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16-25A-4
Section 16-25A-4 Relationship between benefits and expenses; reasonable controls on utilization
and for stability. The health insurance plan provided for in this article shall be designed
by the board to provide a reasonable relationship between the hospital, surgical, and medical
benefits to be included and the expected hospital, surgical, and medical expenses to be incurred
by the affected employee and retiree and dependents and to include reasonable controls, which
may include, but are not limited to, deductible, copayment, coinsurance, and other cost containment
measures to prevent unnecessary utilization of the various hospital, surgical, and medical
services available and to provide reasonable assurance of stability in future years for the
plan. (Acts 1983, No. 83-455, p. 640, §4; Act 2004-646, 1st Sp. Sess., p. 6, §2.)...
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36-29-3
Section 36-29-3 Factors to be considered by board in design of health insurance plan. The health
insurance plan provided for in this chapter shall be designed by the State Employees' Insurance
Board to provide a reasonable relationship between the hospital, surgical, and medical benefits
to be included and the expected hospital, surgical, and medical expenses to be incurred by
the affected employee and retiree and dependents and to include reasonable controls, which
may include, but are not limited to, deductible, copayment, coinsurance, and other cost containment
measures to prevent unnecessary utilization of the various hospital, surgical, and medical
services available and to provide reasonable assurance of stability in future years for the
plan. (Acts 1965, No. 833, p. 1564, §5; Act 2004-647, 1st Sp. Sess., p. 17, §1.)...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/36-29-3.htm - 1K - Match Info - Similar pages
11-91A-2
Section 11-91A-2 Local Government Health Insurance Board; governance and administration of
program. (a) The Local Government Health Insurance Board shall govern and administer the Local
Government Health Insurance Program currently governed and administered by the State Employees'
Insurance Board (SEIB) pursuant to Chapter 29 of Title 36. The transfer of the governance
and administration to the board shall take effect at 12:01 a.m. on January 1, 2015, and thereafter
the board shall take all control and responsibility for the program under procedures and authority
set out in this chapter. (b) The program governed and administered by the board shall provide
a reasonable relationship between the health care benefits to be included and the expected
health care expenses to be incurred by affected employees, retirees, and their dependents.
The board may establish a fully insured or self-insured health care plan for employees and
retirees as defined in this chapter and may adopt rules for the...
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27-54A-2
Section 27-54A-2 Treatment under certain policies and contracts. (a) As used in this section,
the following words have the following meanings: (1) APPLIED BEHAVIOR ANALYSIS. The design,
implementation, and evaluation of environmental modifications, using behavioral stimuli and
consequences, to produce socially significant improvement in human behavior, including the
use of direct observation, measurement, and functional analysis of the relationship between
environment and behavior. (2) AUTISM SPECTRUM DISORDER. Any of the pervasive developmental
disorders or autism spectrum disorders as defined by the most recent edition of the Diagnostic
and Statistical Manual of Mental Disorders (DSM) or the edition that was in effect at the
time of diagnosis. (3) BEHAVIORAL HEALTH TREATMENT. Counseling and treatment programs, including
applied behavior analysis that are both of the following: a. Necessary to develop, maintain,
or restore, to the maximum extent practicable, the functioning of an...
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27-19-103
would result in economies of acquisition or administration. 3. The benefits are reasonable
in relation to the premiums charged. (5) LONG-TERM CARE INSURANCE. Any insurance policy or
rider advertised, marketed, offered, or designed to provide coverage for not less than 12
consecutive months for each covered person on an expense incurred, indemnity, prepaid, or
other basis for one or more necessary or medically necessary diagnostic, preventive, therapeutic,
rehabilitative, maintenance, or personal care services, provided in a setting other
than an acute care unit of a hospital. This term includes group and individual annuities and
life insurance policies or riders that provide directly or that supplement long-term care
insurance. This term also includes a policy or rider that provides for payment of benefits
based upon cognitive impairment or the loss of functional capacity. The term shall also include
qualified long-term care insurance contracts. Long-term care insurance may be...
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34-29-61
VETERINARIAN. A person who is validly and currently licensed to practice veterinary medicine
in Alabama. (13) LICENSED VETERINARY TECHNICIAN. A person who is validly and currently licensed
to practice as a veterinary technician in Alabama. (14) PERSON. Any individual, firm, partnership,
association, joint venture, cooperative, or corporation or any other group or combination
acting in concert; and whether or not acting as a principal, trustee, fiduciary, receiver,
or as any kind of legal or personal representative, or as the successor in interest,
assigning agent, factor, servant, employee, director, officer, or any other representative
of such person. (15) PRACTICE OF VETERINARY MEDICINE: a. To diagnose, treat, correct, change,
relieve, or prevent animal disease, deformity, defect, injury, or other physical or
mental condition; including the prescription or administration of any drug, medicine, biologic,
apparatus, application, anesthesia, or other therapeutic or diagnostic...
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25-5-1
an artificial member of the body by accidental means. (8) INJURIES BY AN ACCIDENT ARISING OUT
OF AND IN THE COURSE OF THE EMPLOYMENT. Without otherwise affecting either the meaning or
interpretation of the clause, the clause does not cover workers except while engaged in or
about the premises where their services are being performed or where their service requires
their presence as a part of service at the time of the accident and during the hours of service
as workers. (9) INJURY. "Injury and personal injury"
shall mean only injury by accident arising out of and in the course of the employment,
and shall not include a disease in any form, except for an occupational disease or where it
results naturally and unavoidably from the accident. Injury shall include physical
injury caused either by carpal tunnel syndrome disorder or by other cumulative trauma
disorder if either disorder arises out of and in the course of the employment, and breakage
or damage to eyeglasses, hearing aids,...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/25-5-1.htm - 9K - Match Info - Similar pages
27-55-2
Section 27-55-2 Definitions. As used in this chapter, these terms shall have the following
meanings: (1) ABUSE. The occurrence of one or more of the following acts by a family or household
member, as defined by subdivision (3) of subsection (b) of Section 15-10-3: a. Attempting
to cause or intentionally, knowingly, or recklessly causing another person, including a minor
child, bodily injury, severe emotional injury, or psychological trauma or conduct
which constitutes the crime of rape. b. Intentionally following another person, including
a minor child, without proper authority, under circumstances that place the person in reasonable
fear of bodily injury or physical harm. c. Subjecting another person, including a minor
child, to false imprisonment or kidnapping. d. Attempting to cause or intentionally, knowingly,
or recklessly causing damage to property to intimidate or attempt to control the behavior
of another person, including a minor child. e. Assault, child abuse, criminal...
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34-25A-3
and require the generation of an image, form, or mold that replicates the patient's body or
body segment and involves the rectification of dimensions, contours, and volumes to achieve
proper fit, comfort, and function for that specific patient. Except for the treatment of scoliosis,
orthosis does not include prefabricated or direct-formed orthotic devices, as defined in this
subdivision and does not include any of the following items: Commercially available knee orthoses
used following injury or surgery; upper extremity adaptive equipment; finger splints;
leather wrist gauntlets; face masks used following burns; wheelchair seating that is an integral
part of the wheelchair and not worn by the patient independent of the wheelchair; fabric or
elastic supports; corsets; arch supports, also known as non-custom or prefabricated orthotics;
low-temperature formed plastic splints; trusses; elastic hose; canes; crutches; cervical collars;
dental appliances, and other similar devices as...
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27-19-31
Section 27-19-31 Renewability. (a) Every individual policy of insurance providing hospital,
medical, or surgical benefits in which an insurer reserves the right to refuse renewal on
an individual basis shall provide, in substance, in a provision thereof, or in an endorsement
thereon or in a rider attached thereto that, subject to the right to terminate the policy
upon nonpayment of premium when due, such right to refuse renewal shall not be exercised before
the renewal date occurring on, or after and nearest, each policy anniversary or, in the case
of lapse and reinstatement, before the renewal date occurring on, or after and nearest, each
anniversary of the last reinstatement and that any refusal of renewal shall be without prejudice
to any claim originating while the policy is in force. Subject to the right to terminate for
nonpayment of premium, the right to refuse renewal by an insurer shall only be exercised after
having given the insured no less than 30 days' notice in writing of...
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