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27-58-1
Section 27-58-1 Definitions. As used in this chapter, the following terms shall have the following
meanings: (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 chapter if it receives, processes, adjudicates,
pays, or denies claims for health care services submitted by or on...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-58-1.htm - 1K - Match Info - Similar pages
27-59-1
Section 27-59-1 Definitions. As used in this chapter, the following terms shall have the following
meanings: (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 chapter if it receives, processes, adjudicates,
pays, or denies claims for health care services submitted by or on...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-59-1.htm - 1K - Match Info - Similar pages
27-27-16
Section 27-27-16 Domestic mutual insurers - Bond or deposit in lieu thereof. (a) Before soliciting
any applications for insurance required under Section 27-27-15, as qualification for the original
certificate of authority, the incorporators of the proposed mutual insurer shall file with
the commissioner a corporate surety bond in the penalty of $15,000.00 in favor of the State
of Alabama and for the use and benefit of the state and of applicant members and creditors
of the corporation. The bond shall be conditioned as follows: (1) Upon payment of any loss
suffered by applicants who have cancelled or lapsed existing insurance policies due to misrepresentation
by the incorporators or by persons soliciting such applications under authorization by the
corporation, to the effect that the making of such application for insurance and prepayment
of premiums in such proposed insurer provides insurance protection prior to issuance of a
certificate of authority to such insurer by the...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-27-16.htm - 2K - Match Info - Similar pages
27-1-22
Section 27-1-22 Uniform prescription drug information card or technology. (a) Every health
benefit plan that provides coverage for prescription drugs or devices, or administers a plan,
including, but not limited to, third party administrators for self-insured plans and state
administered plans, excluding the Alabama Medicaid Program, shall issue to its insureds a
card or other technology containing prescription drug information. The uniform prescription
drug information card or technology shall be in the format approved by the National Council
for Prescription Drug Programs (NCPDP) and shall include all of the required fields and conform
to the most recent pharmacy ID card or technology implementation guide produced by NCPDP or
conform to a national format acceptable to the Commissioner of Insurance. If a health care
plan includes a conditional or situational field, it shall conform to the most recent pharmacy
information card or technology implementation guide by the NCPDP or conform...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-1-22.htm - 3K - 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
27-34-30
Section 27-34-30 Life benefit certificate - Filing with commissioner; standard provisions.
(a) After January 1, 1973, no life benefit certificate shall be delivered, or issued for delivery,
in this state unless a copy of the form has been filed with the commissioner. (b) The certificate
shall contain in substance the following standard provisions or, in lieu thereof, provisions
which are more favorable to the member: (1) Title on the face and filing page of the certificate
clearly and correctly describing its form; (2) A provision stating the amount of rates, premiums,
or other required contributions, by whatever name known, which are payable by the insured
under the certificate; (3) A provision that the member is entitled to a grace period of not
less than a full month, or 30 days at the option of the society, in which the payment of any
premium after the first may be made. During such grace period the certificate shall continue
in full force, but in case the certificate becomes a...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-34-30.htm - 6K - Match Info - Similar pages
32-9-29
Section 32-9-29 Permits for movement of oversized vehicles or loads. (a) Authorized; application;
issuance; seasonal, etc., limitations; refusal, revocation, or cancellation. (1) The Director
of the Department of Transportation or the official of the department designated by the director,
upon application and for good cause being shown therefor, may issue a permit in writing authorizing
the applicant to operate or move upon the state's public roads a vehicle or combination of
no more than two vehicles and loads whose weight, width, length, or height, or combination
thereof, exceeds the maximum limit specified by law; provided, that the load transported by
such vehicle or vehicles is of such nature that it is a unit which cannot be readily dismantled
or separated; provided, however, that bulldozers and similar construction equipment shall
not be deemed readily separable for purposes of this chapter; and further provided, that no
permit shall be issued to any vehicle whose operation upon...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/32-9-29.htm - 10K - Match Info - Similar pages
38-15-4
Section 38-15-4 Registration of certain youth residential institutions or organizations; staff
training plans; rights of children; licensing and inspection of food preparation areas; access
by law enforcement agencies. (a) Commencing on January 1, 2018, the department shall register
any religious, faith-based, or church nonprofit, other nonprofit, or for profit affiliated
youth residential facility, youth social rehabilitation facility, community treatment facility
for youths, youth transitional care facility, long term youth residential facility, private
alternative boarding school, private alternative outdoor program, and any organization entrusted
with the residential care of children in any organizational form or combination defined by
this section, whenever children are housed at the facility or location of the program for
a period of more than 24 hours. At a minimum, registered youth residential institution or
organization under this section shall do all of the following: (1) Be...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/38-15-4.htm - 13K - Match Info - Similar pages
41-15B-2.2
Section 41-15B-2.2 Allocation of trust fund revenues. (a) For each fiscal year, beginning October
1, 1999, contingent upon the Children First Trust Fund receiving tobacco revenues and upon
appropriation by the Legislature, an amount of up to and including two hundred twenty-five
thousand dollars ($225,000), or equivalent percentage of the total fund, shall be designated
for the administration of the fund by the council and the Commissioner of Children's Affairs.
(b) For the each fiscal year, beginning October 1, 1999, contingent upon the Children First
Trust Fund receiving tobacco revenues, the remainder of the Children First Trust Fund, in
the amounts provided for in Section 41-15B-2.1, shall be allocated as follows: (1) Ten percent
of the fund shall be allocated to the Department of Public Health for distribution to one
or more of the following: a. The Children's Health Insurance Program. b. Programs for tobacco
control among children with the purpose being to reduce the consumption...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/41-15B-2.2.htm - 22K - Match Info - Similar pages
13A-9-150
Section 13A-9-150 Public assistance fraud; penalties. (a) For the purposes of this section,
public assistance means money or property provided directly or indirectly to eligible persons
through programs of the federal government, the state, or any political subdivision thereof,
including any program administered by a public housing authority. (b) It shall be unlawful
for an individual or business entity to knowingly do any of the following: (1) Fail, by false
statement, misrepresentation, impersonation, or other fraudulent means, to disclose a material
fact used in making a determination as to the qualification of the person to receive public
assistance. (2) Fail to disclose a change in circumstances in order to obtain or continue
to receive any public assistance to which he or she is not entitled or in an amount larger
than that to which he or she is entitled. (3) Aid and abet another person in the commission
of the prohibitions enumerated in subdivisions (1) and (2). (4) Use,...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/13A-9-150.htm - 12K - Match Info - Similar pages
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