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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36-29-5
Section 36-29-5 Expenses, treatment, etc., not to be included under plan. (a) Such health insurance
shall not include any of the following: (1) Expenses incurred by or on account of an individual
prior to the effective date of the plan. (2) Cosmetic surgery or treatment, except to the
extent necessary for correction of damages caused by accidental injury while covered by the
plan or as a direct result of disease covered by the plan. (3) Services received in a hospital
owned or operated by the United States government for which no charge is made. (4) Services
received for injury or sickness due to war or any act of war, whether declared or undeclared,
which war or act of war shall have occurred after the effective date of this plan. (5) Expenses
for which the individual is not required to make payment. (6) Expenses to the extent of benefits
provided under any employer group plan other than the plan in which the state participates
in the cost thereof. (7) Such other expenses as may be...
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27-45-6
Section 27-45-6 Compliance with article. It shall be unlawful for any insurer or any person
to provide any health insurance policy or employee benefit plan providing for pharmaceutical
services, including without limitation, prescription drugs, that does not conform to the provisions
of this article. (Acts 1988, No. 88-379, p. 565, §6.)...
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27-50-3
Section 27-50-3 Health benefit plan. As used in this chapter, the term "health benefit
plan" has the following meaning: A health insurance policy, including a self-insured
health plan, 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 health care services to patients, insureds, or beneficiaries
in this state. The term does not include accident-only, specified disease, individual hospital
indemnity, credit, dental-only, Medicare-supplement, long-term care, or disability income
insurance; coverage issued as a supplement to liability insurance, workers' compensation or
similar insurance; or automobile medical-payment insurance. For the purpose of this chapter,
a health benefit plan located or domiciled outside of the State 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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27-49-3
Section 27-49-3 Definitions. As used in this chapter, the following terms shall have the following
meanings: (1) HEALTH BENEFIT PLAN. Any individual or group plan, policy, or contract for health
care services issued, delivered, issued for delivery, 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, purchases, or furnishes health care services to patients, insureds,
or beneficiaries in this state. The term includes, but is not limited to, entities created
pursuant to Article 6 of Chapter 4 of Title 10. For the purposes of this chapter, a health
benefit plan located or domiciled outside of the State of Alabama is deemed to be subject
to the provisions of this chapter if it receives, processes,...
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27-56-6
Section 27-56-6 When provisions applicable. This chapter shall apply to services provided under
a policy, plan, or contract providing for third-party payment or prepayment of health or medical
expenses delivered, continued, or renewed in this state on or after August 1, 2001, and to
any such existing policy, plan, or contract, on its anniversary or renewal date, or upon the
expiration of the applicable collective bargaining contract, if any, whichever is later. (Act
2001-477, p. 640, §6.)...
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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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22-21-372
Section 22-21-372 Filing and approval of subscription rates; criteria; submission of relevant
information. (a) No contract providing dental service corporation benefits may be executed
in this state unless the subscription rates outlined in said contract have been filed with
and approved by the commissioner. (b) Subscription rates must be established and justified
in accordance with generally accepted insurance principles, including but not limited to the
experience or judgment of the corporation making the rate filing or actuarial computations.
(c) The commissioner may disapprove subscription rates that are excessive, inadequate or unfairly
discriminatory. Rates are not unfairly discriminatory because they are averaged broadly among
persons covered under group, blanket or franchise contracts. (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...
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22-21-264
Section 22-21-264 Criteria for state agency review. The SHPDA, pursuant to the provisions of
Section 22-21-274, shall prescribe by rules and regulations the criteria and clarifying definitions
for reviews covered by this article. These criteria shall include at least the following:
(1) Consistency with the appropriate State Health Facility and services plans effective at
the time the application was received by the State Agency, which shall include the latest
approved revisions of the following plans: a. The most recent Alabama State Health Plan which
shall include updated inventories and separate bed need methodologies for inpatient rehabilitation
beds, inpatient psychiatric beds and inpatient/residential alcohol and drug abuse beds. b.
Alabama State Health Plan for services to the mentally ill. c. Alabama State Plan for rehabilitation
facilities. d. Alabama developmental disabilities plan. e. Alabama State alcoholism plan.
f. Such other State Plans as may from time to time be...
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