Tennessee health insurance tips


Tennessee insurance law and regulation

The Tennessee Department of Commerce and  Insurance Web site contains help sections for each type of insurance including a section on financially assisted health plans and Medicaid.  The Web site has not yet developed resources to help individuals find commercial low cost health plans like mini-med or core coverage, specific illness policies, Supplemental Accident Insurance and basic health insurance.

The state insurance department can be reached by telephone at (615) 741-2241 or by mail at 500 James Robertson Parkway, Davy Crockett Tower, Nashville TN 37243. The state children’s health insurance plan (CHIP) Web site is Tennessee CoverKids.

News that affects your health insurance and planning

February 18, 2020 – Hospitals are increasingly turning to the courts for enforcement authority to collect outstanding medical debts, relying on the court’s power to enforce contempt of court charges to patients who don’t show up for hearings or do not pay as ordered. Contempt of court carries the threat of arrest and possibility of jail time.  This article in the Brunswick News details the aggressive legal collection practices of Cookeville Regional Medical Center.

June 3, 2019 – Status of alternative non-ACA health plans: Tennessee does not require individuals to maintain adequate health coverage. The state provides no premium or cost-sharing subsidies for individual market coverage, permits insurers to sell non-compliant transitional policies in the individual market and does not limit the sale of short-term coverage more strictly than the federal government. Health plans sold by the Tennessee Farm Bureau are not considered insurance under state law and are exempt from federal and state protections otherwise applicable to the individual insurance market.

March 29, 2019 – Small business health plans – Yesterday a federal court in the District of Columbia ruled in favor of states in striking down U.S. Treasury regulations that permitted the expansion of small business association health plans. Even before the court ruling, association health plans were not showing promise as cost-saving measures as was hoped. What this means to small businesses is that if they want a lower cost health plan then they must design it themselves independently from an insurance company. The problem is that most firms providing benefits services are primarily in the business of selling insurance rather than lowering costs. Freedom Benefits offers an affordable consultation to help small business owners design and document an alternate small business health plan without necessarily requiring the purchase of insurance.

The history of health care planning in Tennessee (Information is outdated and links may be expired)

2/26/2017 Fears continue to spread throughout the state by some people over the proposed repeal of the Affordable Care Act. They credit the law for allowing access that saved their life. For others who who are eager to leave their Obamacare plan, alternatives to Obamacare are now available.

3/23/2016 – Yesterday a group of Christian clergy connected with Moral Movement Tennessee staged a demonstration at the Tennessee state capital yesterday reading 2,000 Scripture verses that directed believers to care for the poor, sick and suffering. The group is advocating for the passage of Tennessee Governor Bill Haslam’s Insure Tennessee proposal. Insure Tennessee would use federal Medicaid funding to expand health insurance coverage in the state that has been blocked in the state legislature by Republicans, Whatever the reasons behind the denial of Obamacare in Tennessee, it seems clear that Judeo-Christian values are not among them.

10/20/2015  Community Health Alliance will not offer coverage during the 2016. Its 17,000 customers will have to choose other insurance companies open enrollment period that begins Nov. 1 at HealthCare.gov insurance marketplace. The closure follows a rate increase of 45% indicating that the plans were substantally underpriced. Some members are reportedly concerned about being able to afford the more expenseve commercial insurance alternatives.

5/20/2015 The controversial plan to expand Medicaid is dead after the Senate Health and Welfare Committee voted against passing Governor’s Haslam’s Insure Tennessee and funding was omitted from the current state budget. About 280,000 low income residents of Tennessee will be left without coverage as a result of the state’s decision.

12/17/2014 Tennessee Governor Bill Haslam delivered a proposal to expand Medicaid health insurance coverage to about 200,000 low-income Tennesseans.

2/11/2014 Professional support for any health care reform issue is available free of charge through an arrangement with OnlineNavigator. All online inquiries are handled personally by Tony Novak, CPA. Online support is available through a number of popular social media channels including Facebook and Google+ as well as e-mail. Telephone support for insurance enrollment is available through Members Insurance Exchange at (800) 609-0683, extension 1.

7/26/2013 Affordable Smart Term Life Insurance is now available to most Tennessee residents from age 20 through 60 directly online with no physical exam, agent appointment or telephone verification. Most policies are issued on the same day with coverage amounts of $25,000 up to $350,000. The level premium life insurance is available for terms of 10, 15, 20 and 30 years. Sample rates for $150,000 coverage for a preferred risk male age 30, non-tobacco $30.85 per month; tobacco user $49.55 per month. A preferred risk female age 30 non-tobacco user would be $26.49 per month and a tobacco user would be $40.96 per month. Rates are higher for older applicants and lower health risks as described online. Pricing is based on input you provide about your medical history but, unlike most other life insurers, does not consider family medical history. Coverage is issued by innovative National Life Group, rated “A” by A.M. Best Company for 2013.

3/11/2013 This page was updated to include a link to the insurance plan that will be used to determine specific “essential health benefits” for insurance that qualified for 2014 federal tax purposes. Also, a link to additional covered benefits required by state law. Non-qualified insurance is likely to continue to be available at a lower cost that does not include these benefits nor qualify for federal tax purposes.

11/14/2012 – Tennessee’s Medicaid system, once considered a model for national health care reform, has now dropped about 100,000 people according to a report in Kaiser Health News. Others fear this problem may expand to other states as the Affordable Care Act requires states to expand Medicaid coverage but lacks the funding to cover this expense.

4/27/2012 – UnitedHealthcare named Clarksville, Murfreesboro and Nashville Tennessee as a top insurance growth markets for affordable health insurance based on a study of individual health insurance rates across the country. Tennessee was the only state in the study that had three different zip codes turn up as opportunities for consumers to save money by switching to one of the innovative plans offered throughUnitedHealthOne.

3/13/2012 Blue Cross Blue Shield of Tennessee will  pay $1.5 million to the U.S. Department of Health and Human Services to settle potential violations of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). The individuals whose privacy may have been compromised will not be compensated under the settlement agreement. Blue Cross has also agreed to a plan to correct gaps in its HIPAA compliance program. The announcement was made through a press release issued by HHS today.

2/1/2012 The Center for Consumer Information and Insurance Oversight, a division of the Center for Medicare and Medicaid Services (CMS)reported that as of June 30, 2011 BlueCross BlueShield of Tennessee and UnitedHealthcare are the state’s largest health insurance providers and as such, earn the right to set the benchmark for the development of the state’s essential benefit plans to debut in 2014 under health reform law.

2/12/2011 With dozens of health plans choices available online offering a wide range of pricing and benefits, how do you find the best combination of price and benefits? Celtic Insurance realizes that the choices can be overwhelming; the company offers more than 40 possible health plan designs in many parts of the United States. A new feature called “Help Me Choose” lets users easily and quickly select the benefits they value most and narrows the list down to a few of the best choices. No personal information is required other than zip code and date of birth.

2/7/2011 The state’s pre-existing condition insurance plan (PCIP) monthly premium rates (per person):

Plan/Age Band
PCIP will cover a broad range of health benefits, including primary and specialty care, hospital care, and prescription drugs. All covered benefits are available for you, beginning on your coverage effective date, even if it’s to treat a pre-existing condition – there are no waiting periods. PCIP applicants who are approved to participate in PCIP can choose from three plan options, with different levels of premiums, calendar year deductibles, prescription deductibles and prescription copays. The HSA Option provides an opportunity to open a Health Savings Account, a tax-exempt account where you can deposit funds for eligible medical expenses. Each of the three PCIP plan options provides preventive care (paid at 100%, with no deductible) when you see an in-network doctor and the doctor indicates preventive diagnosis. Included are annual physicals, flu shots, routine mammograms and cancer screenings. For other care, you will pay a deductible before PCIP pays for your health care and prescriptions. After you pay the deductible, you will pay 20% of medical costs in-network. The maximum you will pay out-of-pocket for covered services in a calendar year is $5,950 in-network/$7,000 out-of-network. There is no lifetime maximum or cap on the amount the plan pays for your care. If you apply for PCIP coverage on the government Web site, you will be billed for the premium once your application is approved. You will need to send in your payment in order for your coverage to be effective. Please do not send in the premium before you are billed. Note that your premium may increase if you age into a higher rate tier, or if PCIP adjusts its premiums to any changes in the commercial market.

1/30/2011 Patients with health insurance and a credit card now have access to VIP treatment when care is needed at a hospital emergency room. Saint Francis Hospitals in Memphis and Bartlett joined the growing list of hospitals that allows patients to use InQuickER, a reservation system that books appointments and reduces waiting time in the emergency room. The reservation system makes check-in easier by recording your insurance and payment information in advance. The service costs $15 to $25. Of course the nature unpredictable medical emergencies mean that the service cannot absolutely guarantee that you’ll be seen immediately at your appointment time, but you get a full refund if not treated within 15 minutes after arrival. The InQuickER service works in conjunction with any of the private health insurance plans listed here at FreedomBenefits.net but is not available to uninsured patients.

12/16/2010 Tennessee Department of Finance officials met representatives of 44 other states and numerous employees of the federal Health and Human Services Department in Washington DC this week for a two-day working meeting to discuss the next steps in establish a government-run health insurance exchange under the American Health Benefit Exchange Model Act. Their attendance at this meeting was paid for by a $1 million federal grant awarded by HHS in September to the state for research how to set up an insurance exchange. Two states (Alaska and Minnesota) declined to participate, saying that it was a waste of taxpayer money. Four other states (not identified in press reports) that received federal grants did not send representatives to the meeting. Attendees included representatives of 16 states that are suing the federal government in an attempt to overturn the federal health reform law; specifically the requirement that forces individuals to buy health insurance on the insurance exchange or pay a hefty tax fine.

In its initial federal grant request for the insurance exchange project, Tennessee said that it would: 1) Provide major deliverables including policy briefs, legal analyses and contractor studies, including a study on whether to merge the small group and individual markets, 2) Analyze Tennessee’s resources and capabilities with significant additional time spent on program integration and business operations.

The meeting reportedly did not address the role of the commercial health insurance exchanges on the implementation of new competing government systems. The model act does not address inter-state insurance exchange proposals nor insurance sales across state lines. Federal officials admitted that they may not be able to provide further guidance until 2012. Meanwhile, most states are motivated to continue to meet requirements to obtain additional funding promised by the federal government for the establishment of insurance exchange by 2014. Freedom Benefits has previously voiced the opinion that the huge amount of money being spent to set up alternate insurance sales system technologies could be better used providing health benefits to the public. We proposed on the Universal Health Insurance blog that adequate commercial insurance sales systems are already in place that could be modified in a public/private partnership to make health insurance more affordable.

5/14/2010 Diabetes Coverage: A new resource to help find health insurance for diabetics in Tennessee is now available at Freedom Benefits.