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27-3A-5
Section 27-3A-5 Standards for utilization review agents. (a) Except as provided in subsection
(b), all utilization review agents shall meet the following minimum standards: (1) Notification
of a determination by the utilization review agent shall be mailed or otherwise communicated
to the provider of record or the enrollee or other appropriate individual within two business
days of the receipt of the request for determination and the receipt of all information necessary
to complete the review. (2) Any determination by a utilization review agent as to the necessity
or appropriateness of an admission, service, or procedure shall be reviewed by a physician
or determined in accordance with standards or guidelines approved by a physician. (3) Any
notification of determination not to certify an admission, service, or procedure shall include
the principal reason for the determination and the procedures to initiate an appeal of the
determination. (4) Utilization review agents shall maintain...
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27-7-1
Section 27-7-1 Definitions. For the purposes of this chapter, the following terms shall
have the meanings respectively ascribed to them by this section: (1) BUSINESS ENTITY.
A corporation, association, partnership, limited liability company, limited liability partnership,
or other legal entity. (2) COMMISSIONER. The Alabama Commissioner of Insurance. (3) HOME STATE.
The District of Columbia and any state or territory of the United States in which an insurance
producer maintains his or her principal place of residence or principal place of business
and is licensed to act as an insurance producer. (4) INSURANCE. As defined in Section
27-1-2. (5) INSURANCE PRODUCER or PRODUCER. A person required to be licensed under the laws
of this state to sell, solicit, or negotiate insurance. (6) INSURER. As defined in Section
27-1-2. For the purposes of this chapter, insurer shall also mean an insurance company licensed
pursuant to Chapter 3, commencing with Section 27-3-1 of this title; a health...
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25-14-9
Section 25-14-9 Written contract; rights and duties of clients; employees, and professional
employer organizations. (a) All professional employer organization arrangements shall have
a written contract between the client and the professional employer organization recognizing
the rights, responsibilities, and duties of each party. The contract shall disclose to the
client the services to be rendered by the professional employer organization, including the
total administrative fees charged for professional employer organization services, the respective
rights and obligations of the parties, and shall provide the following: (1) The professional
employer organization reserves a right of direction and control over contract employees and
exercises that right in the context of the need to do so according to the terms and conditions
of the professional employment agreement. The client, however, as an employer, may retain
sufficient direction and control over covered employees necessary to...
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27-55-2
Section 27-55-2 Definitions. As used in this chapter, these terms shall have the following
meanings: (1) ABUSE. The occurrence of one or more of the following acts by a family or household
member, as defined by subdivision (3) of subsection (b) of Section 15-10-3: a. Attempting
to cause or intentionally, knowingly, or recklessly causing another person, including a minor
child, bodily injury, severe emotional injury, or psychological trauma or conduct which constitutes
the crime of rape. b. Intentionally following another person, including a minor child, without
proper authority, under circumstances that place the person in reasonable fear of bodily injury
or physical harm. c. Subjecting another person, including a minor child, to false imprisonment
or kidnapping. d. Attempting to cause or intentionally, knowingly, or recklessly causing damage
to property to intimidate or attempt to control the behavior of another person, including
a minor child. e. Assault, child abuse, criminal...
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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...
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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...
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25-14-3
Section 25-14-3 Definitions. As used in this chapter, the following terms shall have
the following meanings: (1) ADMINISTRATIVE FEE. The fee charged to a client by a professional
employer organization for professional employer services. The term does not include any amount
of a fee by the professional employer organization that is for wages and salaries, benefits,
workers' compensation, payroll taxes, withholding, or other assessments paid by the professional
employer organization to or on behalf of covered employees under the professional employer
agreement. (2) CLIENT. A person or entity that enters into a professional employer agreement
with a professional employer organization, including a worksite employer. (3) CONTROLLING
PERSON. Any of the following: a. An officer or director of a corporation operating as a professional
employer organization, a shareholder holding 25 percent or more of the voting stock of a corporation
operating as a professional employer organization, or a...
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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...
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36-1A-5
Section 36-1A-5 Participation limited to voluntary, charitable, health and human care
federations and agencies with a substantial local presence. (a) Participation in the Alabama
State Employee Combined Charitable Campaign shall be limited to voluntary, charitable, health
and human care federations and agencies with a substantial local presence that provide or
support direct health and welfare services to individuals or their families and meet the criteria
set forth in this section. "Substantial local presence" is defined as a facility,
staffed by professionals or volunteers, available to provide its services and open at least
15 hours a week. Such services must be available to state employees in the local campaign
community, unless they are rendered to needy persons overseas. Such services must directly
benefit human beings, whether children, youth, adults, the aged, the ill and infirm, or the
mentally or physically handicapped. Such services must consist of care, research, or...
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7-9A-102
Section 7-9A-102 Definitions and index of definitions. (a) Article 9A definitions. In
this article: (1) "Accession" means goods that are physically united with other
goods in such a manner that the identity of the original goods is not lost. (2) "Account,"
except as used in "account for," means a right to payment of a monetary obligation,
whether or not earned by performance, (i) for property that has been or is to be sold, leased,
licensed, assigned, or otherwise disposed of, (ii) for services rendered or to be rendered,
(iii) for a policy of insurance issued or to be issued, (iv) for a secondary obligation incurred
or to be incurred, (v) for energy provided or to be provided, (vi) for the use or hire of
a vessel under a charter or other contract, (vii) arising out of the use of a credit or charge
card or information contained on or for use with the card, or (viii) as winnings in a lottery
or other game of chance operated or sponsored by a State, governmental unit of a State, or...
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