25-5-314
Section 25-5-314 Contracts for medical services at mutually agreed rates. Notwithstanding any
other provisions of this article to the contrary, any employer, workers' compensation insurance
carrier, self-insured employer, or group fund, may contract with physicians, hospitals, and
any other health care provider for the provision of medical services to injured workers at
any rates, fees, or levels of reimbursement which shall be mutually agreed upon between the
physician, hospitals, and any other health care provider and the employer, workers' compensation
insurance carrier, self-insured employer, or group fund. (Acts 1992, No. 92-537, p. 1082,
§46.)...
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27-19-52.1
Section 27-19-52.1 Applicability of article. (a) Except as otherwise specifically provided,
this article shall apply to both of the following: (1) All Medicare supplement policies delivered
or issued for delivery in this state on or after August 1, 2000. (2) All certificates issued
under group Medicare supplement policies, which certificates have been delivered or issued
for delivery in this state. (b) This article shall not apply to a policy of one or more employers
or labor organizations, or of the trustees of a fund established by one or more employees
or labor organizations, or combination thereof, for employees or former employees or a combination
thereof, or for members or former members, or a combination thereof, of the labor organizations.
(c) Except as otherwise specifically provided in subsection (d) of Section 27-19-56, this
article is not intended to prohibit or apply to insurance policies or health care benefit
plans, including group conversion policies, provided to...
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38-15-3
Section 38-15-3 Definitions. For the purposes of this chapter, the following terms shall have
the following meanings: (1) CHILD. A person under the age of 18 years. (2) COMMUNITY TREATMENT
FACILITY FOR YOUTHS. A religious, faith-based, or church nonprofit, other nonprofit, or for
profit youth residential facility that provides mental health treatment services to children
in a group setting and that has the capacity to provide secure containment. (3) DEPARTMENT.
The State Department of Human Resources. (4) DIRECTOR. The Director of the State Department
of Human Resources. (5) LONG TERM YOUTH RESIDENTIAL FACILITY. A religious, faith-based, or
church nonprofit, other nonprofit, or for profit long term residential facility, group care
facility, or similar facility as determined by the director, providing 24-hour nonmedical
care of youth in need of personal services, supervision, or assistance essential for sustaining
the activities of daily living or for the protection of the child and...
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45-37-123.22
Section 45-37-123.22 Powers and duties of the pension board. (a) The pension board shall be
responsible for the general administration and proper operation of the plan, and shall administer
the plan for the exclusive benefit of the members and their beneficiaries, subject to the
specific terms of the plan. The pension board shall administer the plan in accordance with
its terms and shall have the power and discretion to construe the terms of the plan and the
act and to determine all questions arising in connection with the administration, interpretation,
and application of the plan. Any such determination by the pension board shall be conclusive
and binding upon all persons. The pension board may establish procedures, correct any defect,
supply any information, or reconcile any inconsistency in such manner and to such extent as
shall be deemed necessary or advisable to carry out the purpose of the plan; provided, however,
that any procedure, discretionary act, interpretation, or...
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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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12-5A-9
Section 12-5A-9 Participation of eligible employees in Employees' Retirement System; creditable
service; formal leave accounting system; inclusion in health insurance plan. (a) Class specifications
and rates of compensation for employees covered by this chapter, juvenile probation officers,
juvenile probation professional staff, and clerical staff, hereafter called "eligible
employees," and any future employees occupying those positions shall be established by
the Administrative Director of Courts. Notwithstanding the foregoing, the compensation of
any employee shall not be diminished as a result of his or her inclusion in the state court
system personnel system. (b) Eligible employees included in the state court system personnel
system pursuant to this chapter shall, on October 1 of the year their county transitions,
be covered by the Employees' Retirement System. An employee who on that date is participating
in a local retirement plan other than a unit administered by the Employees'...
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22-6-220
Section 22-6-220 Definitions. For the purposes of this article, the following words shall have
the following meanings: (1) CAPITATION PAYMENT. A payment the state Medicaid Agency makes
periodically to the integrated care network on behalf of each recipient enrolled under a contract
for the provision of medical services pursuant to this article. (2) COLLABORATOR. A private
health carrier, third party purchaser, provider, health care center, health care facility,
state and local governmental entity, or other public payers, corporations, individuals, and
consumers who are expecting to collectively cooperate, negotiate, or contract with another
collaborator, or integrated care network in the health care system. (3) INTEGRATED CARE NETWORK.
One or more statewide organizations of health care providers, with offices in each regional
care organization region, that contracts with the Medicaid Agency to provide Medicaid benefits
to certain Medicaid beneficiaries as defined in subdivision (4) and...
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27-45-5
Section 27-45-5 Article does not mandate that pharmaceutical services be provided. The provisions
of this article do not mandate that any type of benefits for pharmaceutical services, including
without limitation, prescription drugs, be provided by a health insurance policy or an employee
benefit plan. (Acts 1988, No. 88-379, p. 565, §5.)...
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33-1-5.2
Section 33-1-5.2 Life and health insurance for certain salaried officers and employees of state
docks. (a) The Alabama State Port Authority is hereby authorized to provide and establish
a plan of life and health insurance for the salaried officers and employees of Alabama state
docks who work full time for the Alabama state docks and receive their compensation on a bi-weekly
basis and also a plan of health insurance for the spouses and dependent children of such officers
and employees and to pay the costs and premiums of such life and health insurance from the
revenues of the Alabama State Port Authority. (b) Such health insurance plan may provide for
group hospitalization, surgical, medical and dental insurance against the financial costs
of hospitalization, surgical, medical and dental treatment and care, and may also include,
among other things, prescribed drugs, medicines, prosthetic appliances, hospital in-patient
and out-patient service benefits, including major medical benefits,...
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34-23-116
Section 34-23-116 Article not applicable to certain services. This article shall not apply
to any services rendered pursuant to provisions of the Alabama Medicaid Program, to the Public
Education Employees' Health Insurance Plan, or to any corporation organized under the provisions
of Title 10, Chapter 4, Article 6, for establishment and operation of health care service
plans. (Acts 1981, No. 81-337, p. 477, §7; Acts 1983, No. 83-637, p. 986, §§1, 2; Act 2012-478,
p. 1325, §1.)...
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