Tenn. Comp. R. & Regs. 0780-01-55-.02

Current through December 10, 2024

Section 0780-01-55-.02 - DEFINITIONS

When used in this Chapter, unless the context clearly requires otherwise, the term:

(1) "Commissioner" means the commissioner of the Tennessee Department of Commerce andInsurance;

(2) "Department" means the Tennessee Department of Commerce and Insurance;

(3) "Certified application counselor" means any employee or volunteer of a certified application counselor organization that enters into an agreement with the exchange to have its employees or volunteers:

(a) Provide information to individuals and employees about the full range of qualified health plan options and insurance affordability programs for which they are eligible;

(b) Assist individuals and employees to apply for coverage in a qualified health plan through the exchange and for insurance affordability programs; and

(c) Help to facilitate enrollment of eligible individuals in qualified health plans and insurance affordability programs.

(4) "Certified application counselor organization" means any organization, including an organization designated as a Medicaid certified application counselor organization by a state Medicaid or CHIP agency, designated by the exchange to certify its staff members or volunteers to act as certified application counselors, and includes those organizations described in 45 CFR § 155.225.

(5) "Exchange" means any health benefit exchange established or operating in this state, including any exchange established or operated by the United States Department of Health and Human Services.

(6) "Navigator" means all persons who are certified or are required to be certified by the federal government under the designation of "navigator" under the federal Patient Protection and Affordable Care Act, including any individual or entity, other than an insurance producer licensed pursuant to Title 56, who receives any funding, directly or indirectly, from an exchange, the state, or the federal government to perform any activities and duties identified in 42 U.S.C. 18031(i). Such persons required to be certified as navigators federally include an employee of a navigator grant awardee or sub-grantee of navigator grant awardee who performs the activities and duties identified in 42 U.S.C. 18031(i).

(7) "Person" means any natural or artificial person including, but not limited to, an individual, partnership, association trust or corporation;

(8) "Qualified health plan" has the meaning given such term in 42 U.S.C.A. § 18021(a).

(9) "Registrant" means any person registered under this chapter or any one required to be licensed under this chapter.

Tenn. Comp. R. & Regs. 0780-01-55-.02

Original rule filed July 21, 1989; effective September 4, 1989. Repeal filed April 14, 2004; effective June 28, 2004. Emergency rule filed September 18, 2013; effective through March 17, 2014. Emergency rule filed September 18, 2013 expired effective March 17, 2014; on March 18, 2014, the rule reverted to its previous status. New rule filed February 20, 2015; effective 5/21/2015.

Authority: Tenn. Public Acts 2013, ch. 377, T.C.A. §§ 56-2-301, 56-6-1301 through 56-6-1305, Public Law 111-148 as amended by Public Law 111-152 (2010), 42 U.S.C. § 18021(a), 42 U.S.C. § 18031(i), and 45 CFR Part 155.