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27-19A-2
Section 27-19A-2 Definitions. As used in this chapter, the following terms shall have the respective
meanings herein set forth, unless the context shall otherwise require: (1) ALABAMA INSURANCE
CODE. Title 27 of the Code of Alabama 1975. (2) INSURER. Such term shall have the meaning
ascribed in Section 27-1-2. (3) PERSON. Such term shall have the meaning ascribed in Section
27-1-2. (4) COMMISSIONER and DEPARTMENT. Such terms, respectively, shall have the meanings
ascribed in Section 27-1-2. (5) CONTRACTUAL OBLIGATION. Any obligation under covered policies
or employee benefit plans. (6) COVERED POLICY OR PLAN. Any policy, employee benefit plan,
or contract within the scope of this chapter. (7) HEALTH INSURANCE POLICY. Any individual,
group, blanket, or franchise insurance policy, insurance agreement, or group hospital service
contract providing benefits for dental care expenses incurred as a result of an accident or
sickness. (8) EMPLOYEE BENEFIT PLAN. Any plan, fund, or program...
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36-29-7
Section 36-29-7 Payment of employer's contribution; coverage for dependents; changes to contributions;
withholding of employee's contribution; State Employees' Insurance Fund. (a) The board is
hereby authorized to provide under the provisions of this chapter that the employer's contribution
to the cost of such plan for coverage of the employee and retiree shall be paid by the employer.
(b) Each employee and retiree shall be entitled to have his or her spouse and dependent children,
as defined by the rules and regulations of the board, included in the coverage provided upon
agreeing to pay the employee's contribution of the health insurance premium for such dependents.
The board shall adopt regulations governing the discontinuance and resumption by such employees
and retirees of coverage for dependents. (c) Subject to Section 36-29-19.3, any further changes
in employee or retiree contribution to the health insurance premium or other out-of-pocket
expenses including, but not limited to,...
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8-32-5
Section 8-32-5 Required provisions, service contracts. (a) Service contracts sold or offered
for sale in this state, in their entirety, shall be written, printed, or typed in eight point
type size, or larger, and shall comply with the requirements set forth in this section, as
applicable. (b) Service contracts insured under a reimbursement insurance policy pursuant
to subdivision (1) of subsection (f) of Section 8-32-3 shall contain a statement in substantially
the following form: "Obligations of the provider under this service contract are guaranteed
under a service contract reimbursement insurance policy." If the provider fails to pay
or to provide service on a claim within 60 days after proof of loss has been filed, the service
contract holder is entitled to make a claim directly against the reimbursement insurance company.
The service contract shall state the name and address of the reimbursement insurance company.
(c) Service contracts not insured under a reimbursement insurance...
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27-2B-2
Section 27-2B-2 Definitions. As used in this chapter, these terms shall have the following
meanings: (1) ADJUSTED RBC REPORT. An RBC report which has been adjusted by the commissioner
in accordance with subsection (e) of Section 27-2B-3. (2) CORRECTIVE ORDER. An order issued
by the commissioner specifying corrective actions which the commissioner has determined are
required. (3) DOMESTIC INSURER. Any insurer domiciled in this state. (4) FOREIGN INSURER.
Any insurer which is licensed to do business in this state but not domiciled in this state.
(5) FRATERNAL BENEFIT SOCIETY. Any insurer licensed under Chapter 34. (6) HEALTH ORGANIZATION.
Any health care service plan, health maintenance organization, limited health service organization,
dental services corporation, or other managed care organization licensed under this title.
This term does not include any life and disability insurer or property and casualty insurer.
(7) INSURER. As defined in Section 27-1-2, including, without...
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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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27-19-52
Section 27-19-52 Definitions. For purposes of this article, the following terms shall have
the meaning indicated herein: (1) APPLICANT. Includes either of the following: a. In the case
of an individual Medicare supplement policy or subscriber contract, the person who seeks to
contract for insurance benefits. b. In the case of a group Medicare supplement policy or subscriber
contract, the proposed certificate holder. (2) CERTIFICATE. Any certificate issued under a
group Medicare supplement policy, which policy has been delivered or issued for delivery in
this state. (3) CERTIFICATE FORM. The form on which the certificate is delivered or issued
for delivery by the issuer. (4) ISSUER. Insurance companies, fraternal benefit societies,
health care service plans, health maintenance organizations, and any other entity delivering
or issuing for delivery in this state Medicare supplement policies or certificates. (5) MEDICARE.
The "Health Insurance for the Aged Act," Title XVIII of the Social...
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27-54-2
Section 27-54-2 Definitions. For purposes of this chapter, the following terms have the following
meanings: (1) DAY TREATMENT SERVICES. Includes, but is not limited to: Physiological, psychological,
and psychosocial concepts, techniques, and processes necessary to maintain or develop functional
skills of clients, provided to individuals and groups for periods of more than two hours but
less than 24 hours a day. (2) HEALTH BENEFIT PLAN. A health care service plan governed by
the provisions of Article 6, Chapter 4, Title 10, and a group health insurance policy, including
an employee welfare health benefit plan, that covers hospital, medical, or surgical expenses,
issued by insurers, 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...
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34-19-21
Section 34-19-21 Coverage or reimbursement for services not required. Nothing contained in
this chapter shall be construed to create a requirement that any health benefit plan, group
insurance plan, policy, or contract for health care services 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 group health care services to patients, insureds, or beneficiaries in this state,
including entities created pursuant to Article 6, commencing with Section 10A-20-6.01, of
Chapter 20, Title 10A, provide coverage or reimbursement for the services described or authorized
in this chapter. (Act 2017-383, ยง4.)...
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36-27-55.7
Section 36-27-55.7 Purchase of credit for prior service with U. S. Department of Agriculture
Farm Service Agency. (a) Any active and contributing member of the Teachers' Retirement System
or the Employees' Retirement System who has 10 years or more of credible service in either
system may claim and purchase service credit in the system for up to 10 years of prior service
for employment as an employee with the United States Department of Agriculture Farm Service
Agency if the member complies with the conditions prescribed in subsection (b). No member
shall receive credit for any service that the member is already credited with in the system
or any other public retirement plan, with the exception of the federal Social Security program.
(b) Any member who is eligible to purchase service credit pursuant to subsection (a) shall
pay to the Secretary-Treasurer of the system, by May 23, 2013, the full actuarially determined
cost for each year of claimed service as determined by the system's...
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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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