residence classified as a single family residence under §. See Tennessee Code 33-2-1401
• Reinsurance intermediary: means a reinsurance intermediary broker, or a reinsurance intermediary manager. See Tennessee Code 56-6-802
• Reinsurer: means any person, firm, association or corporation duly licensed in this state pursuant to the applicable provisions of this title as an insurer with the authority to assume reinsurance. See Tennessee Code 56-6-802
• Remainder: An interest in property that takes effect in the future at a specified time or after the occurrence of some event, such as the death of a life tenant.
• Reporter: Makes a record of court proceedings and prepares a transcript, and also publishes the court's opinions or decisions (in the courts of appeals).
• Representative: when applied to those who represent a decedent, includes executors and administrators, unless the context implies heirs and distributees. See Tennessee Code 1-3-105
• Reputable and responsible character: means that the applicant or licensee can be trusted with responsibility for persons who are particularly vulnerable to abuse, neglect, and financial or sexual exploitation. See Tennessee Code 33-2-402
• Required prescription drug: means a medication that is required as part of a step therapy protocol. See Tennessee Code 56-7-3501
• Rescission: The cancellation of budget authority previously provided by Congress. The Impoundment Control Act of 1974 specifies that the President may propose to Congress that funds be rescinded. If both Houses have not approved a rescission proposal (by passing legislation) within 45 days of continuous session, any funds being withheld must be made available for obligation.
• Resident: means a person to whom a contractual obligation is owed and who resides in this state on the date of entry of a court order that determines a member insurer to be an impaired insurer or a court order that determines a member insurer to be an insolvent insurer. See Tennessee Code 56-12-203
• Resident: means an individual who is legally domiciled in Tennessee. See Tennessee Code 56-7-2902
• Responsible relative: means the parent of an unemancipated child with mental illness, serious emotional disturbance, alcohol dependence, or drug dependence who is receiving service in programs of the department or any relative who accepts financial responsibility for the care and service of a service recipient. See Tennessee Code 33-1-101
• Restitution: The court-ordered payment of money by the defendant to the victim for damages caused by the criminal action.
• Retirement: means withdrawal from membership with a retirement allowance granted under chapters 34-37 of this title. See Tennessee Code 8-34-101
• Retirement system: means the Tennessee consolidated retirement system as defined in §. See Tennessee Code 8-34-101
• Revocable trust: A trust agreement that can be canceled, rescinded, revoked, or repealed by the grantor (person who establishes the trust).
• Right of offset: Banks' legal right to seize funds that a guarantor or debtor may have on deposit to cover a loan in default. It is also known as the right of set-off. ^{Source: OCC}
• Risk retention group: means a captive insurance company organized under the laws of this state pursuant to the Liability Risk Retention Act of 1986, as amended, (15 U. See Tennessee Code 56-13-102
• Run records: means ambulance run reports relative to a response by an ambulance service or invalid vehicle operator during which a patient is evaluated, treated or transported. See Tennessee Code 68-140-302
• Savings and loan association: includes a building and loan association, a federal or state savings and loan association, a federal savings bank, and any other financial institution, the accounts of which are insured by the [former] federal savings and loan insurance corporation (FSLIC) or any successor [repealed] of such corporation. See Tennessee Code 1-3-105
• Scope criteria: means the designated exposure bases, along with minimum magnitudes thereof, for a specified data year, used to establish a preliminary list of insurers considered scoped into the NAIC liquidity stress test framework for a data year. See Tennessee Code 56-11-101
• Secured claim: means any claim secured by mortgage, trust deed, pledge, deposit as security, escrow, or otherwise, but not including special deposit claims or claims against general assets. See Tennessee Code 56-9-103
• Sequester: To separate. Sometimes juries are sequestered from outside influences during their deliberations.
• Serious emotional disturbance: means a condition in a child who currently or at any time during the past year has had a diagnosable mental, behavioral, or emotional disorder of sufficient duration to meet psychiatric diagnostic criteria that results in functional impairment that substantially interferes with or limits the child's role or functioning in family, school, or community activities and includes any mental disorder, regardless of whether it is of biological etiology. See Tennessee Code 33-1-101
• Serious health condition: means an illness, injury, impairment, or physical or mental condition, including transplantation preparation and recovery from surgery related to organ or tissue donation, that involves inpatient care in a hospital, hospice, or residential healthcare facility, continuing treatment or continuing supervision by a healthcare provider as defined in an insurance policy issued under this part. See Tennessee Code 56-7-3603
• Service: means the provision of organized response by ambulances or emergency response vehicles, or the provision of emergency care on an organized basis. See Tennessee Code 68-140-302
• Service: includes any activity to prevent, treat, or ameliorate mental illness, serious emotional disturbance or alcohol or drug use which includes diagnosis, evaluation, residential assistance, training, habilitation, rehabilitation, prevention, treatment, counseling, case coordination, or supervision of persons with mental illness, alcohol and drug abuse issues and serious emotional disturbances. See Tennessee Code 33-2-402
• Service member: means a member of the United States armed forces in active military service. See Tennessee Code 56-7-3603
• Service of process: The service of writs or summonses to the appropriate party.
• Service recipient: means a person who is receiving service, has applied for service, or for whom someone has applied for or proposed service because the person has mental illness or serious emotional disturbance. See Tennessee Code 33-1-101
• Settlement: Parties to a lawsuit resolve their difference without having a trial. Settlements often involve the payment of compensation by one party in satisfaction of the other party's claims.
• sex: means a person's immutable biological sex as determined by anatomy and genetics existing at the time of birth and evidence of a person's biological sex. See Tennessee Code 1-3-105
• Shopping and decision support program: means the program established by a carrier pursuant to this part. See Tennessee Code 56-7-602
• signed: includes a mark, the name being written near the mark and witnessed, or any other symbol or methodology executed or adopted by a party with intention to authenticate a writing or record, regardless of being witnessed. See Tennessee Code 1-3-105
• Significant break in coverage: means a period of sixty-three (63) consecutive days during all of which the individual does not have any creditable coverage, except that neither a waiting period nor an affiliation period is taken into account in determining a significant break in coverage. See Tennessee Code 56-7-2902
• 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
• Small employer: means , in connection with a group health plan with respect to a calendar year and a plan year, an employer who employs an average of at least two (2) but no more than fifty (50) employees on business days during the preceding calendar year and who employs at least two (2) employees on the first day of the plan year. See Tennessee Code 56-7-2802
• Small employer carrier: means any carrier that offers health benefit plans covering eligible employees of one (1) or more small employers. See Tennessee Code 56-7-2203
• Small group market: means the health insurance market under which individuals obtain health insurance coverage, directly or through any arrangement, on behalf of themselves and their dependents, through a group health plan maintained by a small employer. See Tennessee Code 56-7-2802
• Sponsor: means any person or entity that is approved by the commissioner to provide all or part of the capital and surplus required by this chapter and to organize and operate a protected cell captive insurance company. See Tennessee Code 56-13-202
• State: means the state of Tennessee. See Tennessee Code 68-140-302
• State: means any state, district or territory of the United States and the Panama Canal Zone. See Tennessee Code 56-9-103
• State: means the state of Tennessee. See Tennessee Code 8-34-101
• State: means a state, the District of Columbia, Puerto Rico, and a United States possession, territory, or protectorate. See Tennessee Code 56-12-203
• State: includes any state in the United States, the District of Columbia, the Commonwealth of Puerto Rico, Guam, the Northern Mariana Islands, the Virgin Islands, and American Samoa. See Tennessee Code 56-14-102
• Statute: A law passed by a legislature.
• Statute of limitations: A law that sets the time within which parties must take action to enforce their rights.
• Step therapy protocol: means a protocol, policy, or program that establishes a specific sequence in which prescription drugs for a specified medical condition, and medically appropriate for a particular patient, are covered by a health carrier or health benefit plan. See Tennessee Code 56-7-3501
• Structured settlement annuity: means an annuity purchased in order to fund periodic payments for a plaintiff or other claimant in payment for, or with respect to, personal injury suffered by the plaintiff or other claimant. See Tennessee Code 56-12-203
• Subject of abuse: means a person to whom a family member, or a current or former household member, intimate partner, or caretaker, or a perpetrator of sexual assault, a stalker or a sex offender has directed an act as defined in subdivision (1). See Tennessee Code 56-8-202
• Subpoena: A command to a witness to appear and give testimony.
• Subscriber: means a person obligated under a reciprocal insurance agreement. See Tennessee Code 56-16-102
• Subscriber: means a person obligated under a reciprocal insurance agreement. See Tennessee Code 56-16-102
• Subscription: includes a mark, the name being written near the mark and witnessed. See Tennessee Code 1-3-105
• Support: means any activity or resource that enables a service recipient to participate in a service for mental illness or serious emotional disturbance or in community life. See Tennessee Code 33-1-101
• Surplus lines agent: means an agent who is licensed under chapter 6, part 1 of this title who is granted a surplus lines license in accordance with this chapter. See Tennessee Code 56-14-102
• surplus lines insurance: means any insurance coverage permitted by §. See Tennessee Code 56-14-102
• Surplus lines insurer: means an unauthorized company in which a nonadmitted insurance coverage is placed or may be placed under this chapter. See Tennessee Code 56-14-102
• Testate: To die leaving a will.
• Testify: Answer questions in court.
• Testimony: Evidence presented orally by witnesses during trials or before grand juries.
• Third party administrator: means any entity that, on behalf of an insurer or insurance arrangement, provides health insurance coverage to individuals in this state, receives or collects charges, contributions or premiums for, or adjudicates, processes or settles claims in connection with, any type of health benefit provided in or as an alternative to health insurance coverage. See Tennessee Code 56-7-2902
• To be in violation: means that the reinsurance intermediary, insurer, or reinsurer for whom the reinsurance intermediary was acting failed to substantially comply with this part. See Tennessee Code 56-6-802
• Tort: A civil wrong or breach of a duty to another person, as outlined by law. A very common tort is negligent operation of a motor vehicle that results in property damage and personal injury in an automobile accident.
• Transfer: includes the sale and every other and different mode, direct or indirect, of disposing of or of parting with property or with an interest therein, or with the possession thereof or of fixing a lien upon property or upon an interest therein, absolutely or conditionally, voluntarily, by or without judicial proceedings. See Tennessee Code 56-9-103
• Travel insurance supervising entity: means a person that receives a license pursuant to §. See Tennessee Code 56-6-1402
• Travel retailer: means a business entity that makes, arranges, or offers travel services and may offer and disseminate travel insurance as a service to its customers on behalf of and under the direction of a travel insurance supervising entity. See Tennessee Code 56-6-1402
• Treatment resource: means any public or private facility, service, or program providing treatment or rehabilitation services for mental illness or serious emotional disturbance, including, but not limited to, detoxification centers, hospitals, community mental health centers, clinics or programs, halfway houses, and rehabilitation centers. See Tennessee Code 33-1-101
• Trial: A hearing that takes place when the defendant pleads "not guilty" and witnesses are required to come to court to give evidence.
• Trust account: A general term that covers all types of accounts in a trust department, such as estates, guardianships, and agencies. ^{Source: OCC}
• Trustee: A person or institution holding and administering property in trust.
• Unallocated annuity contract: means an annuity contract or group annuity certificate which is not issued to and owned by an individual, except to the extent of any annuity benefits guaranteed to an individual by an insurer under the contract or certificate. See Tennessee Code 56-12-203
• unauthorized company: means an insurance company not licensed to transact business in this state under this title. See Tennessee Code 56-14-102
• under common control with: means the possession, direct or indirect, of the power to direct or cause the direction of the management and policies of a person, whether through the ownership of voting securities, by contract other than a commercial contract for goods or non-management services, or otherwise, unless the power is the result of an official position with or corporate office held by the person. See Tennessee Code 56-11-101
• Uniform business entity application: means the current version of the NAIC uniform business entity application for resident and nonresident business entities. See Tennessee Code 56-6-902
• Uniform Commercial Code: A set of statutes enacted by the various states to provide consistency among the states' commercial laws. It includes negotiable instruments, sales, stock transfers, trust and warehouse receipts, and bills of lading. ^{Source: OCC}
• Uniform individual application: means the current version of the NAIC uniform individual application for resident and nonresident individuals. See Tennessee Code 56-6-902
• United States: includes the District of Columbia and the several territories of the United States. See Tennessee Code 1-3-105
• Uphold: The decision of an appellate court not to reverse a lower court decision.
• Usury: Charging an illegally high interest rate on a loan. ^{Source: OCC}
• Utilization review: means a system for prospective and concurrent review of the necessity and appropriateness in the allocation of health care resources and services given or proposed to be given to an individual within this state. See Tennessee Code 56-6-703
• Utilization review agent: means any person or entity, including the state, performing utilization review, except:
  (A) An agency of the federal government. See Tennessee Code 56-6-703
• Utilization review organization: means :
  (A) A health carrier or other entity, including a designee of such carrier or entity, that reviews or issues prior authorizations for a health carrier. See Tennessee Code 56-7-3702
• Utilization review organization: means an entity that conducts utilization review, as defined in §. See Tennessee Code 56-7-3501
• Venue: The geographical location in which a case is tried.
• Verdict: The decision of a petit jury or a judge.
• Volunteer personnel: means persons who provide emergency care without expectation of remuneration who do not receive payment for services rendered, and who do not depend on the provision of emergency care for their livelihood or a substantial portion of their livelihood. See Tennessee Code 68-140-302
• Voting security: includes any security convertible into or evidencing a right to acquire a voting security. See Tennessee Code 56-11-101
• Waiting period: means , with respect to a group health plan and an individual who is a potential participant or beneficiary in the plan, the period that must pass with respect to the individual before the individual is eligible to be covered for benefits under the terms of the plan. See Tennessee Code 56-7-2802
• Writ: A formal written command, issued from the court, requiring the performance of a specific act.
• Writ of certiorari: An order issued by the Supreme Court directing the lower court to transmit records for a case for which it will hear on appeal.
• Writing agent: means the licensed insurance agent who accepts the application for nonadmitted insurance directly or indirectly from the prospective insured. See Tennessee Code 56-14-102
• Year: means a calendar year, unless otherwise expressed. See Tennessee Code 1-3-105