TN State Updates - 2015 Jan 03 No.01

On Oct. 22, 2015, the Tennessee Insurance Division released Bulletin No. 15-01 in response to the passage of the PACE Act. In light of the PACE Act’s passage, and since Tennessee law is currently consistent with federal law (as amended), for plan years that begin on or after Jan. 1, 2016, Tennessee defines small employers as those who employed on average 1-50 employees on business days during the preceding calendar year. Large employers will be defined as those who employed an average of at least 51 employees on business days during the preceding calendar year. Tennessee will not be applying the state option to extend the definition of small group to those employing 1-100. However, pursuant to subsequent guidance issued by CMS (see the article in this edition of Compliance Corner), carriers may use a 1-100 definition of small employer for 2015 MLR purposes, but must use 1-50 definition in subsequent years.

It is important to note that the PACE Act deals only with from which market (small or large) an employer must buy its plan. It does not alter in any way the PPACA employer mandate that requires an employer with 50 or more full-time equivalent employees to offer an affordable, minimum value plan or face penalties. That federal requirement? continues.

Bulletin No. 15-01 »