8-27-102 - Administration of plan. [Amended effective January 1, 2010. See the Compiler's Notes.] - Tennessee Statutes

8-27-102. Administration of plan. [Amended effective January 1, 2010. See the Compiler's Notes.]

(a)  The state insurance committee has the authority to enter into contracts with insurance companies, claims administrators and other organizations for some or all of the insurance benefits or services, including actuarial and consulting advice, necessary to administer the plans authorized in parts 1, 2 and 7 of this chapter. The procurement of such contracts shall be governed by the provisions of § 12-4-109, and the rules promulgated thereunder.

(b)  The state insurance committee has the authority to promulgate rules and regulations for the purpose of administering the group insurance plan for state officials and employees. Such rules and regulations may include provisions for the handling and resolution of disputes regarding benefits of the insurance plan. (c)  [Amended effective January 1, 2010. See the Compiler's Notes.]

(1)  The state insurance committee has the authority to delegate to a subcommittee or to staff the ability to handle and resolve disputes, including appeals, regarding benefits and the application of medical necessity guidelines of the insurance plan.

     (2)  The subcommittee appointed pursuant to subdivision (c)(1) by the state insurance committee to handle and resolve disputes, including appeals, shall have the authority to grant exceptions to the maximum allowable cost for a covered service if the service is a more cost effective service option than another covered service in the state plan.

[Acts 1976, ch. 804, § 6; T.C.A., § 8-4506; Acts 1990, ch. 776, § 3; 1991, ch. 128, § 1; 1997, ch. 513, § 1; 1999, ch. 116, § 1; 2004, ch. 824, § 1; 2009, ch. 502, § 1.]