2016 Tennessee Code
Title 56 - Insurance
Chapter 32 - Health Maintenance Organization Act of 1986
§ 56-32-123. Bidding.

TN Code § 56-32-123 (2016) What's This?

(a) Each employer, public or private, except any public entity that has a metropolitan form of government and a population of not less than four hundred thousand (400,000), according to the 1980 federal census or any subsequent federal census, in this state that offers its employees a health benefit plan and employs not less than twenty-five (25) employees, shall afford at least two (2) qualified HMOs the opportunity to bid or to provide health care services. This dual offering is contingent upon written requests being received from the HMOs for inclusion in the employer's health benefit plan, and provided the HMOs are different types or models, such as medical group or staff and individual practice association. Where there is a prevailing collective bargaining agreement, the selection of the HMO or organizations to be made available to the employees shall be made under the agreement.

(b) No employer in this state shall be required to pay more for health benefits as a result of the application of this section than would otherwise be required by any prevailing collective bargaining agreement or other contract for the provision of health benefits to its employees; provided, that the employer or benefits fund shall pay to the HMO chosen by each employee or member an amount equal to the lesser of:

(1) The amount paid on behalf of its other employees or members for health benefits; or

(2) The HMO's charge for coverage approved by the commissioner pursuant to ยง 56-32-107.

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