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27-21A-17
Section 27-21A-17 Suspension or revocation of certificate of authority. (a) The commissioner
in consultation with and with the approval of the State Health Officer, where necessary, may
suspend or revoke any certificate of authority issued to a health maintenance organization
under this chapter if he finds that any of the following conditions exist: (1) The health
maintenance organization is operating significantly in contravention of its basic organizational
document or in a manner contrary to that described in any other information submitted under
Section 27-21A-2, unless amendments to such submissions have been filed with the commissioner
and the State Health Officer and approved by the commissioner; (2) The health maintenance
organization issues evidence of coverage or uses a schedule of charges for health care services
which do not comply with requirements of Section 27-21A-7; (3) The health maintenance organization
does not provide or arrange for basic health care services; (4)...
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27-21A-22
Section 27-21A-22 Penalties and enforcement. (a) The commissioner may, in lieu of suspension
or revocation of a certificate of authority under Section 27-21A-17, levy an administrative
penalty in an amount not less than $500.00 nor more than $5,000.00, if reasonable notice in
writing is given of the intent to levy the penalty and the health maintenance organization
has a reasonable time within which to remedy the defect in its operations which gave rise
to the penalty citation. The commissioner may augment this penalty by an amount equal to the
sum that he calculates to be the damages suffered by enrollees or other members of the public.
All moneys collected under this section shall be deposited to the credit of the General Fund.
(b)(1) If the commissioner or the State Health Officer shall for any reason have cause to
believe that any violation of this chapter has occurred or is threatened, the commissioner
or State Health Officer may give notice to the health maintenance organization...
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27-21A-4
Section 27-21A-4 Powers of health maintenance organizations. (a) The powers of a health maintenance
organization include, but are not limited to the following: (1) The purchase, lease, construction,
renovation, operation, or maintenance of hospitals, medical facilities, or both, and their
ancillary equipment; (2) The making of loans other than in the ordinary course of business,
to providers under contract with it in furtherance of its program or the making of loans to
a corporation or corporations in which it owns a majority interest for the purpose of acquiring
or constructing medical facilities and hospitals or in furtherance of a program providing
health care services to enrollees. (3) The furnishing of health care services through providers
which are under contract with or employed by the health maintenance organization. (4) The
contracting with any person for the performance on its behalf of certain functions such as
marketing, enrollment, and administration. (5) The purchase,...
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27-21A-6
Section 27-21A-6 Fiduciary responsibilities of directors, officers, employees, and partners.
(a) Any director, officer, employee, or partner of a health maintenance organization who receives,
collects, disburses, or invests funds in connection with the activities of such organization
shall be responsible for such funds in a fiduciary relationship to the organization. (b) A
health maintenance organization shall maintain in force a fidelity bond on employees and officers
in an amount not less than $25,000 or such other sum as may be prescribed by the commissioner.
All such bonds shall be written with at least a one-year discovery period and if written with
less than a three-year discovery period shall contain a provision that no cancellation or
termination of the bond, whether by or at the request of the insured or by the underwriter,
shall take effect prior to the expiration of 90 days after written notice of such cancellation
or termination has been filed with the commissioner unless...
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5-13B-111
Section 5-13B-111 Asset maintenance. (a) Each foreign bank which is licensed to establish and
maintain an Alabama state branch or Alabama state agency shall hold in this state currency,
bonds, notes, debentures, drafts, bills of exchange, or other evidences of indebtedness, including
loan participation agreements or certificates, or other obligations payable in the United
States or in United States funds or, with the prior approval of the superintendent, in funds
freely convertible into United States funds, or such other assets as the superintendent shall
by regulation or order permit, in an amount which shall bear such relationship as the superintendent
shall by regulation or order prescribe to liabilities of such foreign bank payable at or through
its Alabama state branch or Alabama state agency, including acceptances, but excluding amounts
due and other liabilities to other offices, agencies, or branches of, and wholly owned, except
for a nominal number of directors' shares,...
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27-13-24
Section 27-13-24 Rating organizations - License; application therefor; renewal thereof; fee
for same. (a) No rating organization shall do business in this state unless it shall have
been licensed to do so by the commissioner. Application for such license shall be made on
such forms as the commissioner shall prepare for that purpose. Upon applying for such license,
every rating organization shall file with the department: (1) A copy of its constitution,
its articles of agreement or association or its certificate of incorporation and of its bylaws
or rules governing the conduct of its business or such of the foregoing, if any, as such rating
organization may have; (2) A list of insurers who are, or who have agreed to become, members
of, or subscribers to, such rating organization; (3) The name and address of a person, or
persons, in this state upon whom notices or orders of the commissioner affecting such rating
organization may be served; and (4) Such other information as the...
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27-13-62
Section 27-13-62 Rating organizations - License; application therefor; renewal thereof; fee
for same. No rating organization shall do business in this state until it shall have been
licensed to do so by the commissioner. Application for such license shall be made on such
forms as the commissioner shall prepare for that purpose. Upon applying for such license,
every rating organization shall file with the department: (1) A copy of its constitution,
its articles of agreement or association, or its certificate of incorporation and of its bylaws
or rules governing the conduct of its business or such of the foregoing, if any, as such rating
organization may have; (2) A list of insurers who are or, who have agreed to, become members
of, or subscribers to, such rating organization; (3) The name and address of a person, or
persons, in this state upon whom notices or orders of the commissioner affecting such rating
organization may be served; and (4) Such other information as the commissioner...
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27-19-55
Section 27-19-55 Standards for loss ratios. Medicare supplement policies shall return to policyholders
benefits which are reasonable in relation to the premium charged. The commissioner shall issue
reasonable regulations to establish minimum standards for loss ratios of Medicare supplement
policies on the basis of incurred claims experience, or incurred health care expenses where
coverage is provided by a health maintenance organization on a service rather than reimbursement
basis, and earned premiums in accordance with accepted actuarial principles and practices.
(Acts 1981, No. 81-560, p. 940, §6; Act 2000-795, p. 1876, §3.)...
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27-2B-2
Section 27-2B-2 Definitions. As used in this chapter, these terms shall have the following
meanings: (1) ADJUSTED RBC REPORT. An RBC report which has been adjusted by the commissioner
in accordance with subsection (e) of Section 27-2B-3. (2) CORRECTIVE ORDER. An order issued
by the commissioner specifying corrective actions which the commissioner has determined are
required. (3) DOMESTIC INSURER. Any insurer domiciled in this state. (4) FOREIGN INSURER.
Any insurer which is licensed to do business in this state but not domiciled in this state.
(5) FRATERNAL BENEFIT SOCIETY. Any insurer licensed under Chapter 34. (6) HEALTH ORGANIZATION.
Any health care service plan, health maintenance organization, limited health service organization,
dental services corporation, or other managed care organization licensed under this title.
This term does not include any life and disability insurer or property and casualty insurer.
(7) INSURER. As defined in Section 27-1-2, including, without...
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27-9A-17
Section 27-9A-17 Fingerprints. (a) In order to make a determination of license eligibility,
the commissioner may require fingerprints of applicants and to submit the fingerprints and
the fee required to perform the criminal history record checks to the Alabama Department of
Public Safety and the Federal Bureau of Investigation for state and national criminal history
record checks. (b) The commissioner may require a criminal history record check on each applicant
in accordance with this section. The commissioner shall require each applicant to submit a
full set of fingerprints, including a scanned file from a hard copy fingerprint, in order
for the commissioner to obtain and receive national criminal history records from the Criminal
Justice Information Services Division of the Federal Bureau of Investigation. In the case
of business entity applicants, the commissioner shall require the submission of fingerprints
of all of the following: (1) All executive officers and directors of the...
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