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PUBLIC CHAPTER NO. 183
SENATE BILL NO. 1270
By Johnson
Substituted for: House Bill No. 1304
By Lamberth, Cochran, Hill, Helton-Haynes
AN ACT to amend Tennessee Code Annotated, Title 56 and Section 68-1-115, relative to insurance.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF TENNESSEE:
SECTION 1. Tennessee Code Annotated, Title 56, Chapter 2, Part 1, is amended by adding
the following as a new section:
56-2-1_. Claims experience report.
(a) As used in this section, unless the context otherwise requires:
(1) "Group health plan" or "plan" means an employee welfare benefit plan, as
that term is defined in§ 3(1) of the Employee Retirement Income and Security Act of
1974 (ERISA) (29 U.S.C. § 1002(1)), including insured and self-insured plans, to the
extent that the plan provides medical care, as that term is defined in § 2791 (a)(2) of the
Public Health Service Act (PHS Act) (42 U.S.C. § 30099-91 (a)(2)), including items and
services paid for as medical care, to employees or their dependents directly or through
insurance, reimbursement, or otherwise, that:
(A) Has fifty (50) or more participants as defined in section 3(7) of ERISA
(29 U.S.C. § 1002(7)); or
(8) Is administered by an entity other than the employer that established
and maintains the plan;
(2) "Health benefit plan issuer" means a company or insurance company, as
those terms are defined in§ 56-1-102, or a health maintenance organization, as that
term is defined in § 56-32-102, that qualifies as a health insurance entity as that term
is defined in§ 56-7-109;
(3) "Plan administrator" means an administrator, as that term is defined in 29
U.S.C. § 1002(16)(A); and
(4) "Plan sponsor" has the same meaning as defined in 29 U.S.C. §
1002( 16)(8).
(b) No later than thirty (30) days after a health benefit plan issuer receives a written
request for a claims experience report from a plan, plan sponsor, or plan administrator, the
health benefit plan issuer shall provide the report to the requesting party.
(c) To the extent such information is available to the health benefit plan issuer and is
relevant to the request made under subsection (b), a report provided pursuant to subsection
(b) must include the following information for the thirty-six-month period preceding the date of
the request, for the entire period of coverage, or for the period of time specified in the request,
whichever period is shortest:
(1) Aggregate paid claims experience by month, including claims experience for
medical, dental, and pharmacy benefits, as applicable;
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(2) Total premium or premium equivalent earned by month;
(3) Total number of covered employees on a monthly basis by coverage tier,
including whether coverage was for:
(A) An employee only;
(B) An employee with dependents only;
(C) An employee with a spouse only; or
(D) An employee with spouse and dependents; and
(4) An aggregate report of all claims exceeding seventy-five thousand dollars
($75,000).
(d) In the case of a request made under subsection (b) after the date of termination of
coverage, the report provided under subsection (b) must contain the information outlined in
subsection (c) that is available to the health benefit plan issuer as of the date of the request
and is relevant to the request for the thirty-six-month period preceding the date of termination
of coverage or for the entire policy period, whichever period is shorter.
(e) No later than thirty (30) days after the date of termination of coverage under a
group health plan, a health benefit plan issuer shall provide to a plan, plan sponsor, or plan
administrator who made a request under subsection (b) before the date of termination of
coverage a supplemental written report of the information described in subsection (c) to
update the claims experience report with information that was not included in the original
report.
(f) A plan, plan sponsor, or plan administrator may use information in a written claims
experience report provided under this section only as permitted or required by the Health
Insurance Portability and Accountability Act of 1996 (HIPAA) (42 U.S.C. § 1320d et seq.) and
its implementing regulations.
(g) Except where the release of information is otherwise prohibited by law, a health
benefit plan issuer that releases information in accordance with this section has not violated
a standard of care and is not liable for civil damages resulting from, and is not subject to
criminal prosecution for, releasing such information.
(h) This section applies to the extent not preempted by ERISA.
SECTION 2. Tennessee Code Annotated, Section 56-2-208(b)(6)(F)(vi)(c), is amended by
deleting the language "active" and substituting "inactive".
SECTION 3. Tennessee Code Annotated, Section 56-2-208(b)(8)(C)(iii), is amended by
adding the language "; provided, that the commissioner shall not remove from the list a reciprocal
jurisdiction as defined under subdivisions (b)(8)(A)(ii)(a) or (b)" immediately preceding the period of
the first sentence.
SECTION 4. Tennessee Code Annotated, Section 56-2-208(b)(8)(D), is amended by deleting
the language "subdivision (b)(8)(B)(iv)" and substituting "subdivision (b)(8)(B)(i)(d)".
SECTION 5. Tennessee Code Annotated, Section 56-2-208(b)(10), is amended by deleting
the language "subdivision (b)(2), (b)(3), or (b)(4)" and substituting "subdivision (b)(2), (b)(3), (b)(4),
or (b)(8)".
SECTION 6. Tennessee Code Annotated, Section 56-2-208(b)(11)(B)(ii), is amended by
deleting "subdivision (b)(6)(F)" and substituting "subdivision (b)(6)(G)".
SECTION 7. Tennessee Code Annotated, Section 56-2-208(b)(11 )(C), is amended by
deleting "subdivision (b)(6)(E)" and substituting "subdivision (b)(6)(F)".
SECTION 8. Tennessee Code Annotated, Section 56-2-209(a)(2), is amended by adding the
language", as defined in subsection (d)" immediately preceding the period of the first sentence.
SECTION 9. Tennessee Code Annotated, Section 56-2-209(a)(2)(C), is amended by deleting
the subdivision and substituting:
(C) Clean, irrevocable, unconditional letters of credit, issued or confirmed by a
qualified United States financial institution no later than December 31 of the year for which
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filing is being made, and in the possession of, or in trust for, the ceding company on or
before the filing date of its annual statement; or
SECTION 10. Tennessee Code Annotated, Section 56-2-209(b), is amended by deleting the
subsection and substituting:
(b) Letters of credit meeting applicable standards of issuer acceptability as of the
dates of their issuance, or confirmation, must, notwithstanding the issuing or confirming
qualified United States financial institution's subsequent failure to meet applicable standards
of issuer acceptability, continue to be acceptable as security until their expiration, extension,
renewal, modification, or amendment, whichever first occurs.
SECTION 11. Tennessee Code Annotated, Section 56-2-209(c), is amended by deleting the
language "subdivision (a)(3)" and substituting "subdivision (a)(2)(C) and subsection (b)".
SECTION 12. Tennessee Code Annotated, Section 56-2-209(9)(4), is amended by adding
the following as a new subdivision (A) and redesignating the existing subdivisions accordingly:
(A) Meets the conditions set forth in § 56-2-208(b)(8);
SECTION 13. Tennessee Code Annotated, Section 56-5-102(3), is amended by deleting the
subdivision and substituting:
(3) "Commercial risk insurance" means insurance within the scope of this part that is
not personal risk insurance, including insurance on every kind of farm property or farm risk
that is not personal risk insurance, including farm premises, buildings, machinery, equipment,
motor vehicles, livestock, and other personal property used in farming operations;
SECTION 14. Tennessee Code Annotated, Section 56-5-102(7), is amended by deleting the
subdivision and substituting: •
(7) "Personal risk insurance" means property and casualty insurance that provides:
(A) Insurance on one (1) to four (4) family dwelling units, including mobile
homes;
(8) Individual insurance on household goods in dwellings, mobile homes,
apartments, or other residential facilities;
(C) Insurance on every kind of farm property or farm risk, including farm
premises, buildings, machinery, equipment, motor vehicles, livestock, and other
personal property used in farming operations, unless insured on a commercial risk
insurance policy;
(D) Insurance on private passenger nonfleet motor-driven vehicles, not used
for hire, which are used for personal, farm, or family needs. The motor-driven vehicles
include pickups, station wagons, vans, and vehicles with fewer than four (4) wheels;
(E) Insurance on pleasure watercraft that are used for personal, farm, or
family needs; and
(F) Insurance sold in connection with and incidental to rental agreements for a
period not to exceed ninety (90) days;
SECTION 15. Tennessee Code Annotated, Title 56, Chapter 5, Part 1, is amended by adding
the following new section:
56-5-1_. Coverage of farm risks and property used in farming.
Coverage by a commercial risk insurance policy of farm risks or real or personal
property used in farming must not be considered in determining whether property is classified
as farm or agricultural property under another law or rule in this state.
SECTION 16. Tennessee Code Annotated, Section 56-7-1605(a), is amended by deleting
the subsection and substituting:
(a) In addition to any other requirements of law, policy forms, except as stated in §
56-7-1604, must not be delivered or issued for delivery in this state on or after the dates the
forms are subject to this part, unless:
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(1) The text achieves a minimum score of forty (40) on the Flesch reading
ease test or an equivalent score on another comparable test as provided in
subsection (d);
(2) The style, arrangement, and overall appearance of the policy give no
undue prominence to any portion of the text of the policy or to any endorsements or
riders; and
(3) The policy form contains a table of contents or an index of the principal
sections of the policy, if the policy has more than three thousand (3,000) words.
SECTION 17. Tennessee Code Annotated, Section 56-7-1605(b)(1), is amended by deleting
the language "printed".
SECTION 18. Tennessee Code Annotated, Section 56-7-1605(c), is amended by deleting
the subsection and substituting:
(c) As used in this section, "text" includes all matter contained in a policy form except
the following:
(1) The name and address of the insurer; the name, number, or title of the
policy; the table of contents or index; captions and subcaptions; specification pages,
schedules, or tables; and
(2) Any policy language that is drafted to conform to the requirements of any
federal law, regulation, or agency interpretation; any policy language required by any
collectively bargained agreement; any medical terminology; any words which are
defined in the policy; and any policy language required by law or regulation;
provided, that the insurer identifies the language or terminology excepted by this
subsection (c) and certiffes, in writing, that the language or terminology is entitled to
be excepted by this subsection (c).
SECTION 19. Tennessee Code Annotated, Title 56, Chapter 7, Part 23, is amended by
deleting Sections 56-7-2312 - 56-7-2322.
SECTION 20. Tennessee Code Annotated, Section 68-1-115, is amended by deleting the
language",§ 56-7-2312,".
SECTION 21. The headings in this act are for reference purposes only and do not constitute
a part of the law enacted by this act. However, the Tennessee Code Commission is requested to
include the headings in any compilation or publication containing this act.
SECTION 22. Section 1 and Sections 16 through 20 take effect upon becoming law, the
public welfare requiring it. Sections 2 through 12 take effect July 1, 2025, the public welfare requiring
it. Sections 13 through 15 take effect January 1, 2026, and apply to plans, policies, and agreements
issued, delivered, amended, or renewed to take effect on or after January 1, 2026, the public welfare
requiring it.
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SENATE BILL NO. 1270
PASSED: March 28, 2025
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t RANDY Mel
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SPEAKER OF THE SENATE
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CAMERON SEXTON, SPEAKER
HOUSE OF REPRESENTATIVES
Apr! U!_ APPROVED this I
day of 2025
BILL LEE, GOVERNOREvery fact on this page links to its source, starting with the official bill record.