Rules & Regulations of the State of Tennessee
Title 0780 - Commerce and Insurance
Subtitle 0780-01 - Insurance Division
Chapter 0780-01-81 - Administration of Self Insurance Workers' Compensation Programs by Single Employers or Pools
Section 0780-01-81-.02 - DEFINITIONS

(1) "Affiliate" or "affiliated" means an entity or person who directly or indirectly through one or more intermediaries, controls or is controlled by, or is under common control with, a specified entity or person.

(2) "Commissioner" means the Commissioner of the Department of Commerce and Insurance.

(3) "Control" (including the terms "controlling," "controlled by" and "under common control with") means the possession, direct or indirect, of the power to direct and/or cause the direction of the management and/or policies of a person, whether through the ownership of voting securities, by contract other than a commercial contract for goods or non-management services, or otherwise, unless the power is the result of an official position with or corporate office held by the person. Control shall be presumed to exist if any person, directly or indirectly, owns, controls, holds with the power to vote, or holds proxies representing, ten percent (10%) or more of the voting securities of any other person. This presumption may be rebutted by a showing made in the manner provided by the Insurance Holding Company System Act, T.C.A. §§ 56-11-201, et seq., that control does not exist in fact. The Commissioner may determine, after furnishing all persons in interest notice and an opportunity to be heard and making specific findings of fact to support the determination, that control exists in fact, notwithstanding the absence of a presumption to that effect or the filing of a disclaimer in like manner to T.C.A. § 56-11-205(k).

(4) "Employer" means a single employer that is self-insuring their workers' compensation liabilities under T.C.A. § 50-6-405(a) pursuant to T.C.A. §§ 50-6-405(a) and (b).

(5) "GAAP" means United States generally accepted accounting principles consistently applied.

(6) "Insurance producer" means a person who sells, solicits or negotiates a contract of insurance as those terms are defined in this Rule.

(7) "Insurer" means a person undertaking to provide workers' compensation insurance coverage through a company requiring a certificate of authority issued pursuant to T.C.A. § 56-2-205.

(8) "NAIC" means the National Association of Insurance Commissioners.

(9) "Negotiate" means the act of conferring directly with or offering advice directly to a purchaser or prospective purchaser of a particular contract of insurance or plan of self-insurance concerning any of the substantive benefits, terms or conditions of the contract, provided that the person engaged in that act either sells insurance or obtains insurance coverage from insurers for the purchaser.

(10) "Person" means an individual or business entity.

(11) "Sell" means to exchange a contract of insurance or plan of self-insurance by any means, for money or its equivalent, on behalf of an insurer, employer, or pool.

(12) "Solicit" means attempting to sell insurance or a plan of self-insurance or asking or urging a person to apply for a particular kind of insurance or plan of self-insurance from a particular insurer, employer, or pool.

(13) "Third party administrator" means a person who directly or indirectly collects charges or premiums from, adjusts or settles claims, or provides loss control or account managing services in connection with workers' compensation insurance coverage offered or provided by a self-insured employer under T.C.A. §§ 50-6-405(a) and (b), or a self-insured pool under T.C.A. § 50-6-405(c), except any of the following:

(14) "Pool" means a self-insurance pool operating pursuant to T.C.A. § 50-6-405(c).

(15) "Workers' compensation benefits and/or insurance coverage" means the benefits intended to pay the liabilities that arise out of the requirements of T.C.A. § 50-6-405(a) for an employer's liability.