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27-31B-21
Section 27-31B-21 Conversion to or merger with reciprocal insurer. (a) An association captive
insurance company or industrial insured group formed as a stock or mutual corporation may
be converted to or merged with and into a reciprocal insurer in accordance with a plan therefor
and this section. (b) A plan for this conversion or merger shall satisfy both of the following:
(1) Be fair and equitable to the shareholders, in the case of a stock insurer, or the policyholders,
in the case of a mutual insurer. (2) Provide for the purchase of the shares of any nonconsenting
shareholder of a stock insurer or the policyholder interest of any nonconsenting policyholder
of a mutual insurer in substantially the same manner and subject to the same rights and conditions
as are accorded a dissenting shareholder under Article 13, commencing with Section 10-2B-13.01,
of Chapter 2B of Title 10. (c) A conversion authorized under subsection (a) shall satisfy
all of the following: (1) The conversion shall...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-31B-21.htm - 5K - Match Info - Similar pages
27-20A-2
Section 27-20A-2 Chapter applicable to group, etc., policies. No group, blanket, franchise,
or association health insurance policy providing coverage on an expense incurred basis, nor
group, blanket, franchise, or association service or indemnity type contract issued by a nonprofit
corporation, nor group-type self insurance plan providing protection, insurance, or indemnity
against hospital, medical, or surgical expenses, nor health maintenance organization plan
shall be issued, delivered, executed, or renewed in this state, or approved for issuance or
renewal in this state by the Commissioner of Insurance after 90 days beyond the effective
date of this chapter, unless such policy, contract, or plan, at the option of the policyholder
or sponsor, provides benefits to any insured, subscriber, or other person covered under the
policy, contract, or plan for expenses incurred in connection with the treatment of alcoholism
when such treatment is prescribed by a duly licensed doctor of...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-20A-2.htm - 1K - Match Info - Similar pages
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...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/16-25A-5.htm - 2K - Match Info - Similar pages
16-25A-7
Section 16-25A-7 Authorization and execution of contracts; evidence of coverage; denial of
claims. (a) The board is hereby authorized to execute a contract or contracts to provide for
the benefits or the administration of the plan determined in accordance with the provisions
of this article. Such contract or contracts may be executed with one or more agencies or corporations
licensed to transact or administer group health insurance business in this state. All of the
benefits to be provided under this article may be included in one or more similar contracts
issued by the same or different companies. The board is further authorized to develop a plan
whereby it may become self-insured upon its finding that such arrangement would be financially
advantageous to the state and plan participants. (b) Before entering into any contract or
contracts authorized by subsection (a), the board shall invite competitive bids from all qualified
entities who may wish to administer or offer plans for the...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/16-25A-7.htm - 4K - Match Info - Similar pages
27-1-18
Section 27-1-18 Contract providing for mental health services to entitle insured to reimbursement
for outpatient and inpatient services by qualified psychiatrist or psychologist. (a) Whenever
any group, or blanket hospital or medical expense insurance policy or hospital or medical
service contract issued for delivery in this state provides for the reimbursement of health
or health related services which includes mental health services, and such services are within
the lawful scope of practice of a duly qualified psychiatrist or psychologist, the insured
or other person entitled to benefits under such policy or contract shall be entitled to reimbursement
for outpatient services, and inpatient services if requested by the attending physician, performed
by a duly qualified psychiatrist or psychologist notwithstanding any provisions of the policy
or contract to the contrary. (b) For purposes of this section, a duly qualified psychologist
means, one who is duly licensed or certified at the...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-1-18.htm - 2K - Match Info - Similar pages
27-43-11
Section 27-43-11 Premium rates. (a) No policy of legal expense insurance may be issued in this
state unless the premium rates for the insurance have been filed with and approved by the
commissioner. (b) Premium rates must be established and justified in accordance with generally
accepted insurance principles, including, but not limited to, the experience or judgment of
the insurer making the rate filing or actuarial computations. (c) The commissioner may disapprove
rates that are excessive, inadequate, or unfairly discriminatory. Rates are not unfairly discriminatory
because they are averaged broadly among persons insured under group, blanket, or franchise
policies. (d) The commissioner may require the submission of whatever relevant information
is deemed necessary in determining whether to approve or disapprove a filing made under this
section or Section 27-43-10. (Acts 1981, No. 81-719, p. 1214, ยง1.)...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-43-11.htm - 1K - Match Info - Similar pages
27-1-17
Section 27-1-17 Limitation periods for payment of claims; overdue claims; retroactive denials,
adjustments, etc.; penalties. (a) Each insurer, health service corporation, and health benefit
plan that issues or renews any policy of accident or health insurance providing benefits for
medical or hospital expenses for its insured persons shall pay for services rendered by Alabama
health care providers within 45 calendar days upon receipt of a clean written claim or 30
calendar days upon receipt of a clean electronic claim. If the insurer, health service corporation,
or health benefit plan is denying or pending the claim, the insurer, health service corporation,
or health benefit plan shall, within 45 calendar days for a written claim and 30 calendar
days for an electronic claim, notify the health care provider or certificate holder of the
reason for denying or pending the claim and what, if any, additional information is required
to process the claim. Any undisputed portion of the claim...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-1-17.htm - 17K - Match Info - Similar pages
27-19-1
Section 27-19-1 Applicability of article. Nothing in this article shall apply to or affect:
(1) Any policy of liability or workmen's compensation insurance, with or without supplementary
expense coverage therein; (2) Any group or blanket policy; (3) Life insurance, endowment,
or annuity contracts, or contracts supplemental thereto which contain only such provisions
relating to disability insurance as: a. Provide additional benefits in case of death or dismemberment
or loss of sight by accident; or b. Operate to safeguard such contracts against lapse or to
give a special surrender value, or special benefit or an annuity in the event that the insured
or annuitant becomes totally and permanently disabled, as defined by the contract or supplemental
contract; (4) Reinsurance; or (5) Industrial insurance, which is disability insurance issued
under policies sold on a debit basis, bearing the words "industrial policy" imprinted
on the face of the policy as part of the descriptive matter, and...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-19-1.htm - 1K - 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
27-42-5
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...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-42-5.htm - 5K - Match Info - Similar pages
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