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27-13-20
Section 27-13-20 Definitions. For the purposes of this article, unless otherwise stated, the
following terms shall have the meanings respectively ascribed to them by this section. (1)
RATE. The unit charge by which the measure of exposure or the amount of insurance specified
in a policy of insurance or covered thereunder is multiplied to determine the premium. (2)
PREMIUM. The consideration paid, or to be paid, to an insurer for the issuance and delivery
of any binder or policy of insurance. (3) RATE-MAKING. The examination and analysis of every
factor and influence related to, and bearing upon, the hazard and risk made the subject of
insurance, the collection and collation of such factors and influences into rating systems
and the application of such rating systems to individual risks. (4) RATING SYSTEM. Every schedule,
class, classification, rule, guide, standard, manual, table, rating plan, policy, policy form,
or compilation, by whatever name described, containing the rates used by...
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27-13-60
Section 27-13-60 Definitions. For the purposes of this article, unless otherwise stated, the
following terms shall have the meanings respectively ascribed to them by this section: (1)
RATE. The unit charge by which the measure of exposure or the amount of insurance specified
in a policy of insurance or covered thereunder is multiplied to determine the premium. (2)
PREMIUM. The consideration paid or to be paid to an insurer for the issuance and delivery
of any binder or policy of insurance. (3) RATE-MAKING. The examination and analysis of every
factor and influence related to and bearing upon the hazard and risk made the subject of insurance;
the collection and collation of such factors and influences into rating plans; systems; and
the application of such rating systems to individual risks. (4) RATING PLAN. Every schedule,
class, classification, rule, guide, standard, manual, table, rating plan, policy, policy form,
or compilation by whatever name described, containing the rates used...
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25-14-9
Section 25-14-9 Written contract; rights and duties of clients; employees, and professional
employer organizations. (a) All professional employer organization arrangements shall have
a written contract between the client and the professional employer organization recognizing
the rights, responsibilities, and duties of each party. The contract shall disclose to the
client the services to be rendered by the professional employer organization, including the
total administrative fees charged for professional employer organization services, the respective
rights and obligations of the parties, and shall provide the following: (1) The professional
employer organization reserves a right of direction and control over contract employees and
exercises that right in the context of the need to do so according to the terms and conditions
of the professional employment agreement. The client, however, as an employer, may retain
sufficient direction and control over covered employees necessary to...
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27-42-5
Section 27-42-5 Definitions. As used in this chapter, the following terms shall have the following
meanings, respectively, unless the context clearly indicates otherwise: (1) ACCOUNT. Any one
of the three accounts created by Section 27-42-6. (2) AFFILIATE. A person who directly, or
indirectly, through one or more intermediaries, controls, is controlled by, or is under common
control with another person on December 31 of the year immediately preceding the date the
insurer becomes an insolvent insurer. (3) ASSOCIATION. The Alabama Insurance Guaranty Association
created under Section 27-42-6. (4) CLAIMANT. Any insured making a first party claim or any
person instituting a liability claim. The term does not include a person who is an affiliate
of an insolvent insurer. (5) COMMISSIONER. The Commissioner of Insurance of the State of Alabama.
(6) CONTROL. The possession, direct or indirect, of the power to direct or cause the direction
of the management and policies of a person, whether...
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25-5-8
Section 25-5-8 Employers' options to secure payment of compensation. (a) Option to insure risks.
An employer subject to this chapter may secure the payment of compensation under this chapter
by insuring and keeping insured his or her liability in some insurance corporation, association,
organization, insurance association, corporation, or association formed of employers and workers
or formed by a group of employers to insure the risks under this chapter, operating by mutual
assessment or other plans or otherwise. Notwithstanding the 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...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/25-5-8.htm - 14K - Match Info - Similar pages
27-13-27
Section 27-13-27 Rate-making and making rating systems. Every rating organization and every
insurer which makes its own rates shall make rates that are not unreasonably high or inadequate
for the safety and soundness of the insurer and which do not unfairly discriminate between
risks in this state involving essentially the same hazards and shall, in rate-making and in
making rating systems: (1) Adopt basis classifications, which shall be used as the basis of
all manual, minimum, class, schedule, or experience rates; (2) Adopt reasonable standards
for construction, for protective facilities and for other conditions that materially affect
the hazard or peril, which shall be applied in the determination or fixing of rates; (3) Give
consideration to past experience within the state and without the state when necessary, and
due consideration may be given to prospective loss experience within the state and without
the state when necessary, over such period of years as appears to be fairly...
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27-13-65
Section 27-13-65 Rate-making and making rating plans. Every rating organization and every insurer
which makes its own rates shall make rates that are not unreasonably high or inadequate for
the safety and soundness of the insurer and which do not unfairly discriminate between risks
in this state and shall, in rate-making and in making rating plans: (1) Adopt basis classifications,
which shall be used as the basis of all manual, minimum, class, schedule, or experience rates;
(2) Give consideration to past experience within the state and without the state, when necessary,
and due consideration may be given to prospective loss experience within the state and without
the state, when necessary, over such period of years as appears to be fairly representative
of the frequency of the occurrence of the particular risk; and (3) Give consideration to all
factors reasonably related to the kind of insurance involved, including a reasonable profit
for the insurer and, in the case of participating...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-13-65.htm - 1K - 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...
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27-21A-7
Section 27-21A-7 Evidence of coverage and charges for health care services. (a)(1) Every enrollee
residing in this state is entitled to an evidence of coverage. If the enrollee obtains such
coverage through an insurance policy or a contract issued by a health care service plan, the
insurer or the health care service plan shall issue the evidence of coverage. Otherwise, the
health maintenance organization shall issue the evidence of coverage. (2) No evidence of coverage,
or amendment thereto, shall be issued or delivered to any person in this state until a copy
of the basic form of the evidence of coverage, or amendment thereto, has been filed with the
commissioner and the State Health Officer, and approved by the commissioner. (3) An evidence
of coverage shall contain: a. No provisions or statements which encourage misrepresentation,
or which are untrue, misleading, or deceptive as defined in subsection (a) of Section 27-21A-13;
and b. A clear and concise statement, if a contract, or a...
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34-23-181
Section 34-23-181 Definitions. The following words shall have the following meanings as used
in this article: (1) HEALTH BENEFIT PLAN. Any individual or group plan, employee welfare benefit
plan, policy, or contract for health care services issued, delivered, issued for delivery,
or renewed in this state by a health care insurer, health maintenance organization, accident
and sickness insurer, fraternal benefit society, nonprofit hospital service corporation, nonprofit
medical service corporation, health care service plan, or any other person, firm, corporation,
joint venture, or other similar business entity that pays for insureds or beneficiaries in
this state. The term includes, but is not limited to, entities created pursuant to Article
6 of Chapter 20 of Title 10A. A health benefit plan located or domiciled outside of the State
of Alabama is deemed to be subject to this article if it receives, processes, adjudicates,
pays, or denies claims for health care services submitted by or...
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