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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