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25-5-8
foregoing, the insurance association, organization, or corporation shall have first had its
contract and plan of business approved in writing by the Commissioner of the Department of
Insurance of Alabama and have been authorized by the Department of Insurance to transact the
business of workers' compensation insurance in this state and under the plan. Notwithstanding
any other provision of the law to the contrary, the obligations of employers under law for
workers' compensation benefits for injury of employees may be insured by any combination
of life, disability, accident, health, or other insurance provided that the coverages insure
without limitation or exclusion the workers' compensation benefits of this state. (b) Option
to operate as self-insurer. An employer subject to this chapter who elects not to insure his
or her liability thereunder shall furnish satisfactory proof to the secretary of his or her
financial ability to pay directly compensation in the amount and manner and...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/25-5-8.htm - 14K - Match Info - Similar pages
27-19-22
Section 27-19-22 Optional policy provisions - Relation of earnings to insurance. (a) There
may be a provision as follows: "Relation of Earnings to Insurance: If the total monthly
amount of loss of time benefits promised for the same loss under all valid loss of time coverage
upon the insured, whether payable on a weekly or monthly basis, shall exceed the monthly earnings
of the insured at the time disability commenced or his average monthly earnings for the period
of two years immediately preceding a disability for which claim is made, whichever is the
greater, the insurer will be liable only for such proportionate amount of such benefits under
this policy as the amount of such monthly earnings or such average monthly earnings of the
insured bears to the total amount of monthly benefits for the same loss under all such coverage
upon the insured at the time such disability commences and for the return of such part of
the premiums paid during such two years as shall exceed the pro rata...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-19-22.htm - 2K - Match Info - Similar pages
27-19-39
Section 27-19-39 Policies, etc., providing for reimbursement for visual service. Whenever any
policy of insurance or any medical service plan or hospital service contract or hospital and
medical service contract provides for reimbursement for any visual service in Alabama which
is within the lawful scope of practice of a duly licensed optometrist, as defined in Section
34-22-1, the insured or other person entitled to benefits under such policy shall be entitled
to reimbursement for such services, whether such services are performed by a duly licensed
physician or by a duly licensed optometrist, whichever the insured selects, notwithstanding
any provision to the contrary in any statute or in such policy, plan, or contract. Duly licensed
optometrists shall be entitled to participate in such policies, plans, or contracts providing
for visual services to the same extent as fully licensed physicians. (Acts 1967, No. 508,
p. 1224.)...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-19-39.htm - 1K - Match Info - Similar pages
27-56-2
Section 27-56-2 Definitions. As used in this chapter, 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) EYE CARE PROVIDER. A licensed optometrist or a licensed ophthalmologist. (3)
INSURANCE POLICY, PLAN, OR CONTRACT PROVIDING FOR THIRD-PARTY PAYMENT OR PREPAYMENT OF HEALTH
OR MEDICAL EXPENSES. Includes an individual or group policy for accident or health insurance,
an individual or group hospital or health care service contract, an individual or group health
maintenance organization contract, an organized delivery system contract, or a preferred provider
organization contract, and any other similar policy, plan, or contract. This term shall not
include any employee welfare benefit plan, as defined...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-56-2.htm - 1K - Match Info - Similar pages
36-29-13
Section 36-29-13 Appropriations to board; recognition of Medicaid premiums paid by retiree.
(a) There is hereby provided from the funds of the State Employees' Health Insurance Plan
$1,592,605.00 (estimated) for the fiscal year beginning October 1, 1985. The State Employees'
Insurance Board is hereby authorized to expend $22.35 per month per eligible retired employee
towards coverage for said retired employee for the fiscal year beginning October 1, 1985.
(b) It is the intent of the Legislature that subsequent appropriations to the State Employees'
Insurance Board pursuant to this section shall be included in the appropriations made for
active employees from employer funds pursuant to subsection (d) of Section 36-29-7 beginning
with the fiscal year 1986-87 and each year thereafter and shall be increased to fully fund
the employer's portion of the benefits provided for in Section 36-29-10. (c) The board shall
recognize any Medicare premium paid by a retiree in determining any increases...
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36-29-5
Section 36-29-5 Expenses, treatment, etc., not to be included under plan. (a) Such health insurance
shall not include any of the following: (1) Expenses incurred by or on account of an individual
prior to the effective date of the plan. (2) Cosmetic surgery or treatment, except to the
extent necessary for correction of damages caused by accidental injury while covered
by the plan or as a direct result of disease covered by the plan. (3) Services received in
a hospital owned or operated by the United States government for which no charge is made.
(4) Services received for injury or sickness due to war or any act of war, whether
declared or undeclared, which war or act of war shall have occurred after the effective date
of this plan. (5) Expenses for which the individual is not required to make payment. (6) Expenses
to the extent of benefits provided under any employer group plan other than the plan in which
the state participates in the cost thereof. (7) Such other expenses as may be...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/36-29-5.htm - 1K - Match Info - Similar pages
36-34-2
Section 36-34-2 Local units authorized to participate in certain health insurance plan. As
an alternative to the provisions of Section 36-34-1, the local units are authorized to participate
in a health insurance plan developed by the State Employees' Insurance Board or the Alabama
Retired State Employees' Association to provide health insurance coverage to retirees, designated
beneficiaries, and surviving spouses of active members of the local units who are receiving
benefits from the Employees' Retirement System. The costs of extending the health insurance
to the retirees, designated beneficiaries, or surviving spouses under the aforementioned developed
health insurance plan may be paid from any funds available to the local units which are otherwise
unencumbered. (Acts 1995, No. 95-771, p. 1829, §2.)...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/36-34-2.htm - 1K - Match Info - Similar pages
16-22-8
Section 16-22-8 Dental insurance. (a) It is the intent of the Legislature that the annual allotments
for hospital medical insurance made to educational personnel may be used to purchase dental
insurance. (b) Local boards of education shall approve the plan and carrier for dental coverage.
Employee review and evaluation of available policies shall be considered by the board before
final approval of a plan. (Acts 1982, 1st Ex. Sess., No. 82-673, p. 106, §§1, 2.)...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/16-22-8.htm - 786 bytes - Match Info - Similar pages
27-3A-3
Section 27-3A-3 Definitions. As used in this chapter, the following words and phrases shall
have the following meanings: (1) DEPARTMENT. The Alabama Department of Public Health. (2)
ENROLLEE. An individual who has contracted for or who participates in coverage under an insurance
policy, a health maintenance organization contract, a health service corporation contract,
an employee welfare benefit plan, a hospital or medical services plan, or any other benefit
program providing payment, reimbursement, or indemnification for health care costs for the
individual or the eligible dependents of the individual. (3) PROVIDER. A health care provider
duly licensed or certified by the State of Alabama. (4) UTILIZATION REVIEW. A system for prospective
and concurrent review of the necessity and appropriateness in the allocation of health care
resources and services given or proposed to be given to an individual within this state. The
term does not include elective requests for clarification of...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-3A-3.htm - 3K - Match Info - Similar pages
45-8A-22.118
in the plan, then the defined benefit dollar limitation of subsection (b) shall be multiplied
by a fraction, a. the numerator of which is the number of years, or part thereof, of participation
in the plan, and b. the denominator of which is 10. However, in no event shall such fraction
be less than 1/10th. Notwithstanding the foregoing, no adjustment shall be made to the defined
benefit dollar limitation for a distribution on account of a participant becoming disabled
by reason of personal injuries or sickness, or as a result of the death of a participant.
For purposes of this section, a "year of participation" means each accrual computation
period for which the following conditions are met: a. the participant is credited with a period
of service for benefit accrual purposes, required under the terms of the plan in order to
accrue a benefit for the accrual computation period, and b. the participant is included as
a participant under the eligibility provisions of the plan for...
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