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22-21B-3
Section 22-21B-3 Definitions. The following words and terms shall have the meanings ascribed
to them in this section, unless otherwise required by their respective context: (1) CONSCIENCE.
The religious, moral, or ethical principles held by a health care provider. (2) DISCRIMINATION.
Discrimination includes, but is not limited to: Hiring, termination, refusal of staff privileges,
refusal of board certification, demotion, loss of career specialty, reduction of wages or
benefits, adverse treatment in the terms and conditions of employment, refusal to award any
grant, contract, or other program, or refusal to provide residency training opportunities.
(3) HEALTH CARE PROVIDER. Any individual who may be asked to participate in any way in a health
care service, including, but not limited to: A physician, physician's assistant, nurse, nurse's
aide, medical assistant, hospital employee, clinic employee, nursing home employee, pharmacist,
researcher, medical or nursing school faculty, student,...
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26-23C-2
Section 26-23C-2 Legislative findings. (a) The Legislature of the State of Alabama finds all
of the following: (1) Under the Patient Protection and Affordable Care Act, P.L. 111-148,
federal tax dollars, via affordability credits, subsidies provided to individuals between
150-400 percent of the federal poverty level, are routed to exchange participating health
insurance plans, including plans that provide coverage for abortions. (2) Federal funding
of insurance plans that provide abortions is an unprecedented change in federal abortion funding
policy. The Hyde Amendment, as passed each year in the Labor Health and Human Services Appropriations
bill, and the Federal Employee Health Benefits Program, FEHBP, prohibit federal funds from
subsidizing health insurance plans that provide abortions. Under this new law, however, exchange
participating health insurance plans that provide abortions can receive federal funds. (3)
The provision of federal funding for health insurance plans that...
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27-57-2
Section 27-57-2 Coverage; applicability. (a) All group health benefit plans, policies, contracts,
and certificates executed, delivered, issued for delivery, continued, or renewed in this state
on or after August 1, 2004, shall offer, at the time of proposal, sale, or renewal of a policy
subject to this chapter, to include colorectal cancer examinations within the coverage. Such
offer of coverage shall include colorectal cancer examinations for covered persons who are
50 years of age or older, or for covered persons who are less than 50 years of age and at
high risk for colorectal cancer according to current American Cancer Society colorectal cancer
screening guidelines. (b) This chapter shall apply to group accident and sickness insurance
policies issued by a fraternal benefit society, a nonprofit hospital service corporation,
a nonprofit medical service corporation, a group health care plan, a health maintenance organization,
or any similar entity. (Act 2004-502, p. 969, §2.)...
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11-91A-3
Section 11-91A-3 Employee, retiree, and dependent coverage; premiums; summary documents. (a)
All full-time employees, elected officials, and retirees of employer participants who are
eligible for health care benefits for themselves or their dependents under the provisions
of the program shall be entitled to coverage and benefits as designated by the board. (b)
Each employee and retiree shall be entitled to have his or her spouse and dependent children,
as those persons are defined by the board, included in the coverage under rules and regulations
promulgated by the board upon agreeing to pay the employee's contribution of the health care
premium for the dependents. The board shall adopt rules and regulations governing the discontinuance
and resumption of coverage for dependents by the employees and retirees. The board shall adopt
rules governing the discontinuance and resumption of coverage for dependents by the employees
and retirees. (c) The board shall establish premiums required...
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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...
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27-1-22
Section 27-1-22 Uniform prescription drug information card or technology. (a) Every health
benefit plan that provides coverage for prescription drugs or devices, or administers a plan,
including, but not limited to, third party administrators for self-insured plans and state
administered plans, excluding the Alabama Medicaid Program, shall issue to its insureds a
card or other technology containing prescription drug information. The uniform prescription
drug information card or technology shall be in the format approved by the National Council
for Prescription Drug Programs (NCPDP) and shall include all of the required fields and conform
to the most recent pharmacy ID card or technology implementation guide produced by NCPDP or
conform to a national format acceptable to the Commissioner of Insurance. If a health care
plan includes a conditional or situational field, it shall conform to the most recent pharmacy
information card or technology implementation guide by the NCPDP or conform...
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27-56-5
Section 27-56-5 Third-party payment. (a) No insurance policy, plan, or contract providing for
third-party payment or prepayment of health or medical expenses that provides coverage for
eye care services shall be issued or renewed after August 1, 2001, unless such insurance policy,
plan, or contract does the following: (1) Provides a covered person direct access to any eye
care provider participating in, or otherwise eligible to provide services under, the policy,
plan, or contract for all eye care services covered under the policy, plan, or contract, without
any referral or preapproval requirement, including, but not limited to, the following services,
if covered: a. Medical treatment of glaucoma. b. Postoperative eye care. (2) Ensures that
any list of medical or health care providers participating in, or otherwise eligible to provide
services under, the policy, plan, or contract includes eye care providers to the same extent
that such list includes other medical or health care...
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11-91A-8
Section 11-91A-8 Awarding of contracts. (a) Before entering into any contract or contracts
for a carrier or third party administrator, the board shall solicit competitive proposals
from companies or agencies qualified to administer or offer plans for group health care coverage.
The board shall carefully evaluate all proposals received and award the contract or contracts
to the most qualified company or agency taking into consideration all relevant factors, including,
but not limited to, the following: The benefits offered; the proposed administrative costs
and the costs to be incurred by the employer participant and its employees, retirees, and
dependents; and the experience of the companies or agencies submitting proposals. In evaluating
these factors, the board may employ the services of impartial professional insurance analysts
or actuaries. The contract or contracts executed by the board with the selected carrier or
third party administrator shall be a contract to offer coverage to...
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16-25A-5
Section 16-25A-5 Authorization for health insurance plan; election of optional or supplemental
coverage. (a) The board is hereby empowered and authorized to establish a fully insured or
self-insured health insurance plan for employees and, under certain conditions, retired employees
and to adopt and promulgate rules and regulations for the administration of such plan subject
to such limitations as may be contained in this article. Such plan may provide for group hospitalization,
surgical, medical, cancer, cash indemnity, and dental insurance against the financial costs
of hospitalization, surgical, and medical treatment and care and may also include, among other
things, prescribed drugs, medicines, prosthetic appliances, hospital inpatient and outpatient
service benefits, and hospital/medical expenses indemnity benefits, including major medical
benefits or such other coverage or benefits as may be deemed appropriate and desirable by
the board, within the limits of such funds as may be...
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27-19-55
Section 27-19-55 Standards for loss ratios. Medicare supplement policies shall return to policyholders
benefits which are reasonable in relation to the premium charged. The commissioner shall issue
reasonable regulations to establish minimum standards for loss ratios of Medicare supplement
policies on the basis of incurred claims experience, or incurred health care expenses where
coverage is provided by a health maintenance organization on a service rather than reimbursement
basis, and earned premiums in accordance with accepted actuarial principles and practices.
(Acts 1981, No. 81-560, p. 940, §6; Act 2000-795, p. 1876, §3.)...
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