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11-91-1
Section 11-91-1 Provision by governing bodies of counties and municipalities for group life,
health, accident, etc., insurance, etc., for officers and employees authorized. (a) The council,
commission, or similar governing body of each municipal corporation, the board of directors
of each incorporated municipal board, the county commission of each county, the board of education
of each city and the board of education of each county, now existing or established after
August 16, 1947, shall have power and authority to contract for and obtain and maintain policies
of group life, health, accident, and hospitalization insurance or any one or more of them
and shall have power and authority to contract for and obtain and maintain individual annuity
contracts, retirement income policies or group annuity contracts to provide a retirement plan
for the benefit of such of the officers and employees of such municipality, incorporated municipal
board, county, or board as may be determined by such...
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27-59-3
Section 27-59-3 Implementation of coverage. (a) The benefits provided in this chapter shall
be subject to the same annual deductible or co-insurance established for all covered benefits
within a given policy. Private third party payors may not reduce or eliminate coverage due
to the requirements of this chapter. (b) A health benefit plan subject to this chapter may
not terminate services, reduce capitation payment, or otherwise penalize an attending physician
or health care provider who orders medical care consistent with this chapter. (c) Nothing
in this chapter is intended to expand the list of designations of covered providers as specified
in any health benefit plan. (Act 2008-502, p. 1106, §3.)...
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27-7-1
Section 27-7-1 Definitions. For the purposes of this chapter, the following terms shall have
the meanings respectively ascribed to them by this section: (1) BUSINESS ENTITY. A corporation,
association, partnership, limited liability company, limited liability partnership, or other
legal entity. (2) COMMISSIONER. The Alabama Commissioner of Insurance. (3) HOME STATE. The
District of Columbia and any state or territory of the United States in which an insurance
producer maintains his or her principal place of residence or principal place of business
and is licensed to act as an insurance producer. (4) INSURANCE. As defined in Section 27-1-2.
(5) INSURANCE PRODUCER or PRODUCER. A person required to be licensed under the laws of this
state to sell, solicit, or negotiate insurance. (6) INSURER. As defined in Section 27-1-2.
For the purposes of this chapter, insurer shall also mean an insurance company licensed pursuant
to Chapter 3, commencing with Section 27-3-1 of this title; a health...
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22-6-11
Section 22-6-11 Breast and cervical cancer prevention and treatment. (a) This section shall
be known and may be cited as the "2009 Breast and Cervical Cancer Prevention and Treatment
Act." (b)(1) Medicaid eligibility and coverage shall be extended to a woman who has been
determined to be eligible to participate in and has been screened for breast or cervical cancer
by any health care provider or entity, or both, that satisfies any of the following: a. Receives
direct payment for screening services by National Breast and Cervical Cancer Early Detection
Program (NBCCEDP) Title XV funds. b. Is funded at least in part by NBCCEDP grantee Title XV
funds for screening services. c. Is not funded at all by NBCCEDP grantee Title XV funds but
has been identified by the Department of Public Health as part of the Alabama Breast and Cervical
Cancer Early Detection Program and operates consistently within its guidelines. (2) Coverage
under this section shall be limited to any woman screened and...
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27-57-2
Section 27-57-2 Coverage; applicability. (a) All group health benefit plans, policies, contracts,
and certificates executed, delivered, issued for delivery, continued, or renewed in this state
on or after August 1, 2004, shall offer, at the time of proposal, sale, or renewal of a policy
subject to this chapter, to include colorectal cancer examinations within the coverage. Such
offer of coverage shall include colorectal cancer examinations for covered persons who are
50 years of age or older, or for covered persons who are less than 50 years of age and at
high risk for colorectal cancer according to current American Cancer Society colorectal cancer
screening guidelines. (b) This chapter shall apply to group accident and sickness insurance
policies issued by a fraternal benefit society, a nonprofit hospital service corporation,
a nonprofit medical service corporation, a group health care plan, a health maintenance organization,
or any similar entity. (Act 2004-502, p. 969, §2.)...
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16-6D-6
Section 16-6D-6 Innovation plan. (a) The innovation plan of a local school system shall include,
at a minimum, all of the following: (1) The school year that the local school system expects
the school flexibility contract to begin. (2) The list of state laws, regulations, and policies,
including rules, regulations, and policies promulgated by the State Board of Education and
the State Department of Education, that the local school system is seeking to waive in its
school flexibility contract. (3) A list of schools included in the innovation plan of the
local school system. (b) A local school system is accountable to the state for the performance
of all schools in its system, including innovative schools, under state and federal accountability
requirements. (c) A local school system may not, pursuant to this chapter, waive requirements
imposed by federal law, requirements related to the health and safety of students or employees,
requirements imposed by ethics laws, requirements imposed...
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22-6-220
Section 22-6-220 Definitions. For the purposes of this article, the following words shall have
the following meanings: (1) CAPITATION PAYMENT. A payment the state Medicaid Agency makes
periodically to the integrated care network on behalf of each recipient enrolled under a contract
for the provision of medical services pursuant to this article. (2) COLLABORATOR. A private
health carrier, third party purchaser, provider, health care center, health care facility,
state and local governmental entity, or other public payers, corporations, individuals, and
consumers who are expecting to collectively cooperate, negotiate, or contract with another
collaborator, or integrated care network in the health care system. (3) INTEGRATED CARE NETWORK.
One or more statewide organizations of health care providers, with offices in each regional
care organization region, that contracts with the Medicaid Agency to provide Medicaid benefits
to certain Medicaid beneficiaries as defined in subdivision (4) and...
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27-1-16
Section 27-1-16 Standard health insurance claim form; electronic claims form; various claim
forms. (a)(1) The Commissioner of the Department of Insurance shall prescribe a standard health
insurance claim form to be used by all hospitals. The forms shall be prescribed in a format
which allows for the use of generally accepted diagnosis and treatment coding systems by providers
of health care and payors. The standard form shall be accepted and used by all insurers doing
business in the State of Alabama and by all state agencies which pay providers of health care
for hospital services. (2) The Commissioner of the Department of Insurance shall also prescribe
a format for all health insurance claims transmitted or submitted for payment by electronic
or electro-mechanical means. Such a format shall be used by all insurers doing business in
the State of Alabama and by all state agencies which pay providers of health care for hospital
services. (b) An advisory committee of five persons, two...
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27-19-52
Section 27-19-52 Definitions. For purposes of this article, the following terms shall have
the meaning indicated herein: (1) APPLICANT. Includes either of the following: a. In the case
of an individual Medicare supplement policy or subscriber contract, the person who seeks to
contract for insurance benefits. b. In the case of a group Medicare supplement policy or subscriber
contract, the proposed certificate holder. (2) CERTIFICATE. Any certificate issued under a
group Medicare supplement policy, which policy has been delivered or issued for delivery in
this state. (3) CERTIFICATE FORM. The form on which the certificate is delivered or issued
for delivery by the issuer. (4) ISSUER. Insurance companies, fraternal benefit societies,
health care service plans, health maintenance organizations, and any other entity delivering
or issuing for delivery in this state Medicare supplement policies or certificates. (5) MEDICARE.
The "Health Insurance for the Aged Act," Title XVIII of the Social...
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27-54-2
Section 27-54-2 Definitions. For purposes of this chapter, the following terms have the following
meanings: (1) DAY TREATMENT SERVICES. Includes, but is not limited to: Physiological, psychological,
and psychosocial concepts, techniques, and processes necessary to maintain or develop functional
skills of clients, provided to individuals and groups for periods of more than two hours but
less than 24 hours a day. (2) HEALTH BENEFIT PLAN. A health care service plan governed by
the provisions of Article 6, Chapter 4, Title 10, and a group health insurance policy, including
an employee welfare health benefit plan, that covers hospital, medical, or surgical expenses,
issued by insurers, 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...
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