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22-6-153
Section 22-6-153 Contract to provide medical care to Medicaid beneficiaries; enrollment; grievance
procedures; duties of Medicaid Agency. (a) Subject to approval of the federal Centers for
Medicare and Medicaid Services, the Medicaid Agency shall enter into a contract in each Medicaid
region for at least one fully certified regional care organization to provide, pursuant to
a risk contract under which the Medicaid Agency makes a capitated payment, medical care to
Medicaid beneficiaries. However, the Medicaid Agency may enter into a contract pursuant to
this section only if, in the judgment of the Medicaid Agency, care of Medicaid beneficiaries
would be better, more efficient, and less costly than under the then existing care delivery
system. The Medicaid Agency may contract with more than one regional care organization in
a Medicaid region. Pursuant to the contract, the Medicaid Agency shall set capitation payments
for the regional care organization. (b) The Medicaid Agency shall...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-6-153.htm - 10K - Match Info - Similar pages
27-44-8
Section 27-44-8 Powers and duties of association. (a) If a member insurer is an impaired insurer,
the association may, in its discretion and subject to any conditions imposed by the association
that do not impair the contractual obligations of the impaired insurer, and that are approved
by the commissioner: (1) Guarantee or reinsure, or cause to be guaranteed, assumed, or reinsured,
any or all of the covered policies of the impaired insurers. (2) Provide such moneys, pledges,
notes, guarantees, or other means as are proper to effectuate subdivision (1), and assure
payment of the contractual obligations of the impaired insurer pending action under subdivision
(1). (b) If a member insurer is an insolvent insurer, the association shall, in its discretion
and subject to the approval of the commissioner, do either of the following: (1)a. Guarantee,
assume, or reinsure, or cause to be guaranteed, assumed, or reinsured, the covered policies
of the insolvent insurer. b. Assure payment of the...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-44-8.htm - 24K - Match Info - Similar pages
37-6-3
Section 37-6-3 Enumerated powers. A cooperative shall have the power: (1) To sue and be sued
in its corporate name. (2) To adopt a corporate seal and alter the same at its pleasure. (3)
To generate, manufacture, purchase, acquire and transmit electric energy and to distribute,
sell, supply and dispose of electric energy to its members, to governmental agencies and political
subdivisions and to other persons; provided, however, that should a cooperative acquire any
electric facilities dedicated or devoted to the public use, it may continue to serve the persons
served directly from such facilities at the time of such acquisition without requiring that
such persons become members, and, provided further, that such nonmembers shall have the right
to become members upon nondiscriminatory terms. Cooperatives may not condition membership
or provision of service on compliance by the member with requirements not directly related
to the electric or other service to be provided by the cooperative....
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/37-6-3.htm - 19K - Match Info - Similar pages
27-36A-16
Section 27-36A-16 Requirements of a principle-based valuation. (a) A company must establish
reserves using a principle-based valuation that meets the following conditions for policies
or contracts as specified in the valuation manual: (1) Quantify the benefits and guarantees,
and the funding, associated with the contracts and their risks at a level of conservatism
that reflects conditions that include unfavorable events that have a reasonable probability
of occurring during the lifetime of the contracts. For polices or contracts with significant
tail risk, reflects conditions appropriately adverse to quantify the tail risk. (2) Incorporate
assumptions, risk analysis methods and financial models, and management techniques that are
consistent with, but not necessarily identical to, those utilized within the company's overall
risk assessment process, while recognizing potential differences in financial reporting structures
and any prescribed assumptions or methods. (3) Incorporate...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-36A-16.htm - 3K - Match Info - Similar pages
27-30-17
Section 27-30-17 Contracts - Annual valuation - Benefits, aid, or services other than cash.
(a) The commissioner shall each year cause all outstanding contracts or policies of every
mutual aid association to be carefully valued as of December 31 of the preceding year at 40
percent of the retail value of the benefits, aid, or services provided under the terms of
its contracts or policies or at the average wholesale cost of the funeral supplies, benefits,
aid, and services so provided for, whichever amount is the greater, as shown by the number
of contracts or policies in force according to the books and records of the association, and
shall at the time compute the net value of all such outstanding contracts or policies of every
such association in the following manner: (1) On all outstanding contracts or policies issued
prior to September 16, 1953, the commissioner shall compute the net value thereof by the two
following separate methods: a. Method No. 1: On the basis of $1.50 for each...
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27-36A-2
Section 27-36A-2 Definitions. For purposes of this chapter, the following definitions shall
apply on or after the operative date of the valuation manual as defined by Section 27-36A-15:
(1) ACCIDENT AND HEALTH INSURANCE. Contracts that incorporate morbidity risk and provide protection
against economic loss resulting from accident, sickness, or medical conditions and as may
be specified in the valuation manual. (2) APPOINTED ACTUARY. A qualified actuary who is appointed
in accordance with the valuation manual to prepare the actuarial opinion required in subsection
(b) of Section 27-36A-4. (3) COMPANY. An entity, which (i) has written, issued, or reinsured
life insurance contracts, accident and health insurance contracts, or deposit-type contracts
in this state and has at least one such policy in force or on claim or (ii) has written, issued,
or reinsured life insurance contracts, accident and health insurance contracts, or deposit-type
contracts in any state and is required to hold a...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-36A-2.htm - 3K - Match Info - Similar pages
27-36A-7
Section 27-36A-7 Computation of minimum standard by calendar year of issue. (a) The interest
rates used in determining the minimum standard for the valuation of the following shall be
the calendar year statutory valuation interest rates as defined in this section: (1) Life
insurance policies issued in a particular calendar year, on or after the operative date of
Section 27-15-78. (2) Individual annuity and pure endowment contracts issued in a particular
calendar year on or after January 1, 1982. (3) Annuities and pure endowments purchased in
a particular calendar year on or after January 1, 1982, under group annuity and pure endowment
contracts. (4) The net increase, if any, in a particular calendar year after January 1, 1982,
in amounts held under guaranteed interest contracts. (b) Calendar year statutory valuation
interest rates. (1) The calendar year statutory valuation interest rates, I, shall be determined
as follows and the results rounded to the nearest one-quarter of one...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-36A-7.htm - 12K - Match Info - Similar pages
27-36A-18
Section 27-36A-18 Confidentiality. (a) For purposes of this section, "confidential information"
shall mean all of the following: (1) A memorandum in support of an opinion submitted under
Section 27-36A-4 and any other documents, materials, and other information, including, but
not limited to, all working papers, and copies thereof, created, produced, or obtained by
or disclosed to the commissioner or any other person in connection with such memorandum. (2)
All documents, materials, and other information, including, but not limited to, all working
papers, and copies thereof, created, produced, or obtained by or disclosed to the commissioner
or any other person in the course of an examination made under subsection (f) of Section 27-36A-15;
provided, however, that if an examination report or other material prepared in connection
with an examination made under Chapter 2 is not held as private and confidential information
under Section 27-2-24, an examination report or other material...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-36A-18.htm - 7K - Match Info - Similar pages
27-29-3.1
Section 27-29-3.1 Acquisition involving change in control of insurer authorized to do business
in Alabama; pre-acquisition notification; violation of competitive standards. (a) The following
definitions shall apply for the purposes of this section only: (1) ACQUISITION. Any agreement
or arrangement the consummation of which results in a person acquiring directly or indirectly
the control of another person, and includes, but is not limited to, the acquisition of voting
securities, the acquisition of assets, bulk reinsurance, and mergers. (2) INVOLVED INSURER.
Includes an insurer which either acquires or is acquired, is affiliated with an acquirer or
acquired, or is the result of a merger. (b)(1) Except as exempted in subdivision (2), this
section applies to any acquisition in which there is a change in control of an insurer authorized
to do business in this state. (2) This section shall not apply to the following: a. A purchase
of securities solely for investment purposes so long as the...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-29-3.1.htm - 12K - Match Info - Similar pages
27-34-30
Section 27-34-30 Life benefit certificate - Filing with commissioner; standard provisions.
(a) After January 1, 1973, no life benefit certificate shall be delivered, or issued for delivery,
in this state unless a copy of the form has been filed with the commissioner. (b) The certificate
shall contain in substance the following standard provisions or, in lieu thereof, provisions
which are more favorable to the member: (1) Title on the face and filing page of the certificate
clearly and correctly describing its form; (2) A provision stating the amount of rates, premiums,
or other required contributions, by whatever name known, which are payable by the insured
under the certificate; (3) A provision that the member is entitled to a grace period of not
less than a full month, or 30 days at the option of the society, in which the payment of any
premium after the first may be made. During such grace period the certificate shall continue
in full force, but in case the certificate becomes a...
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