2019 Tennessee Code
Title 56 - Insurance
Chapter 27 - Medical Service Plan Law, 1945
§ 56-27-102. Chapter definitions.
- As used in this chapter, unless the context otherwise requires:
(1) “Beneficiary” means a person designated in the subscription certificate referred to in subdivision (9), as entitled to the medical services referred to in subdivision (9);
(2) “Commissioner” means the commissioner of commerce and insurance;
(3) “Covered dependent” is the spouse, an adult dependent or child of a subscriber who is named in the subscription certificate issued to the subscriber, and with respect to whom appropriate premium is specified in the certificate;
(4) “Medical service plan” means a plan or arrangement under which medical services are or may be rendered to a subscriber, a covered dependent or other beneficiary by a licensed physician and surgeon at the expense of a medical service plan corporation or other person, in consideration of periodical prepayments made by the subscriber or another in the subscriber's behalf prior to the occurrence of the condition calling for the rendition of medical or surgical services;
(5) “Medical service plan corporation” means a corporation organized without capital stock and not for profit, and incorporated in accordance with § 56-27-103, specifically for the purpose of establishing, maintaining and operating a nonprofit medical service plan;
(6) “Medical services” means the general and usual services and care rendered and administered by doctors of medicine. “Medical services” does not include hospital services;
(7) “Participating physician” means a doctor of medicine licensed to practice medicine and surgery in this state under title 63, chapter 6, who agrees in writing with a medical service plan corporation to perform the medical services specified in the subscription certificates issued by the corporation, and at the rates of compensation as shall be determined by the board of directors of the corporation, and who agrees to abide by the bylaws, rules and regulations of the corporation applicable to participating physicians;
(8) “Person” includes a natural person, a copartnership, an association, a common-law trust or a corporation; and
(9) “Subscriber” means a person to whom a subscription certificate is issued by a medical service plan corporation that sets forth the beneficiaries and the kinds and extent of the medical services for which the corporation is liable to make payment.
