Federal COBRA, HIPAA and the ACA are covered in the national Group Health Insurance guide. This guide covers the Tennessee rules for group health. Start with one big change: in 2025, Public Chapter 183 deleted Tenn. Code Ann. 56-7-2312 through 56-7-2322, which held Tennessee's own group continuation and conversion law. Questions based on the old state continuation rules are out of date. For employers covered by federal COBRA, continuation now comes from COBRA.

Benefit reductions and coordination (56-7-2323, 56-7-2324)

• A group accident and sickness policy can't exclude or reduce benefits because the person also has:
  • blanket or franchise school accident coverage, or
  • an individual policy the insured or family pays for entirely
• The non-reduction rule doesn't apply to a student accident policy when the school is the policyholder and pays 100% of the premium, with no contribution from students or parents.
• School children's accident policies: when written notice and a physician's statement are timely, the policy pays medical expenses incurred within 1 year of the accident (56-7-2325).

Dependency benefits (56-7-2602)

• The insurer must offer the required dependency benefits to the group.
• The group policyholder may reject them, or choose an alternative level of benefits if one is offered.

Group-related licensing and conduct

• HMO agents need a producer license with the accident and health line (Rule 0780-01-56-.10).
• The military sales rule doesn't apply to stand-alone health and disability income policies (Rule 0780-01-89-.04).

Common exam traps

• Tennessee's state group continuation and conversion law was repealed in 2025 (Pub. Ch. 183). Don't apply the old state continuation periods.
• A group plan can't reduce benefits because of individually paid coverage or school accident coverage.
• Dependency benefits must be offered, but the group policyholder can reject them.