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27-15-75
Section 27-15-75 Calculation of adjusted premiums. (a)(1) This section shall not apply to policies
issued on or after the operative date of Section 27-15-78, as defined therein. Except as provided
in subsection (c), the adjusted premiums for any policy shall be calculated on an annual basis
and shall be such uniform percentage of the respective premiums specified in the policy for
each policy year, excluding extra premiums on a substandard policy, that the present value
at the date of issue of the policy, of all such adjusted premiums shall be equal to the sum
of: a. The then present value of the future guaranteed benefits provided for by the policy.
b. Two percent of the amount of the insurance if the insurance be uniform in amount, or of
the equivalent uniform amount, as defined in this article, if the amount of insurance varies
with the duration of the policy. c. Forty percent of the adjusted premium for the first policy
year. d. Twenty-five percent of either the adjusted premium...
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27-19-56
Section 27-19-56 Outline of coverage; disclosure of information. (a) In order to provide for
full and fair disclosure in the sale of Medicare supplement policies, no Medicare supplement
policy shall be delivered or issued for delivery in this state and no certificate shall be
delivered pursuant to a group Medicare supplement policy delivered or issued for delivery
in this state unless an outline of coverage is delivered to the applicant at the time application
is made. (b) The commissioner shall prescribe the format and content of the outline of coverage
required by subsection (a) of this section. For purposes of this section, "format"
means style, arrangements, and overall appearance, including, but not limited to, the size,
color, and prominence of type and the arrangement of text and captions. This outline of coverage
shall include all of the following: (1) A description of the principal benefits and coverage
provided in the policy. (2) A statement of the renewal provisions...
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27-19A-12
Section 27-19A-12 Dental services - Coverages; fees; exceptions. (a) As used in this section,
the following terms shall have the following meanings: (1) COVERED PERSON. Any individual,
family, or family member on whose behalf third-party payment or prepayment of health or medical
expenses is provided under an insurance policy, plan, or contract providing for third-party
payment or prepayment of health care or medical expenses. (2) COVERED SERVICES. Dental care
services for which a reimbursement is available under an enrollee's plan contract, or for
which a reimbursement would be available but for the application of contractual limitations
such as deductibles, copayments, coinsurance, waiting periods, annual or lifetime maximums,
frequency limitations, alternative benefit payments, or any other limitation. (3) DENTAL CARE
PROVIDER. A licensed dentist. (4) DENTAL PLAN. Includes any policy of insurance which is issued
by a health care service contractor which provides for coverage of...
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27-55-8
Section 27-55-8 Construction. This chapter does not and shall not be construed as creating
a private cause of action and does not and shall not require insurers, including any health
benefit plan, to extend coverage to any providers or type of providers for which coverage
is not specifically provided within the policy or certificate of insurance or health benefit
plan, or to add additional providers to existing networks, or to add any health care benefits.
(Act 2000-595, p. 1185, §8.)...
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36-29-6
Section 36-29-6 Authorization and execution of contracts; documentation of benefits. (a) The
board is hereby authorized to execute a contract or contracts to provide the plan determined
in accordance with the provisions of this chapter. 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 chapter may
be included in one or more similar contracts issued by the same or different companies. (b)
Before entering into any contract or contracts authorized by subsection (a) of this section,
the board shall invite competitive bids from all qualified entities who may wish to administer
or offer plans for the health insurance coverage desired. The board shall award such contract
or contracts on a competitive basis as determined by the benefits afforded, administrative
costs, the costs to be incurred by employee, retiree, and employer, the...
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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...
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27-19-28
Section 27-19-28 Exclusion of hospitalization benefits for mental patients in tax-supported
institutions. (a) No policy of health, sickness, or accident insurance delivered, or issued
for delivery, in this state, including both individual and group policies, which provide coverage
for psychiatric treatment or mental illness shall exclude hospitalization benefits for mental
patients in tax-supported institutions of the State of Alabama, or any county or municipality
thereof. (b) The provisions of this section shall not apply to any policy of insurance in
effect prior to September 20, 1971, nor shall the provisions of this section apply to any
employee benefit plan providing hospital benefits for mental patients where such employee
benefit plan is established by the employer and contributions to the plan are provided by
the employer and the employee, or either of them, and such plan is not evidenced by individual,
or group or blanket policies of health, sickness, or accident insurance...
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27-19-55
Section 27-19-55 Standards for loss ratios. Medicare supplement policies shall return to policyholders
benefits which are reasonable in relation to the premium charged. The commissioner shall issue
reasonable regulations to establish minimum standards for loss ratios of Medicare supplement
policies on the basis of incurred claims experience, or incurred health care expenses where
coverage is provided by a health maintenance organization on a service rather than reimbursement
basis, and earned premiums in accordance with accepted actuarial principles and practices.
(Acts 1981, No. 81-560, p. 940, §6; Act 2000-795, p. 1876, §3.)...
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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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8-33-2
Section 8-33-2 Definitions. As used in this chapter, the following words shall have the following
meanings: (1) ADMINISTRATOR. A third party other than the warrantor who is designated by the
warrantor to be responsible for the administration of vehicle protection product warranties.
(2) COMMISSIONER. The Commissioner of the Department of Insurance. (3) DEPARTMENT. The Department
of Insurance. (4) INCIDENTAL COSTS. Expenses specified in the warranty incurred by the warranty
holder related to the failure of the vehicle protection product to perform as provided in
the warranty. Incidental costs may include, without limitation, insurance policy deductibles,
rental vehicle charges, the difference between the actual value of the stolen vehicle at the
time of theft and the cost of a replacement vehicle, sales taxes, registration fees, transaction
fees, and mechanical inspection fees. (5) SERVICE CONTRACT. A contract or agreement as defined
in subdivision (13) of Section 8-32-2. (6) VEHICLE...
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