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22-21-361
Section 22-21-361 Definitions. The following terms shall have the meanings respectively
ascribed by this section unless the context clearly indicates otherwise: (1) COMMISSIONER.
The commissioner of insurance of this state. (2) DENTAL SERVICE PLAN or PLAN. Any plan or
other arrangement whereby dental services are provided in whole or in part through a dental
service corporation by dentists participating in the plan to provide dental services to those
members of the public who become subscribers to the plan under a contract with such corporation.
The terms "dental service plan" or "plan" do not include an insurer authorized
by the insurance department to transact insurance in this state or to a nonprofit health insurance
plan organized pursuant to Section 10-4-100, or to any policy of insurance or contract
which includes dental benefits issued by such insurer or nonprofit health insurance plan.
(3) DEPARTMENT. The Department of Insurance. (4) LICENSE. The certificate of authority issued...
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22-21-375
Section 22-21-375 Issuance of license; revocation; procedures for review and mediation
of complaints. (a) The Department of Insurance shall issue a license to each applicant upon
payment of the prescribed fees and upon being satisfied that: (1) The applicant has been organized
in a bona fide manner for the purpose of establishing, maintaining, and operating a dental
service plan. (2) Each contract executed, or proposed to be executed, by the applicant and
a dentist obligates, or will when executed obligate, such dentist to render the service or
accept payment for the service to which each subscriber may be entitled under the terms of
the contract issued to the subscriber. (3) Each contract issued, or proposed to be issued,
to subscribers is in a form approved by the department and that the rates charged, or proposed
to be charged, for each form of such contract and benefits to be provided pursuant thereto
are fair and reasonable and are actuarially sound. (4) No contributions to the...
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27-1-17
Section 27-1-17 Limitation periods for payment of claims; overdue claims; retroactive
denials, adjustments, etc.; penalties. (a) Each insurer, health service corporation, and health
benefit plan that issues or renews any policy of accident or health insurance providing benefits
for medical or hospital expenses for its insured persons shall pay for services rendered by
Alabama health care providers within 45 calendar days upon receipt of a clean written claim
or 30 calendar days upon receipt of a clean electronic claim. If the insurer, health service
corporation, or health benefit plan is denying or pending the claim, the insurer, health service
corporation, or health benefit plan shall, within 45 calendar days for a written claim and
30 calendar days for an electronic claim, notify the health care provider or certificate holder
of the reason for denying or pending the claim and what, if any, additional information is
required to process the claim. Any undisputed portion of the claim...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-1-17.htm - 17K - Match Info - Similar pages
22-21-371
Section 22-21-371 Individual, group, blanket or franchise contracts authorized; certificates
of coverage; filing and approval of contracts and certificates; requirements; grounds for
disapproval. (a) Dental service plan contracts may be written on individual, group, blanket
or franchise basis. Each contractual obligation for such dental service(s) must be evidenced
by a contract. Each person covered under a group contract must be issued a certificate of
coverage. (b) No contract or certificate of dental service benefits may be issued in this
state unless a copy of the form has been filed and approved by the commissioner. (c) The commissioner
may not approve any form that does not meet the following requirements: (1) Contracts must
contain a list and description of the dental service payments promised or the dental work
for which expenses are to be reimbursed, and any limits on the amounts to be paid or reimbursed;
(2) Contracts and certificates must indicate the name of the dental...
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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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22-21-366
Section 22-21-366 Subscriber rates subject to approval of department; provisions in
contract between corporation and dentist. (a) The rates charged by a dental service plan corporation
to the subscribers for dental services shall at all times be subject to the approval of the
department. (b) Every contract between a dental service plan corporation and a dentist, whereby
the plan provides for payment of a fee or fees to the dentist for dental services rendered
by the dentist to subscribers, shall contain a clause stating that the dental service plan
corporation shall be liable for such fee or fees rather than the subscribers receiving said
dental services. Such contract shall also contain a clause whereby, upon termination of the
contract by either party or upon expiration thereof, a dentist is obligated to complete any
procedure which he has undertaken upon any subscriber. (Acts 1982, No. 82-463, p. 741, ยง7.)...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-21-366.htm - 1K - Match Info - Similar pages
22-21-386
Section 22-21-386 Examination and investigation of corporations by department; power
to summon and examine witnesses; payment of expenses. (a) The Department of Insurance, any
agent or examiner of the department, or any other person appointed by the department shall
have the power of visitation and examination into the affairs, transactions, accounts, business
records, and assets of any such dental service plan corporation, shall have free access to
all of the books, papers, and documents that relate to the business of the corporation, may
summon and qualify witnesses under oath, and may examine its officers, agents, and employees
or other relative persons regarding the affairs, transactions, and condition of the corporation.
The corporation whose affairs are examined shall pay to the department for deposit into the
State Treasury the traveling expenses and any other expenses of the examiner or other person
making the examination which shall be credited as provided by Section...
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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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22-21-363
Section 22-21-363 Application for certificate of authority; contents. (a) The incorporators
shall file with the commissioner an application for a certificate of authority to do business
upon a form to be furnished by the department, which shall include or have attached the following:
(1) The names, and for the preceding 10 years, all addresses and all occupations of all incorporators
and proposed directors and officers; (2) A certified copy of the corporate articles and bylaws
and all amendments thereto, a list of the names, addresses, and occupations of all directors
and principal officers and, if previously incorporated, for the three most recent years, the
corporation annual statements and reports; (3) All agreements relating to the corporation
to which any incorporator or proposed director or officer is a party; (4) A statement of the
amount and sources of the funds available for organization expenses and the proposed arrangements
for reimbursement and compensation of incorporators...
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11-95-7
Section 11-95-7 Powers of corporation. In addition to all other powers granted elsewhere
in this chapter, a corporation shall have the following powers, together with all powers incidental
thereto or necessary to the discharge thereof in corporate form: (1) To have succession by
its corporate name for the duration of time (which may be perpetuity, subject to the provisions
of Section 11-95-19) specified in its certificate of incorporation; (2) To sue and
be sued in its own name in civil suits and actions, and to defend suits against it; (3) To
adopt and make use of a corporate seal and to alter the same at pleasure; (4) To adopt and
alter bylaws for the regulation and conduct of its affairs and business; (5) To acquire, construct,
equip, enlarge, improve, maintain, and operate hospital facilities in the authorizing county
and to do all things necessary to that end; (6) To receive, acquire, take and hold, whether
by purchase, gift, lease, devise, or otherwise, real and personal property...
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