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27-45-2
Section 27-45-2 Definitions. As used in this article, the following terms shall have the respective
meanings herein set forth, unless the context shall otherwise require: (1) ALABAMA INSURANCE
CODE. Title 27 of the Code of Alabama 1975. (2) INSURER. Such term shall have the meaning
ascribed in Section 27-1-2. (3) PERSON. Such term shall have the meaning ascribed in Section
27-1-2. (4) COMMISSIONER and DEPARTMENT. Such terms, respectively, shall have the meanings
ascribed in Section 27-1-2. (5) CONTRACTUAL OBLIGATION. Any obligation under covered policies
or employee benefit plans. (6) COVERED POLICY OR PLAN. Any policy, employee benefit plan,
or contract within the scope of this article. (7) HEALTH INSURANCE POLICY. Any individual,
group, blanket, or franchise insurance policy, insurance agreement, or group hospital service
contract providing for pharmaceutical services, including without limitation, prescription
drugs, incurred as a result of accident or sickness, or to prevent same....
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34-23-181
Section 34-23-181 Definitions. The following words shall have the following meanings as used
in this article: (1) HEALTH BENEFIT PLAN. Any individual or group plan, employee welfare benefit
plan, policy, or contract for health care services issued, delivered, issued for delivery,
or renewed in this state by a health care insurer, health maintenance organization, accident
and sickness insurer, fraternal benefit society, nonprofit hospital service corporation, nonprofit
medical service corporation, health care service plan, or any other person, firm, corporation,
joint venture, or other similar business entity that pays for insureds or beneficiaries in
this state. The term includes, but is not limited to, entities created pursuant to Article
6 of Chapter 20 of Title 10A. A health benefit plan located or domiciled outside of the State
of Alabama is deemed to be subject to this article if it receives, processes, adjudicates,
pays, or denies claims for health care services submitted by or...
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11-104-2
Section 11-104-2 Definitions. As used in this chapter, the following terms shall have the following
meanings: (1) DEPENDENTS. The spouse, children, or other dependents of the retired employee,
as defined by and covered under the documents governing the governmental entities' benefit
plans that provide post-employment benefits. (2) EMPLOYEE. Any person who is an employee of
any governmental entity located in the state who may become eligible for post-employment benefits
from the governmental entity. (3) EMPLOYER. Any governmental entity that sponsors, in whole
or in part, post-employment benefits. (4) FISCAL YEAR. The annual period at the end of which
a governmental entity determines its financial condition. (5) GASB. The Governmental Accounting
Standards Board. (6) GOVERNMENTAL ENTITY. Any political subdivision of the state, any department,
agency, board, commission, or authority of any such political subdivision, or any public corporation,
authority, agency, instrumentality, board,...
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27-19-103
would result in economies of acquisition or administration. 3. The benefits are reasonable
in relation to the premiums charged. (5) LONG-TERM CARE INSURANCE. Any insurance policy or
rider advertised, marketed, offered, or designed to provide coverage for not less than 12
consecutive months for each covered person on an expense incurred, indemnity, prepaid, or
other basis for one or more necessary or medically necessary diagnostic, preventive, therapeutic,
rehabilitative, maintenance, or personal care services, provided in a setting other
than an acute care unit of a hospital. This term includes group and individual annuities and
life insurance policies or riders that provide directly or that supplement long-term care
insurance. This term also includes a policy or rider that provides for payment of benefits
based upon cognitive impairment or the loss of functional capacity. The term shall also include
qualified long-term care insurance contracts. Long-term care insurance may be...
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41-15B-2.2
5. Provision of other forensic services for children when requested by the council. b. The
Department of Forensic Sciences shall prepare an annual accounting of the distribution of
monies received and the effectiveness of programs implemented pursuant to this chapter and
shall file the accounting with the council before July 1. Sufficient safeguards shall be implemented
to ensure that the new monies increase and not supplant or decrease existing state support.
(12) One-half of one percent of the fund shall be allocated to the Department of Rehabilitation
Services for distribution to one or more of the following: a. Early intervention services
for children from birth through age three and services for children who have traumatic brain
injury. b. Child death review teams pursuant to Article 5 of Chapter 16 of Title 26.
The Department of Rehabilitation Services shall work in cooperation with the Department of
Public Health to administer this paragraph. (Act 99-390, p. 628, §3.)...
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27-1-22
Section 27-1-22 Uniform prescription drug information card or technology. (a) Every health
benefit plan that provides coverage for prescription drugs or devices, or administers a plan,
including, but not limited to, third party administrators for self-insured plans and state
administered plans, excluding the Alabama Medicaid Program, shall issue to its insureds a
card or other technology containing prescription drug information. The uniform prescription
drug information card or technology shall be in the format approved by the National Council
for Prescription Drug Programs (NCPDP) and shall include all of the required fields and conform
to the most recent pharmacy ID card or technology implementation guide produced by NCPDP or
conform to a national format acceptable to the Commissioner of Insurance. If a health care
plan includes a conditional or situational field, it shall conform to the most recent pharmacy
information card or technology implementation guide by the NCPDP or conform...
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36-35-3
Section 36-35-3 Alabama Prescription Cost Initiative Board. (a) The Alabama Prescription Cost
Initiative Board is created. (b) The board shall consist of the following voting members:
The executive director or chief staff person of the State Employees Insurance Board (SEIB)
and the Public Education Employees Health Insurance Plan (PEEHIP), the Chair of the Board
of Directors of SEIB, the Chair of the Board of Directors of PEEHIP, and the State Health
Officer. The Director of the Medicaid Agency may serve in a nonvoting capacity. (c) The board
shall promulgate policies to implement this chapter and may hire an executive director and
necessary staff to implement and administer this chapter with or without regard to the state
Merit System. (d) The board through its executive director may enter into agreements with
a prescription drug buying group or manufacturer to negotiate price discounts or rebates on
behalf of the board or any participating department or governmental entity. (e) The...
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27-19A-2
of this chapter. (7) HEALTH INSURANCE POLICY. Any individual, group, blanket, or franchise
insurance policy, insurance agreement, or group hospital service contract providing benefits
for dental care expenses incurred as a result of an accident or sickness. (8) EMPLOYEE BENEFIT
PLAN. Any plan, fund, or program heretofore or hereafter established or maintained by an employer
or by an employee organization, or by both, to the extent that such plan, fund, or program
was established or is maintained for the purpose of providing for its participants or their
beneficiaries, through the purchase of insurance or otherwise, dental care benefits in the
event of accident or sickness. (9) DENTAL CARE SERVICES. Any services furnished to any person
for the purpose of preventing, alleviating, curing, or healing human dental illness or injury.
(10) DENTIST. Any person who furnishes dental care services and who is licensed as a dentist
by the State of Alabama. (Acts 1984, No. 84-411, p. 960, §2.)...
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27-54A-2
Section 27-54A-2 Treatment under certain policies and contracts. (a) As used in this section,
the following words have the following meanings: (1) APPLIED BEHAVIOR ANALYSIS. The design,
implementation, and evaluation of environmental modifications, using behavioral stimuli and
consequences, to produce socially significant improvement in human behavior, including the
use of direct observation, measurement, and functional analysis of the relationship between
environment and behavior. (2) AUTISM SPECTRUM DISORDER. Any of the pervasive developmental
disorders or autism spectrum disorders as defined by the most recent edition of the Diagnostic
and Statistical Manual of Mental Disorders (DSM) or the edition that was in effect at the
time of diagnosis. (3) BEHAVIORAL HEALTH TREATMENT. Counseling and treatment programs, including
applied behavior analysis that are both of the following: a. Necessary to develop, maintain,
or restore, to the maximum extent practicable, the functioning of an...
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27-59-1
Section 27-59-1 Definitions. As used in this chapter, the following terms shall have the following
meanings: (1) HEALTH BENEFIT PLAN. Any individual or group plan, employee welfare benefit
plan, policy, or contract for health care services issued, delivered, issued for delivery,
or renewed in this state by a health care insurer, health maintenance organization, accident
and sickness insurer, fraternal benefit society, nonprofit hospital service corporation, nonprofit
medical service corporation, health care service plan, or any other person, firm, corporation,
joint venture, or other similar business entity that pays for insureds or beneficiaries in
this state. The term includes, but is not limited to, entities created pursuant to Article
6 of Chapter 20 of Title 10A. A health benefit plan located or domiciled outside of the State
of Alabama is deemed to be subject to this chapter if it receives, processes, adjudicates,
pays, or denies claims for health care services submitted by or on...
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