27-19-105
Section 27-19-105 Regulations for long-term care policies; outline of coverage, policy summary, and monthly report. (a) The commissioner may adopt regulations that include standards for full and fair disclosure setting forth the manner, content, and required disclosures for the sale of long-term care insurance policies, terms of renewability, initial and subsequent conditions of eligibility, nonduplication of coverage provisions, coverage of dependents, preexisting conditions, termination of insurance, continuation or conversion, probationary periods, limitations, exceptions, reductions, elimination periods, requirements for replacement, recurrent conditions, and definitions of terms. Regulations under this subsection should recognize the developing and unique nature of long-term care insurance and the distinction between group and individual long-term insurance policies. (b) No long-term care insurance policy may do any of the following: (1) Be cancelled, nonrenewed, or otherwise...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-19-105.htm - 11K - Match Info - Similar pages
27-54-4
Section 27-54-4 Illnesses covered; requirements of benefit plans, etc. (a) All group health benefit plans shall offer to provide, at a minimum, additional benefits according to this chapter for a person receiving medical treatment for any of the following mental illnesses diagnosed by an appropriately licensed provider. (1) Schizophrenia, schizophrenia form disorder, schizo affective disorder. (2) Bipolar disorder. (3) Panic disorder. (4) Obsessive-compulsive disorder. (5) Major depressive disorder. (6) Anxiety disorders. (7) Mood disorders. (8) Any condition or disorder involving mental illness, excluding alcohol and substance abuse, that falls under any of the diagnostic categories listed in the mental disorders section of the International Classification of Disease, as periodically revised. (b) All group health benefit plans, policies, contracts, and certificates executed, delivered, issued for delivery, continue, or renewed in this state on or after January 1, 2001, shall offer, at...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-54-4.htm - 3K - Match Info - Similar pages
27-1-20
Section 27-1-20 Patient Right to Know Act. (a) This section shall be known and may be cited as the "Patient Right to Know Act." (b) As used in this section, unless the context clearly indicates otherwise, the following words shall have the following meanings: (1) ENROLLEE. A person who purchases individual health care coverage or an employer who purchases a group health care plan. (2) PROVIDER. A physician, dentist, podiatrist, pharmacist, optometrist, psychologist, clinical social worker, advanced nurse practitioner, registered optician, licensed professional counselor, physical therapist, and chiropractor. (c)(1) All persons, firms, corporations, associations, health maintenance organizations, health insurance services, or preferred provider organizations, any employer-sponsored health benefit plan, or any similar organization or entity, providing health, accident, or dental insurance coverage, either directly or indirectly, shall provide an enrollee with a written description of the...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-1-20.htm - 3K - Match Info - Similar pages
36-29-6
Section 36-29-6 Authorization and execution of contracts; documentation of benefits. (a) The board is hereby authorized to execute a contract or contracts to provide the plan determined in accordance with the provisions of this chapter. Such contract or contracts may be executed with one or more agencies or corporations licensed to transact or administer group health insurance business in this state. All of the benefits to be provided under this chapter may be included in one or more similar contracts issued by the same or different companies. (b) Before entering into any contract or contracts authorized by subsection (a) of this section, the board shall invite competitive bids from all qualified entities who may wish to administer or offer plans for the health insurance coverage desired. The board shall award such contract or contracts on a competitive basis as determined by the benefits afforded, administrative costs, the costs to be incurred by employee, retiree, and employer, the...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/36-29-6.htm - 3K - Match Info - Similar pages
27-1-10.1
Section 27-1-10.1 Insurance coverage for drugs to treat life-threatening illnesses. (a) The Legislature finds and declares the following: (1) The citizens of this state rely upon health insurance to cover the cost of obtaining health care and it is essential that the citizens' expectation that their health care costs will be paid by their insurance policies is not disappointed and that they obtain the coverage necessary and appropriate for their care within the terms of their insurance policies. (2) Some insurers deny payment for drugs that have been approved by the Federal Food and Drug Administration, hereafter referred to as FDA, when the drugs are used for indications other than those stated in the labelling approved by the FDA, off-label use, while other insurers with similar coverage terms do pay for off-label use. (3) Denial of payment for off-label use can interrupt or effectively deny access to necessary and appropriate treatment for a person being treated for a...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-1-10.1.htm - 6K - Match Info - Similar pages
27-51-1
Section 27-51-1 Payment for services of licensed physician assistant. (a) An insurance policy or contract providing for third-party payment or prepayment of health or medical expenses shall include a provision for the payment to a supervising physician for necessary medical or surgical services that are provided by a licensed physician assistant practicing under the supervision of the physician, and pursuant to the rules, regulations, and parameters for physician assistants, if the policy or contract pays for the same care and treatment provided by a licensed physician or doctor of osteopathy. (b) An insurance policy or contract subject to this section shall not impose a practice or supervision restriction which is inconsistent with or more restrictive than provided by law. (c) This section shall apply to services provided under a policy or contract delivered, continued, or renewed in this state on or after August 1, 1997, and to any existing policy or contract, on the policy's or...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-51-1.htm - 2K - Match Info - Similar pages
27-19A-12
Section 27-19A-12 Dental services - Coverages; fees; exceptions. (a) As used in this section, the following terms shall have the following meanings: (1) COVERED PERSON. Any individual, family, or family member on whose behalf third-party payment or prepayment of health or medical expenses is provided under an insurance policy, plan, or contract providing for third-party payment or prepayment of health care or medical expenses. (2) COVERED SERVICES. Dental care services for which a reimbursement is available under an enrollee's plan contract, or for which a reimbursement would be available but for the application of contractual limitations such as deductibles, copayments, coinsurance, waiting periods, annual or lifetime maximums, frequency limitations, alternative benefit payments, or any other limitation. (3) DENTAL CARE PROVIDER. A licensed dentist. (4) DENTAL PLAN. Includes any policy of insurance which is issued by a health care service contractor which provides for coverage of...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-19A-12.htm - 2K - Match Info - Similar pages
16-25A-7
Section 16-25A-7 Authorization and execution of contracts; evidence of coverage; denial of claims. (a) The board is hereby authorized to execute a contract or contracts to provide for the benefits or the administration of the plan determined in accordance with the provisions of this article. Such contract or contracts may be executed with one or more agencies or corporations licensed to transact or administer group health insurance business in this state. All of the benefits to be provided under this article may be included in one or more similar contracts issued by the same or different companies. The board is further authorized to develop a plan whereby it may become self-insured upon its finding that such arrangement would be financially advantageous to the state and plan participants. (b) Before entering into any contract or contracts authorized by subsection (a), the board shall invite competitive bids from all qualified entities who may wish to administer or offer plans for the...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/16-25A-7.htm - 4K - Match Info - Similar pages
30-3D-502
Section 30-3D-502 Employer's compliance with income-withholding order of another state. (a) Upon receipt of an income-withholding order, the obligor's employer shall immediately provide a copy of the order to the obligor. (b) The employer shall treat an income-withholding order issued in another state which appears regular on its face as if it had been issued by a tribunal of this state. (c) Except as otherwise provided in subsection (d) and Section 30-3D-503, the employer shall withhold and distribute the funds as directed in the withholding order by complying with terms of the order which specify: (1) the duration and amount of periodic payments of current child support, stated as a sum certain; (2) the person designated to receive payments and the address to which the payments are to be forwarded; (3) medical support, whether in the form of periodic cash payment, stated as a sum certain, or ordering the obligor to provide health insurance coverage for the child under a policy...
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27-54-2
Section 27-54-2 Definitions. For purposes of this chapter, the following terms have the following meanings: (1) DAY TREATMENT SERVICES. Includes, but is not limited to: Physiological, psychological, and psychosocial concepts, techniques, and processes necessary to maintain or develop functional skills of clients, provided to individuals and groups for periods of more than two hours but less than 24 hours a day. (2) HEALTH BENEFIT PLAN. A health care service plan governed by the provisions of Article 6, Chapter 4, Title 10, and a group health insurance policy, including an employee welfare health benefit plan, that covers hospital, medical, or surgical expenses, issued by insurers, health maintenance organizations, preferred provider organizations, medical service organizations, physician-hospital organizations, or any other person, firm, corporation, joint venture, or other similar business entity that pays for, purchases, or furnishes health care services to patients, insureds, or...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-54-2.htm - 3K - Match Info - Similar pages
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