16-25A-1
Section 16-25A-1 Definitions. When used in this article, the following terms shall have the following meanings, respectively, unless the context clearly indicates otherwise: (1) EMPLOYEE. Any person covered by the Public Education Employees' Health Insurance Plan pursuant to Section 16-25A-11 or person who is employed full-time in any public institution of education within the State of Alabama which provides instruction at any combination of grades K through 14, exclusively, under the auspices of the State Board of Education or the Alabama Institute for Deaf and Blind; provided, any person employed part-time by any public institution of education within the State of Alabama which provides instruction at any combination of grades K through 14, exclusively, under the auspices of the State Board of Education or the Alabama Institute for Deaf and Blind, shall be included in the definition of employee if such person shall agree to have deducted from his or her compensation a pro rata...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/16-25A-1.htm - 6K - Match Info - Similar pages
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...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/34-23-181.htm - 3K - Match Info - Similar pages
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...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-1-22.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
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...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-1-16.htm - 3K - Match Info - Similar pages
36-29-1
Section 36-29-1 Definitions. When used in this chapter, the following terms shall have the following meanings, respectively, unless the context clearly indicates otherwise: (1) BOARD. The State Employees' Insurance Board. (2) CLASS. An employee or retiree shall be included in one of the following classes: (i) active employee single, (ii) active employee family, (iii) non-Medicare retiree single, (iv) non-Medicare retiree family, (v) Medicare retiree single, (vi) Medicare retiree family, (vii) non-Medicare retiree with Medicare eligible dependent(s), or (viii) Medicare retiree with non-Medicare dependent(s). (3) EMPLOYEE. A person who works full time for the State of Alabama or for a county health department and who receives his or her full compensation on a monthly basis through means of a state warrant drawn upon the State Treasury or by check drawn by the Treasurer of the Alabama State Port Authority or by check drawn by the treasurer of the Alabama state agency for surplus property...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/36-29-1.htm - 11K - Match Info - Similar pages
22-6-151
Section 22-6-151 Regional care organizations; governing board of directors; citizen's advisory committee; solvency and financial requirements; reporting; provider standards committee. (a) A regional care organization shall serve only Medicaid beneficiaries in providing medical care and services. (b) Notwithstanding any other provision of law, a regional care organization shall not be deemed an insurance company under state law. (c)(1) A regional care organization and an organization with probationary regional care organization certification shall have a governing board of directors composed of the following members: a. Twelve members shall be persons representing risk-bearing participants in the regional care organization or organization with probationary certification. A participant bears risk by contributing cash, capital, or other assets to the regional care organization. A participant also bears risk by contracting with the regional care organization to treat Medicaid beneficiaries...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-6-151.htm - 9K - Match Info - Similar pages
31-5-7
Section 31-5-7 State Service Commissioner - Duties generally; compensation. (a) The State Service Commissioner shall submit to the State Board of Veterans' Affairs for its approval an annual budget of all funds appropriated by the Legislature to the department for the specific purposes for which they are appropriated, and also a budget of any federal funds which may be allotted to the state by the federal government for the purposes of the department according to the regulations of the federal authorities. He shall publish annually a full report of the operations and administration of the department, together with recommendations and suggestions, and submit such report to the state board. (b) It shall be the duty of the state commissioner to: (1) Prepare detailed plans for, and fully develop, a comprehensive statewide veterans' assistance program. (2) Cooperate with all other heads of the state departments in coordinating the plans and programs of state agencies which may properly be...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/31-5-7.htm - 5K - Match Info - Similar pages
12-5A-9
Section 12-5A-9 Participation of eligible employees in Employees' Retirement System; creditable service; formal leave accounting system; inclusion in health insurance plan. (a) Class specifications and rates of compensation for employees covered by this chapter, juvenile probation officers, juvenile probation professional staff, and clerical staff, hereafter called "eligible employees," and any future employees occupying those positions shall be established by the Administrative Director of Courts. Notwithstanding the foregoing, the compensation of any employee shall not be diminished as a result of his or her inclusion in the state court system personnel system. (b) Eligible employees included in the state court system personnel system pursuant to this chapter shall, on October 1 of the year their county transitions, be covered by the Employees' Retirement System. An employee who on that date is participating in a local retirement plan other than a unit administered by the Employees'...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/12-5A-9.htm - 11K - 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
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