Tennessee § 56-7-2211 - Contracting with a small employer insurer — Compliance with federal laws.

§ 56-7-2211. Contracting with a small employer insurer — Compliance with federal laws.

A health group cooperative shall contract only with a small employer insurer that demonstrates: That the insurer or health maintenance organization is licensed and in good standing with the department; The capacity to administer the group health insurance plans; The ability to monitor and evaluate the quality and cost effectiveness of care and applicable procedures; The ability to conduct utilization management and applicable procedures and policies; The ability to assure enrollees a sufficient number of health care providers, including specialty providers; and A satisfactory grievance procedure and the ability to respond to enrollees' calls, questions, and complaints. A health group cooperative shall comply with federal laws applicable to cooperatives and group health insurance plans issued through cooperatives, to the extent required by federal law and this title or rules promulgated pursuant to this title. Acts 2008, ch. 1036, § 6; T.C.A. § 56-7-2225 . Code Commission Notes. This section was renumbered from § 56-7-2225 to § 56-7-2211 by authority of the Code Commission in 2016. Compiler's Notes. Acts 2008, ch. 1036, § 7 provided that the department of commerce and insurance is authorized to promulgate rules to effectuate the purposes of this act. The rules shall be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.