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
27-54A-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...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-54A-2.htm - 10K - Match Info - Similar pages
25-5-318
Section 25-5-318 One-time discount to small employers. (a) For purposes of this article, "small employer" means an employer who is not experienced-rated for workers' compensation insurance purposes and whose annual workers' compensation premium is less than $5,000.00. (b) The Department of Insurance shall promulgate a plan by which all insurance companies writing workers' compensation insurance in this state shall grant a one-time discount to small employers who qualify under this article and by which surcharges are assessed against small employers who experience two or more employee on-the-job injuries resulting in payment of indemnity or medical payments during a one-year period. (c) A small employer who has not experienced an employee on-the-job injury resulting in payment of indemnity or medical payments during the most recent one-year period for which statistics are available shall receive a one-time discount of 10 percent on the amount of the employer's workers' compensation...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/25-5-318.htm - 3K - 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
27-3-14
Section 27-3-14 Deposit requirements - Alien insurers - Generally. (a) An alien insurer shall not have authority to transact insurance in this state unless it has and maintains within the United States as deposits with trustees, public depositaries or in trust institutions approved by the commissioner under Section 27-3-15 assets available for discharge of its United States insurance obligations, which assets shall be in amount not less than the outstanding liabilities of the insurer arising out of its insurance transactions in the United States together with the greater of the following sums: (1) The largest deposit required by Section 27-3-11 to be made by foreign insurers transacting like kinds of insurance; or (2) $300,000.00. (b) Of the amount deposited by an alien insurer, an amount not less than that required under subdivisions (a)(1) or (a)(2) of this section shall be deposited and maintained on deposit in cash or securities eligible for deposit under Section 27-6-3 with the...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-3-14.htm - 2K - 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
22-6-221
Section 22-6-221 Service by integrated care network; board of directors. (a) An integrated care network shall serve only Medicaid beneficiaries in providing medical care and services. For the purposes of this article, a beneficiary cannot be a member of both an integrated care network and a regional care organization. (b) An integrated care network shall provide required medical care and services to Medicaid beneficiaries and may coordinate care provided by or through an affiliation of other health care providers or other programs as the Medicaid Agency shall determine. (c) Notwithstanding any other provision of law, the integrated care network shall not be deemed an insurance company under state law. (d)(1) An integrated care network shall have a governing board of directors composed of the following members: a. Twelve members shall be persons representing risk bearing participants. A participant bears risk by contributing cash, capital, or other assets to the integrated care network....
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-6-221.htm - 2K - Match Info - Similar pages
31-9-83
Section 31-9-83 Distributions from fund; eligibility; purposes. THIS SECTION WAS AMENDED BY ACT 2018-94 IN THE 2018 REGULAR SESSION, EFFECTIVE FEBRUARY 15, 2018. THIS IS NOT IN THE CURRENT CODE SUPPLEMENT. (a) Disbursements from the recovery fund for purposes set out in this section shall only be available as provided herein upon a proclamation from the Governor or Legislature made pursuant to Section 31-9-8, and a proclamation made by the local governing body in the county or municipality affected by the disaster. The following rules shall apply for all distributions from the recovery fund for purposes set out in this section: (1) Distributions may not be used for state emergency response and relief efforts, except as determined appropriate pursuant to rules adopted by the committee under Section 31-9-86. (2) Distributions under this section shall only be available to reimburse an eligible county or municipality for those expenses not covered by insurance or other similar programs....
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/31-9-83.htm - 4K - Match Info - Similar pages
15-18-175
Section 15-18-175 Eligibility; exclusion; sentencing. (a) An offender who meets one of the following minimum criteria shall be considered eligible for punishment in the community under this article: (1) Persons who, without this option, would be incarcerated in a correctional institution or who are currently incarcerated in a correctional institution. (2) Persons who are convicted of misdemeanors. (b) The following offenders are excluded from consideration for punishment in the community: (1) Persons who are convicted of offenses as listed in subdivision (14) of Section 15-18-171. (2) Persons who demonstrate a pattern of violent behavior. In reaching this determination, the court may consider prior convictions and other acts not resulting in conviction or criminal charges, and the offender's behavior while in state or county confinement. (c) The eligibility criteria established in this section shall be interpreted as guidelines for the benefit of the court in making a determination of...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/15-18-175.htm - 7K - Match Info - Similar pages
27-61-1
Section 27-61-1 Surplus Lines Insurance Multi-State Compliance Compact. The Surplus Lines Insurance Multi-State Compliance Compact Act is enacted into law and entered into with all jurisdictions mutually adopting the compact in the form substantially as follows: PREAMBLE WHEREAS, with regard to Non-Admitted Insurance policies with risk exposures located in multiple states, the 111th United States Congress has stipulated in Title V, Subtitle B, the Non-Admitted and Reinsurance Reform Act of 2010, of the Dodd-Frank Wall Street Reform and Consumer Protection Act, hereafter, the NRRA, that: (A) The placement of Non-Admitted Insurance shall be subject to the statutory and regulatory requirements solely of the insured's Home State, and (B) Any law, regulation, provision, or action of any State that applies or purports to apply to Non-Admitted Insurance sold to, solicited by, or negotiated with an insured whose Home State is another State shall be preempted with respect to such application;...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-61-1.htm - 62K - Match Info - Similar pages
|