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16-25A-44
Section 16-25A-44 Participation of employees; purchase of benefits. In order to carry out the
provisions of the flexible employee benefit plan or any long-term care plan, or both, the
head of each department, agency, board of education, or other employer with employees as defined
by Section 16-25A-1 shall provide, at no local administrative cost to the employee, the flexible
employee benefit plan as provided for in this article to every employee and is authorized
on behalf of the state to deduct or reduce from salary or wages amounts voluntarily designated
by the employees pursuant to salary reduction agreements or benefit deduction agreements for
purchasing benefits offered under the plan and such reduction from salary and wages shall
be remitted to the board for administration of the program. Employers with employees as defined
by Section 16-25A-11 must offer such benefits as required by and under such conditions as
established by the board. (Act 2004-650, 1st Sp. Sess., p. 31, ยง5.)...
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27-21B-10
Section 27-21B-10 Enforcement of health care coverage for certain employers. (a) In any case
in which a noncustodial parent is required by a court or administrative order to provide health
care coverage for such child and the employer of the noncustodial parent is known to the Department
of Human Resources, the department shall use the federally required medical support notice
to provide notice to the employer of the requirement for employer-based health care coverage
for the child through the parent of the child who has been ordered to provide health care
coverage for the child unless a court or administrative order stipulates that alternative
health care coverage to employer-based coverage is to be provided for a child subject to a
Title IV-D child support order. In the case of an employer entered in the directory of new
hires pursuant to Section 25-11-5, the department shall send the federal medical support notice
to any employer of a noncustodial parent subject to the order within...
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16-25A-6
Section 16-25A-6 Exclusions. Such health insurance shall not include the following: (1) Expenses
incurred by or on account of an individual prior to the effective date of the plan as to him;
(2) Hearing aids and examinations for the prescription or fitting thereof; (3) Cosmetic surgery
or treatment, except to the extent necessary for correction of damage caused by accidental
injury while covered by the plan or as a direct result of disease covered by the plan; (4)
Services received in a hospital owned or operated by the United States government for which
no charge is made; (5) 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; (6) Expenses for which the individual is not required to make payment;
(7) Expenses to the extent of benefits provided under any employer group plan other than this
plan in which the state participates in the cost thereof; (8)...
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27-21A-3
Section 27-21A-3 Issuance of certificate of authority. (a)(1) Upon receipt of an application
for issuance of a certificate of authority, the commissioner shall forthwith transmit copies
of such application and accompanying documents to the State Health Officer. (2) The State
Health Officer shall determine whether the applicant for a certificate of authority, with
respect to health care services to be furnished: a. Has demonstrated the willingness and potential
ability to assure that such health care services will be provided in a manner to assure both
availability and accessibility of adequate personnel and facilities and in a manner enhancing
availability, accessibility, and continuity of service; b. Has arrangements, established in
accordance with the regulations promulgated by the State Health Officer, for an on-going quality
assurance program concerning health care processes and outcomes; and c. Has a procedure, established
in accordance with regulations of the State Health...
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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-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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27-21B-6
Section 27-21B-6 Health coverage through employer. When a parent is required by a court or
administrative order to provide health coverage and the parent is eligible for family health
coverage through an employer doing business in the state, all of the following shall apply:
(1) The parent shall be able to enroll any child in family coverage without regard to open
enrollment season restrictions. (2) If the parent fails to enroll a child, the child's other
parent or the agency can make the enrollment. (3) The child shall not be disenrolled unless
the employer is provided satisfactory written evidence of any of the following: a. The court
or administrative order is no longer in effect. b. The child is or will be enrolled in comparable
health coverage through another employer which will take effect not later than the effective
date of the disenrollment. c. The employer has eliminated family coverage for all of its employees.
(4) The employer shall withhold from the employee's compensation...
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27-52-21
Section 27-52-21 Commissioner of Insurance; benefits offered to small employers; "small
employer" defined. (a) The Commissioner of Insurance shall, by regulation, establish
the conditions, restrictions, requirements, and plan of operation of the Alabama Small Employer
Allocation Program consistent with the requirements of the Health Insurance Portability and
Accountability Act of 1996 and any and all federal regulations adopted pursuant thereto, which
plan benefits shall be inclusive of the provisions of Sections 27-1-10 and 27-19-39. The program
shall be patterned after the Small Employer Health Insurance Availability models developed
by the National Association of Insurance Commissioners. (b) All insurers that offer health
benefit plans to small employers in this state on and after August 1, 1997, shall be required
to meet the requirements of the program as a condition of authority to transact business in
this state. (c) For the purposes of this article, a "small employer" means any...
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36-27-21.7
Section 36-27-21.7 Cost-of-living increases to certain retirees whose retirement is based on
employer participation under Section 36-27-6; amounts; election by employer; construction
of section. (a) There is hereby provided, to each pensioner, annuitant and retiree of any
retirement plan other than the Employees' Retirement System whose retirement is based upon
service to an employer participating in the Employees' Retirement System under Section 36-27-6,
and whose effective date of retirement is prior to October 1, 1989, a cost-of-living increase
of ten percent of his current monthly benefit; provided, however, such increase shall not
be less than $20.00 nor more than $50.00 per month. (b) There is hereby provided, to each
pensioner whose retirement is based upon service to an employer participating in the Employees'
Retirement System under Section 36-27-6, but who retired prior to such employer's participation
in the said Employees' Retirement System and who receives a monthly...
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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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