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27-31B-2
Section 27-31B-2 Definitions. As used in this chapter, the following terms shall have the following
meanings, unless the context clearly indicates otherwise: (1) AFFILIATED COMPANY. Any company
in the same corporate system as a parent, an industrial insured, or a member organization
by virtue of common ownership, control, operation, or management. (2) ALIEN CAPTIVE INSURANCE
COMPANY. Any insurance company formed to write insurance business for its parents and affiliates
and licensed pursuant to the laws of an alien jurisdiction which imposes statutory or regulatory
standards in a form acceptable to the commissioner on companies transacting the business of
insurance in that jurisdiction. (3) ASSOCIATION. Any legal association of individuals, corporations,
limited liability companies, partnerships, associations, or other entities whereby either
of the following exists: a. The member organizations of which, or the association itself,
whether or not in conjunction with some or all of the...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-31B-2.htm - 10K - Match Info - Similar pages
27-42-8
Section 27-42-8 Powers and duties. (a) The association shall: (1)a. Be obligated to pay covered
claims existing prior to the order of liquidation arising within 30 days after the order of
liquidation, or before the policy expiration date if less than 30 days after the order of
liquidation, or before the insured replaces the policy or causes its cancellation, if he or
she does so within 30 days of the order of liquidation. The obligation shall be satisfied
by paying to the claimant an amount as follows: 1. The full amount of a covered claim for
benefits under workers' compensation insurance coverage. 2. An amount not exceeding ten thousand
dollars ($10,000) per policy for a covered claim for the return of unearned premium. 3. An
amount not exceeding three hundred thousand dollars ($300,000) or the policy limits, whichever
is less, per claim for all covered claims. For purposes of this limitation, all claims of
any kind whatsoever arising out of, or related to, bodily injury or death to...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-42-8.htm - 10K - Match Info - Similar pages
27-56-3
Section 27-56-3 Payment for services. An insurance policy, plan, or contract providing for
third-party payment or prepayment of health or medical expenses shall include a provision
for the payment to a licensed optometrist for each service which falls within the scope of
the optometrist's license, if the policy, plan, or contract pays for the same service when
provided by any other provider for such services. (Act 2001-477, p. 640, ยง3.)...
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22-6-153
Section 22-6-153 Contract to provide medical care to Medicaid beneficiaries; enrollment; grievance
procedures; duties of Medicaid Agency. (a) Subject to approval of the federal Centers for
Medicare and Medicaid Services, the Medicaid Agency shall enter into a contract in each Medicaid
region for at least one fully certified regional care organization to provide, pursuant to
a risk contract under which the Medicaid Agency makes a capitated payment, medical care to
Medicaid beneficiaries. However, the Medicaid Agency may enter into a contract pursuant to
this section only if, in the judgment of the Medicaid Agency, care of Medicaid beneficiaries
would be better, more efficient, and less costly than under the then existing care delivery
system. The Medicaid Agency may contract with more than one regional care organization in
a Medicaid region. Pursuant to the contract, the Medicaid Agency shall set capitation payments
for the regional care organization. (b) The Medicaid Agency shall...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-6-153.htm - 10K - Match Info - Similar pages
23-1-41
Section 23-1-41 Self-insurance program for department employees. (a) The State Department of
Transportation is authorized and empowered and may, with the approval of the Governor provide
for a self-insurance program covering a certain amount to be paid to the employees of the
State Department of Transportation who may be killed or injured in the line and scope of their
employment; provided, that the amount paid to any such party on account of death or injury
shall not exceed the amount or amounts as provided by the Workers' Compensation Act of this
state. The Director of Transportation may, with the approval of the Governor, enter into an
agreement with an agency, company, or corporation qualified to administer a self-insured Workers'
Compensation program to administer the program or, in the alternative, the director may elect
to administer the program with State Department of Transportation personnel. The cost of this
program shall be paid out of the funds of the State Department of...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/23-1-41.htm - 2K - Match Info - Similar pages
25-14-7
Section 25-14-7 Grounds for disciplinary action. The following acts constitute grounds for
which disciplinary action against a registrant or controlling person may be taken by the secretary:
(1) Being convicted of or entering a guilty plea or a plea of nolo contendere to, any of the
following: a. A crime in any jurisdiction which relates to the operation of a professional
employer organization or the ability to engage in business as a professional employer organization.
b. Fraud, deceit, or misconduct in the classification of employees and reporting of employee
wages under the workers' compensation laws of this state. c. Fraud, deceit, or misconduct
in the establishment of or maintenance of workers' compensation coverage, regardless of whether
self-insured or otherwise. d. Fraud, deceit, or misconduct in the operation of a professional
employer organization. (2) Failing to maintain evidence of the workers' compensation insurance
coverage required in accordance with this chapter. (3)...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/25-14-7.htm - 2K - Match Info - Similar pages
27-14-11.1
Section 27-14-11.1 Contents of policies - Denial or reduction of benefits due to Medicaid eligibility
void. (a) For purposes of this section, "private insurer" is defined as any of the
following: (1) Any commercial insurance company offering health or casualty insurance to individuals
or groups, including both experience-rated contracts and indemnity contracts. (2) Any profit
or nonprofit prepaid plan offering either medical services or full or partial payment for
the diagnosis or treatment of an injury, disease, or disability. (3) Any organization administering
health or casualty insurance plans for professional associations, unions, fraternal groups,
employer-employee benefit plans, and any similar organization offering these payments or services,
including self-insured and self-funded plans. (4) Any health insurer, including group health
plans, as defined in Section 607(1) of the Employee Retirement Income Security Act of 1974,
self-insured plans, service benefit plans, managed care...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-14-11.1.htm - 3K - Match Info - Similar pages
27-57-1
Section 27-57-1 Definitions. As used in this chapter, the following words and terms shall have
the following meanings: (1) COLORECTAL CANCER EXAMINATIONS. Examinations and laboratory tests
specified in current American Cancer Society guidelines for colorectal cancer screening of
asymptomatic individuals. (2) HEALTH BENEFIT PLAN. A group health insurance policy that covers
hospital, medical, or surgical expenses, 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 beneficiaries in this
state. For the purposes of this chapter, a health benefit plan located or domiciled outside
of the State of Alabama is deemed to be subject to this chapter if it receives, processes,
adjudicates, pays, or denies claims for health care services submitted...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-57-1.htm - 1K - Match Info - Similar pages
25-5-338
Section 25-5-338 Construction of article. (a) No physician-patient relationship is created
between an employee or job applicant and an employer, medical review officer, or any person
performing or evaluating a drug test solely by the establishment, implementation, or administration
of a drug-testing program. (b) Nothing in this article shall be construed to prevent an employer
from establishing reasonable work rules related to employee possession, use, sale, or solicitation
of drugs, including convictions for drug related offenses, and taking action based upon a
violation of any of those rules. (c) Nothing in this article shall be construed to operate
retroactively, and nothing in this article shall abrogate the right of an employer under state
or federal law to conduct drug tests, or implement employee drug-testing programs. Notwithstanding
the foregoing, only those programs that meet the criteria outlined in this article qualify
for reduced workers' compensation insurance premiums...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/25-5-338.htm - 2K - Match Info - Similar pages
27-1-17.1
Section 27-1-17.1 Payment of providers through electronic funds transfer methods. (a) As used
in this section, the following words shall have the following meanings: (1) ACH ELECTRONIC
FUNDS TRANSFER. An electronic funds transfer through the Health Insurance Portability and
Accountability Act (HIPPA) standard Automated Clearing House network. (2) COVERED HEALTH CARE
PROVIDER. A physician as defined in Section 34-24-50.1; a dentist as defined in Section 34-9-1;
a chiropractor as defined in Section 34-24-120; an individual engaged in the practice of optometry
as defined in Section 34-22-1; other licensed health care professionals as defined in Title
34; a hospital as defined in Section 22-21-20; and a health care facility, or other provider
who or that is accredited, licensed, or certified and who or that is performing within the
scope of that accreditation, license, or certification. (3) HEALTH INSURANCE PLAN. Any hospital
and medical expense incurred policy, health maintenance...
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