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36-29-14
Section 36-29-14 Health insurance coverage under State Employees' Insurance Board; operation
of board. (a) Any agency of the state, or any governmental entity, body, or subdivision thereto,
any county, any municipality, any municipal foundation, any fire or water district, authority,
or cooperative, any regional planning and development commission established pursuant to Sections
11-85-50 through 11-85-73, that is not and was not for the 12 months immediately preceding
the date of application to participate in any plan created pursuant to the provisions of this
article a member of an existing government sponsored health insurance program, formed under
the provisions of Section 11-26-2, the Association of County Commissions of Alabama or the
Alabama League of Municipalities, the Alabama Retired State Employees' Association, the Alabama
State Employees Credit Union, Easter Seals Alabama, Alabama State University, the Alabama
Rural Water Association, Rainbow Omega, Incorporated, The Arc...
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27-14-11.1
Section 27-14-11.1 Contents of policies - Denial or reduction of benefits due to Medicaid eligibility
void. (a) For purposes of this section, "private insurer" is defined as any of the
following: (1) Any commercial insurance company offering health or casualty insurance to individuals
or groups, including both experience-rated contracts and indemnity contracts. (2) Any profit
or nonprofit prepaid plan offering either medical services or full or partial payment for
the diagnosis or treatment of an injury, disease, or disability. (3) Any organization administering
health or casualty insurance plans for professional associations, unions, fraternal groups,
employer-employee benefit plans, and any similar organization offering these payments or services,
including self-insured and self-funded plans. (4) Any health insurer, including group health
plans, as defined in Section 607(1) of the Employee Retirement Income Security Act of 1974,
self-insured plans, service benefit plans, managed care...
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27-19A-7
Section 27-19A-7 Contracting directly with patient; distribution of information about policy
or plan; payment and reimbursement procedures. The provisions of this chapter do not prohibit
the following conduct and shall be construed to provide that: (1) A dentist may contract directly
with a patient for the furnishing of dental care services to said patient as may be otherwise
authorized by law; (2) Any person providing a health insurance policy or employee benefit
plan, or an employer, or an employee organization may: a. Make available to its insureds,
beneficiaries, participants, employees, or members information relating to dental care services
by the distribution of factually accurate information regarding dental care services, rates,
fees, location, and hours of service, provided such distribution is made upon the request
of any dentist licensed by this state; or b. Establish an administrative mechanism which facilitates
payment for dental care services by insureds, beneficiaries,...
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27-19-20
Section 27-19-20 Optional policy provisions - Insurance with other insurers - Expense-incurred
benefits. (a) There may be a provision as follows: "Insurance with Other Insurers: If
there be other valid coverage, not with this insurer, providing benefits for the same loss
on a provision of service basis or on an expense-incurred basis and of which this insurer
has not been given written notice prior to the occurrence or commencement of loss, the only
liability under any expense-incurred coverage of this policy shall be for such proportion
of the loss as the amount which would otherwise have been payable hereunder plus the total
of the like amounts under all such other valid coverages for the same loss of which this insurer
had notice bears to the total like amounts under all valid coverages for such loss, and for
the return of such portion of the premiums paid as shall exceed the pro rata portion for the
amount so determined. For the purpose of applying this provision when other...
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27-19-21
Section 27-19-21 Optional policy provisions - Insurance with other insurers - Other benefits.
(a) There may be a provision as follows: "Insurance with Other Insurers: If there be
other valid coverage, not with this insurer, providing benefits for the same loss on other
than an expense-incurred basis and of which this insurer has not been given written notice
prior to the occurrence or commencement of loss, the only liability for such benefits under
this policy shall be for such proportion of the indemnities otherwise provided hereunder for
such loss as the like indemnities of which the insurer had notice (including the indemnities
under this policy) bear to the total amount of all like indemnities for such loss and for
the return of such portion of the premium paid as shall exceed the pro rata portion for the
indemnities thus determined." (b) If the foregoing policy provision is included in a
policy which also contains the policy provision set out in Section 27-19-20, there shall be...
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27-44-5
Section 27-44-5 Definitions. As used in this chapter, the following terms shall have the following
meanings, respectively, unless the context clearly indicates otherwise: (1) ACCOUNT. Either
of the three accounts created under Section 27-44-6. (2) ASSOCIATION. The Alabama Life and
Disability Insurance Guaranty Association created under Section 27-44-6. (3) AUTHORIZED ASSESSMENT
or the term AUTHORIZED when used in the context of assessments. A resolution by the board
of directors has been passed whereby an assessment will be called immediately or in the future
from member insurers for a specified amount. An assessment is authorized when the resolution
is passed. (4) BENEFIT PLAN. A specific employee, union, or association of natural persons
benefit plan. (5) CALLED ASSESSMENT or the term CALLED when used in the context of assessments.
A notice that has been issued by the association to member insurers requiring that an authorized
assessment be paid within the time frame set forth within...
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27-52-2
Section 27-52-2 Authority. The plan shall have the general powers and authority granted under
the laws of this state to health insurers and in addition thereto, the specific authority
to do all of the following: (1) Enter into contracts as are necessary or proper to carry out
the provisions and purposes of this article, including the authority, with the approval of
the commissioner, to enter into contracts with similar plans of other states for the joint
performance of common administrative functions, or with persons or other organizations for
the performance of administrative functions. (2) Sue or be sued, including taking any legal
actions necessary or proper to recover or collect assessments due the plan. (3) Take legal
action as necessary to do any of the following: a. To avoid the payment of improper claims
against the plan or the coverage provided by or through the plan. b. To recover any amounts
erroneously or improperly paid by the plan. c. To recover any amounts paid by the...
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36-29-1
Section 36-29-1 Definitions. When used in this chapter, the following terms shall have the
following meanings, respectively, unless the context clearly indicates otherwise: (1) BOARD.
The State Employees' Insurance Board. (2) CLASS. An employee or retiree shall be included
in one of the following classes: (i) active employee single, (ii) active employee family,
(iii) non-Medicare retiree single, (iv) non-Medicare retiree family, (v) Medicare retiree
single, (vi) Medicare retiree family, (vii) non-Medicare retiree with Medicare eligible dependent(s),
or (viii) Medicare retiree with non-Medicare dependent(s). (3) EMPLOYEE. A person who works
full time for the State of Alabama or for a county health department and who receives his
or her full compensation on a monthly basis through means of a state warrant drawn upon the
State Treasury or by check drawn by the Treasurer of the Alabama State Port Authority or by
check drawn by the treasurer of the Alabama state agency for surplus property...
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27-55-3
Section 27-55-3 Prohibited practices; disclosure of information. (a) No insurer may: (1) Deny,
refuse to issue, renew, or reissue, cancel, or otherwise terminate, restrict, or exclude coverage
on an insurance policy or health benefit plan on the basis of an applicant's or insured's
abuse status, or on the basis of any association, relationship, or assistance to a subject
of abuse. (2) Exclude or limit coverage for a loss, deny benefits, or deny a claim on the
basis of the insured's abuse status, or on the basis of any association, relationship, or
assistance to a subject of abuse, except as otherwise permitted or required by the laws of
this state relating to acts of abuse committed by a life insurance beneficiary. Notwithstanding
anything to the contrary in this section, a liability insurer may include policy provisions
providing that a payment required by this subsection may be denied or, if paid, recovered
by the insurer from the insured, if the claim arose out of an act of abuse by...
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27-4A-3
Section 27-4A-3 Generally. (a) Subject to the exceptions and exemptions hereinafter set forth,
for the year beginning on January 1, 1995, and for each year thereafter, every insurer shall
pay to the commissioner a premium tax equal to the percentage, as set out in this subsection,
of the premiums received by the insurer for business done in this state, whether the same
was actually received by the insurer in this state or elsewhere: (1) PREMIUM TAX ON LIFE INSURANCE
PREMIUMS. a. Except as hereinafter provided, the rates of taxation on life insurance premiums
shall be those amounts set out in the following schedule: Year Foreign Insurers Domestic Insurers
1995 2.9 1.3 1996 2.8 1.6 1997 2.7 1.8 1998 2.5 2.1 Every Year Thereafter 2.3 2.3 b. Individual
life insurance policies in a face amount of greater than $5,000 and up to and including $25,000,
excluding group life insurance policies, shall be taxed at the rate of one percent per annum.
c. Individual life insurance policies in a face...
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