Buying a short-term plan in Tennessee
- Tennessee defaults to federal short-term health insurance rules.
- Short-term plans can have initial terms up to 364 days and total duration of up to 36 months.
- Tennessee’s Insurance Commissioner has generally expressed support for the expansion of short-term plans.
- Tennessee’s Tri-City area has the highest rate of pre-existing conditions in the nation – and short-term plans don’t cover pre-existing conditions.
- Tennessee has rate and form filing requirements for short-term plans.
- Several sections of Tennessee insurance statute apply to short-term plans.
- At least seven insurers offer short-term plans in Tennessee.
Tennessee follows federal guidelines on short-term plans
Tennessee does not limit the duration of short-term plans, so the state defaults to the federal rules. The Trump Administration’s new regulations allow short-term health insurance plans to have initial terms of up to 364 days, and total duration, including renewals, of up to 36 months (prior to October 2, federal rules limited short-term plans to three months in duration and renewals were prohibited). Insurers can impose shorter maximum terms however, and can opt not to allow renewals.
The President of the National Association of Insurance Commissioners (NAIC), Julie Mix McPeak, serves as the Insurance Commissioner for Tennessee. In April 2018, NAIC submitted a letter to HHS that was generally supportive of the then-proposed rule change to expand access to short-term health insurance plans. In particular, NAIC supported the provision to allow short-term plans to have initial terms of up to 364 days, instead of the three-month limit that was imposed under a regulation finalized by the Obama Administration in 2016.
Mix McPeak has expressed support for the expansion of short-term plans, while also noting how important it is for consumers to understand what they’re buying, and how short-term health plans differ from ACA-compliant plans.
It’s noteworthy that Northeastern Tennessee’s Tri-Cities has the highest rate of pre-existing conditions in the US: 41 percent of adults in that area have health conditions that would have prevented them from buying individual market health insurance prior to 2014 (when the ACA reformed that market and banned medical underwriting). The short-term market, however, still uses medical underwriting, and the policies generally do not cover pre-existing conditions
Tennessee regulations and short-term health insurance
Insurers that offer short-term plans in Tennessee are required to file the rates and plans with the Tennessee Department of Commerce and Insurance, and there are specific state rules that apply to rate and form filing in Tennessee for plans that aren’t subject to ACA regulations (including short-term health plans).
Several sections of Tennessee insurance statute (Title 56) apply to short-term plans sold in the state, including:
- 56-7-2301 – 2368, Mandated Insurer or Plan Coverage
- 56-7-2401 – 2410, Mandated Scope of Practice
- 56-7-2501 – 2508, Mandated Insurer or Plan Options
- 56-7-2601 – 2606, Mandated Offerings of Coverage
At least six insurers offer short-term plans in Tennessee
- Companion Life
- Everest Prime
- Independence American Insurance Company
- National General
- Standard Life
- National General
Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org. Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.