27-57-5
Section 27-57-5 Coverage by participating providers; selection criteria and utilization protocols;
maximum benefits, exclusions, etc. (a) This chapter does not require and shall not be construed
to require the coverage of services of providers who are not designated as covered providers,
or who are not selected as a participating provider, by a group health benefit plan or insurer
having a participating network of service providers. Nothing in this chapter is intended to
expand the list or designation of participating providers as specified in any health benefit
plan. (b) Insurers or other issuers of any health benefit plan covered by this chapter shall
continue to be able to establish and apply selection criteria and utilization protocols for
health care providers including the designation of types of providers for which coverage is
provided as well as credentialing criteria used in the selection of providers. (c) A group
health benefit plan, policy, or contract that provides coverage...
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11-91-2
Section 11-91-2 Contracting for and purchase of insurance policies generally; requirements
as to amounts of insurance under policies and coverage of policies. (a) All such governing
bodies shall have authority to contract for and purchase any or all such policies of insurance
from any insurer or insurers admitted to transact the business of such insurance in the State
of Alabama, and the governing bodies of all state colleges and universities shall have, in
addition to powers previously granted, the authority to contract for and purchase any or all
such policies of insurance from any nonprofit corporation organized and operated without profit
to any private shareholder or individual exclusively for the purpose of aiding or strengthening
educational institutions by issuing insurance and annuity contracts only to or for the benefit
of such institutions and individuals engaged in the services of such institutions. (b) The
amounts of insurance under any such policy must be based upon some...
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27-12-14
Section 27-12-14 Inducements as to property, casualty, or surety insurance. (a) No property,
casualty, or surety insurer, or any employee thereof, and no broker, agent, or solicitor shall
pay, allow, or give, or offer to pay, allow, or give, directly or indirectly, as an inducement
to insurance or after insurance has been effected, any rebate, discount, abatement, credit,
or reduction of the premium named in a policy of insurance, or any special favor or advantage
in the dividends or other benefits to accrue thereon or any valuable consideration or inducement
whatever not specified in the policy except to the extent provided for in rating systems filed
with the commissioner by, or on behalf of, the insurer and approved by the commissioner. (b)
No insured named in a policy nor any employee of such insured shall knowingly receive or accept,
directly or indirectly, any such rebate, discount, abatement, credit, or reduction of premium.
(c) Nothing in this section shall be construed as...
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27-17-13
Section 27-17-13 Policy provisions - Nonforfeiture benefits and cash surrender values. There
shall be provisions for nonforfeiture benefits and cash surrender values as required by Section
27-15-28; except, that, with respect to benefits provided in the form of funeral or monument
merchandise and services, the required minimum cash surrender values shall be two thirds of
the cash surrender values which would be required for a cash life insurance policy having
a face amount equal to the cash benefit provided in accordance with Section 27-17-9. (Acts
1971, No. 407, p. 707, §404.)...
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27-7-4.2
Section 27-7-4.2 Licenses - Applicability to insurance producer. (a) Nothing in this chapter
shall be construed to require an insurer to obtain an insurance producer license. In this
section, the term "insurer" does not include an insurer's officers, directors, employees,
subsidiaries, or affiliates. (b) A license as an insurance producer shall not be required
of any of the following: (1) An officer, director, or employee of an insurer or of an insurance
producer, provided that the officer, director, or employee does not receive any commission
on policies written or sold to insure risks residing, located, or to be performed in this
state and any of the following: a. The officer, director, or employee's activities are executive,
administrative, managerial, clerical, or a combination of these, and are only indirectly related
to the sale, solicitation, or negotiation of insurance. b. The officer, director, or employee's
function relates to underwriting, loss control, inspection, or the...
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27-7-44
Section 27-7-44 Rules and regulations governing disclosure of nonpublic personal information.
Subject to the requirements of subsection (b) of Section 27-7-43, the commissioner may make
reasonable rules and regulations for any person engaged in providing insurance necessary to
implement and enforce the privacy provisions of 15 U.S.C. Sections 6801, et seq., being Sections
501, et seq., of Public Law 106-102, commonly known as the "Gramm-Leach-Bliley Act."
Notwithstanding the foregoing, rules and regulations adopted by the commissioner pursuant
to this section shall not apply to workers' compensation claims, workers' compensation insurance,
workers' compensation programs, or employee welfare benefit plans as defined in 29 U.S.C.
Section 1002(1) or any third-party administrator to the extent it provides services to a workers'
compensation program or employee welfare benefit plan. (Act 2001-702, p. 1509, §21.)...
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36-29-14.1
Section 36-29-14.1 Election by soil and water conservation districts to receive coverage for
officers and employees. (a) The governing body of any county soil and water conservation district
may, by resolution legally adopted to conform to rules prescribed by the State Employees'
Insurance Board, elect to have its officers and employees who are full-time employees working
at least a 40-hour work week and its retiring employees who worked full time at least a 40-hour
work week during their active employment become eligible to participate in the State Employees'
Health Insurance Plan. The term "officers" and "employees" as used in
this section shall include those persons appointed or employed by the individual officers
and performing their duties in public offices, but shall not include members of soil and water
conservation district boards, known as district supervisors who are expressly prohibited from
participating in said health insurance plan. (b) Each employee who is covered by the...
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27-1-16
Section 27-1-16 Standard health insurance claim form; electronic claims form; various claim
forms. (a)(1) The Commissioner of the Department of Insurance shall prescribe a standard health
insurance claim form to be used by all hospitals. The forms shall be prescribed in a format
which allows for the use of generally accepted diagnosis and treatment coding systems by providers
of health care and payors. The standard form shall be accepted and used by all insurers doing
business in the State of Alabama and by all state agencies which pay providers of health care
for hospital services. (2) The Commissioner of the Department of Insurance shall also prescribe
a format for all health insurance claims transmitted or submitted for payment by electronic
or electro-mechanical means. Such a format shall be used by all insurers doing business in
the State of Alabama and by all state agencies which pay providers of health care for hospital
services. (b) An advisory committee of five persons, two...
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27-43-4
Section 27-43-4 Applicability of chapter. The insurance laws of this state, including this
chapter, do not apply to: (1) Retainer contracts made by attorneys-at-law with individual
clients with fees based on estimates of the nature and amount of services to be provided to
the specific client and similar contracts made with a group of clients involved in the same
or closely related legal matters; (2) Any lawyer referral services authorized by the State
Bar of Alabama; (3) The furnishing of legal assistance by labor unions and other employee
organizations to their members in matters relating to employment or occupations; (4) The furnishing
of legal assistance to members and/or dependents by churches, cooperatives, educational institutions,
credit unions, labor unions, or other organizations of employees, where such organizations
contract with and pay directly a lawyer or law firm(s) for the provision of legal services,
where the assistance is provided as an incident to membership and not...
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27-58-4
Section 27-58-4 Benefits subject to annual deductible, coinsurance, exclusions, reductions,
etc. (a) The benefits provided in this chapter shall be subject to the same annual deductible
or coinsurance established for all covered benefits within a given policy. Private third party
payors may not reduce or eliminate coverage due to the requirements of this chapter. (b) A
health benefit plan subject to this chapter shall not terminate services, reduce capitation
payment, or otherwise penalize an attending physician or health care provider who orders medical
care consistent with this chapter. (c) Nothing in this chapter is intended to expand the list
of designations of covered providers as specified in any health benefit plan. (Act 2007-389,
p. 778, §4.)...
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