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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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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27-45-2
Section 27-45-2 Definitions. As used in this article, the following terms shall have
the respective meanings herein set forth, unless the context shall otherwise require: (1)
ALABAMA INSURANCE CODE. Title 27 of the Code of Alabama 1975. (2) INSURER. Such term shall
have the meaning ascribed in Section 27-1-2. (3) PERSON. Such term shall have the meaning
ascribed in Section 27-1-2. (4) COMMISSIONER and DEPARTMENT. Such terms, respectively,
shall have the meanings ascribed in Section 27-1-2. (5) CONTRACTUAL OBLIGATION. Any
obligation under covered policies or employee benefit plans. (6) COVERED POLICY OR PLAN. Any
policy, employee benefit plan, or contract within the scope of this article. (7) HEALTH INSURANCE
POLICY. Any individual, group, blanket, or franchise insurance policy, insurance agreement,
or group hospital service contract providing for pharmaceutical services, including without
limitation, prescription drugs, incurred as a result of accident or sickness, or to prevent
same....
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27-3A-3
Section 27-3A-3 Definitions. As used in this chapter, the following words and phrases
shall have the following meanings: (1) DEPARTMENT. The Alabama Department of Public Health.
(2) ENROLLEE. An individual who has contracted for or who participates in coverage under an
insurance policy, a health maintenance organization contract, a health service corporation
contract, an employee welfare benefit plan, a hospital or medical services plan, or any other
benefit program providing payment, reimbursement, or indemnification for health care costs
for the individual or the eligible dependents of the individual. (3) PROVIDER. A health care
provider duly licensed or certified by the State of Alabama. (4) UTILIZATION REVIEW. A system
for prospective and concurrent review of the necessity and appropriateness in the allocation
of health care resources and services given or proposed to be given to an individual within
this state. The term does not include elective requests for clarification 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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32-7-22
Section 32-7-22 Motor vehicle liability policy defined; policy provisions. (a) A motor
vehicle liability policy, as the term is used in this chapter, means an owner's or an operator's
policy of liability insurance, certified as provided in Section 32-7-20 or Section
32-7-21 as proof of financial responsibility, and issued, except as otherwise provided in
Section 32-7-21, by an insurance carrier duly authorized to transact business in this
state, to or for the benefit of the person named in the policy as insured. (b) The owner's
policy of liability insurance: (1) Shall designate by explicit description or by appropriate
reference all motor vehicles to be insured; and (2) Shall insure the person named in the policy
and any other person, as insured, using any motor vehicle or motor vehicles designated in
the policy with the express or implied permission of the named insured, against loss from
the liability imposed by law for damages arising out of the ownership, maintenance, or use
of...
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36-26-121
Section 36-26-121 Annual itemized statement of employee and retirement benefits, and
total employer contributions to retirement systems and health insurance plans. (a) As used
in this article, the following words have the following meanings: (1) EMPLOYEE BENEFIT. Any
benefit a public employee received or accrued from his or her employer, including, but not
limited to, salary or wages; insurance; allowance for days off such as vacation, holidays,
sick leave, or personal days; and contributions toward retirement or pension benefits. (2)
HEALTH INSURANCE PLAN. Either of the following health insurance plans as it applies to an
individual public employee or retiree: a. The State Employees' Health Insurance Plan. b. The
Public Education Employees' Health Insurance Plan. (3) RETIREE. A retiree or a beneficiary
of a deceased retiree who receives an employee benefit or pension benefit from a retirement
system, as defined in this section. (4) RETIREMENT SYSTEM. One of the following as
it applies...
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27-12-10
Section 27-12-10 Financial inducements to purchase insurance. (a) No person shall issue
or deliver, or permit its agents, officers, or employees to issue or deliver, agency company
stock or other capital stock, or benefit certificates or shares in any common-law corporation,
or securities, or any special or advisory board contract or other contract of any kind promising
returns and profits as an inducement to insurance. The commissioner shall refuse to issue
a certificate of authority or license to any insurer or other person that is in violation
of this section and shall revoke the certificate of authority or license of any such
violating insurer or person if such authority or license is already outstanding. (b) No person
shall issue or deliver, or permit its agents, officers, or employees to issue or deliver,
in this state, any life insurance policy or contract of annuity in which are used such words
as "investment plan," "expansion plan," "profit-sharing," "charter
plan," "founders'...
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27-12A-1
Section 27-12A-1 Definitions. As used in this chapter, the following terms shall have
the following meanings: (1) COMMISSIONER. The Alabama Commissioner of Insurance or his or
her designee. (2) DEPARTMENT. The Alabama Department of Insurance. (3) INSURANCE. As defined
in Section 27-1-2, and specifically including any contract, arrangement, or agreement,
in which one undertakes to do any one of the following: a. Pay or indemnify another as to
loss from certain contingencies called risks. b. Pay or grant a specified amount or determinable
benefit to another in connection with ascertainable risk contingencies. c. Pay an annuity
to another. d. Act as surety. For the purposes of this chapter, insurance also includes any
health benefit plan as defined in Section 27-53-1. (4) INSURANCE PRODUCER or PRODUCER.
As defined in Section 27-7-1. (5) INSURER. A person entering into agreements, contracts
of insurance, arrangements, or reinsurance, or a health benefit plan, or a group health plan
as...
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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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