Rules & Regulations of the State of Tennessee
Title 0780 - Commerce and Insurance
Subtitle 0780-01 - Insurance Division
Chapter 0780-01-76 - Self-Insurance Associations and Non-Profit Business Coalitions for Health
Section 0780-01-76-.08 - CONTRIBUTION RATES

Universal Citation: TN Comp Rules and Regs 0780-01-76-.08

Current through September 24, 2024

(1) A self-funded qualified multiple employer welfare arrangement shall establish and maintain contribution rates that fund the greater of:

(a) The amount recommended and certified by a qualified actuary in order for the self-funded qualified multiple employer welfare arrangement to remain financially solvent; or

(b) The sum of projected claims liability for the year, plus all projected costs of operation of the arrangement for the year, plus an amount equal to any deficiency in the surplus of the arrangement for all prior years, minus an amount equal to the surplus of the arrangement in excess of the minimum required level of surplus.

(2) A self-funded qualified multiple employer welfare arrangement shall establish and maintain contribution rates that are not excessive, inadequate, or unfairly discriminatory.

(3) A self-funded qualified multiple employer welfare arrangement shall, before use, file with the Commissioner:

(a) A rate or fee of any kind to be charged a participating employer or employee;

(b) Every rating manual, schedule, plan, rule, or formula; and

(c) Any modification to the rating manual, schedule, plan, rule or formula.

(4) The Commissioner shall disapprove a contribution rate or fee submitted under paragraph (3) of this rule that does not meet the requirements of paragraphs (1) and (2) of this section or is in any respect not in compliance with or in violation of law.

(5) A filing under paragraph (3) of this rule must state the effective date and must provide a comprehensive description of the coverage.

Authority: T.C.A. § 56-26-204(b).

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