27-21A-2
Section 27-21A-2 Establishment of health maintenance organizations. (a) Notwithstanding any law of this state to the contrary, any person may apply to the commissioner for and obtain a certificate of authority to establish and operate a health maintenance organization in compliance with this chapter. No person shall establish or operate a health maintenance organization in this state without obtaining a certificate of authority under this chapter. A foreign corporation may qualify under this chapter, subject to its registration to do business in this state as a foreign corporation under the provisions of Sections 10-2A-220, et seq. (b) Health maintenance organizations licensed as of May 29, 1986, shall be issued a certificate of authority in accordance with Section 27-21A-29. (c) Each application for a certificate of authority shall be verified by an officer or authorized representative of the applicant, shall be in a form prescribed by the commissioner, and shall set forth or be...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-21A-2.htm - 6K - Match Info - Similar pages
27-1-17
Section 27-1-17 Limitation periods for payment of claims; overdue claims; retroactive denials, adjustments, etc.; penalties. (a) Each insurer, health service corporation, and health benefit plan that issues or renews any policy of accident or health insurance providing benefits for medical or hospital expenses for its insured persons shall pay for services rendered by Alabama health care providers within 45 calendar days upon receipt of a clean written claim or 30 calendar days upon receipt of a clean electronic claim. If the insurer, health service corporation, or health benefit plan is denying or pending the claim, the insurer, health service corporation, or health benefit plan shall, within 45 calendar days for a written claim and 30 calendar days for an electronic claim, notify the health care provider or certificate holder of the reason for denying or pending the claim and what, if any, additional information is required to process the claim. Any undisputed portion of the claim...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-1-17.htm - 17K - Match Info - Similar pages
25-4-10
Section 25-4-10 Employment. (a) Subject to other provisions of this chapter, "employment" means: (1) Any service performed prior to January 1, 1978, which was employment as defined in this section prior to such date and, subject to the other provisions of this section, services performed for remuneration after December 31, 1977, including service in interstate commerce, by: a. Any officer of a corporation; or b. Any individual who, under the usual common law rules applicable in determining the employer-employee relationship, has the status of an employee; or c. Any individual other than an individual who is an employee under paragraphs a. or b. of this subdivision (1) who performs services for remuneration for any person: 1. As an agent-driver or commission-driver engaged in distributing meat products, bakery products, beverages (other than milk) or laundry or dry cleaning services for a principal; 2. As a traveling or city salesman engaged upon a full-time basis in the solicitation on...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/25-4-10.htm - 38K - Match Info - Similar pages
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...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-21A-3.htm - 7K - Match Info - Similar pages
27-60-2
Section 27-60-2 Interstate Insurance Product Regulation Compact. The State of Alabama hereby agrees to the following interstate compact known as the Interstate Insurance Product Regulation Compact: ARTICLE I. PURPOSES. The purposes of this compact are, through means of joint and cooperative action among the compacting states: 1. To promote and protect the interest of consumers of individual and group annuity, life insurance, disability income, and long-term care insurance products; 2. To develop uniform standards for insurance products covered under the compact; 3. To establish a central clearinghouse to receive and provide prompt review of insurance products covered under the compact and, in certain cases, advertisements related thereto, submitted by insurers authorized to do business in one or more compacting states; 4. To give appropriate regulatory approval to those product filings and advertisements satisfying the applicable uniform standard; 5. To improve coordination of...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-60-2.htm - 45K - Match Info - Similar pages
27-21A-29
Section 27-21A-29 Existing health maintenance organizations. (a) Notwithstanding any other provision of this chapter, any health maintenance organization licensed by the State Board of Health and in operation on May 29, 1986, shall be granted a certificate of authority upon payment of the application fee prescribed in Section 27-21A-21 and compliance with Section 27-21A-12. Nothing in this section shall prohibit any such health maintenance organization from continuing to conduct business in this state until such certificate of authority is issued. (b) Any health maintenance organization which was licensed in this state prior to January 1, 1986, may continue to operate under existing noncontractual provider arrangements (which have been approved by the State Health Officer) for three years. (c) After issuance of a certificate of authority in accordance with subsection (a) of this section, the commissioner may require submission by the health maintenance organization of any additional...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-21A-29.htm - 1K - Match Info - Similar pages
27-3-17
Section 27-3-17 Application for certificate of authority - Filing. To apply for an original certificate of authority an insurer shall file with the commissioner its application therefor, accompanied by the applicable fees as specified in Section 27-4-2, showing its name, location of its home office or, if an alien insurer, principal office in the United States, kinds of insurance to be transacted, state or country of domicile and such additional information as the commissioner may reasonably require, together with the following documents, as applicable: (1) A copy of its corporate charter, articles of incorporation or other charter documents with all amendments thereto, certified by the public officer with whom the originals are on file in the state or country of domicile; (2) If a mutual insurer, a copy of its bylaws, as amended, certified by its secretary or other officer having custody thereof; (3) If a foreign reciprocal insurer, copies of the power of attorney of its...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-3-17.htm - 3K - Match Info - Similar pages
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...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-21A-7.htm - 3K - Match Info - Similar pages
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...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-12A-1.htm - 3K - Match Info - Similar pages
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,...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-21A-4.htm - 2K - Match Info - Similar pages
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