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27-52-4
Section 27-52-4 Coverage. The plan shall offer health care coverage consistent with major medical
expense coverage to every eligible person who is not eligible for Medicare. The coverage to
be issued by the plan, its schedule of benefits, exclusions, and other limitations shall be
established by the plan, which plan benefits shall be inclusive of the provisions of Sections
27-1-10 and 27-19-39, and subject to the approval of the commissioner. (Acts 1997, No. 97-713,
p. 1476, §4.)...
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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
27-44-8
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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27-60-2
committees as its bylaws may provide for the carrying out of its functions. 4. Corporate records
of the commission. The commission shall maintain its corporate books and records in accordance
with the bylaws. 5. Qualified immunity, defense, and indemnification. a. The members, officers,
executive director, employees, and representatives of the commission shall be immune from
suit and liability, either personally or in their official capacity, for any claim for damage
to or loss of property or personal injury or other civil liability caused by
or arising out of any actual or alleged act, error, or omission that occurred, or that the
person against whom the claim is made had a reasonable basis for believing occurred within
the scope of commission employment, duties, or responsibilities. Nothing in this paragraph
shall be construed to protect any such person from suit or liability, or both, for any damage,
loss, injury, or liability caused by the intentional or willful and wanton...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-60-2.htm - 45K - Match Info - Similar pages
12-15-314
care to participate in activities that are age or developmentally appropriate for the child
based on a reasonable and prudent parent standard, provided the activities are consistent
with provisions of any existing court order, individualized service plan, or promulgated policy
of the department that provides guidance to caregivers concerning the reasonable and prudent
parent standard. The guidance shall include factors for the caregiver to consider prior to
allowing a child to participate in age or developmentally appropriate normal childhood activities.
(2) A caregiver shall be immune from liability in a civil action to recover damages for injury,
death, or loss to person or property that results from a caregiver's decisions using a reasonable
and prudent parent standard. This subsection shall not be construed to remove or limit any
existing liability protection provided by law. (Act 2008-277, p. 441, §18; Act 2010-712,
p. 1744, §13; Act 2016-129, p. 290, §1; Act 2018-273, §1.)...
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16-44B-1
Commission may deem appropriate. The executive director shall serve as secretary to the Interstate
Commission, but shall not be a Member of the Interstate Commission. The executive director
shall hire and supervise such other persons as may be authorized by the Interstate Commission.
D. The Interstate Commission's executive director and its employees shall be immune from suit
and liability, either personally or in their official capacity, for a claim for damage to
or loss of property or personal injury or other civil liability caused or arising
out of or relating to an actual or alleged act, error, or omission that occurred, or that
such person had a reasonable basis for believing occurred, within the scope of Interstate
Commission employment, duties, or responsibilities; provided, that such person shall not be
protected from suit or liability for damage, loss, injury, or liability caused by the
intentional or willful and wanton misconduct of such person. 1. The liability of...
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27-59-3
Section 27-59-3 Implementation of coverage. (a) The benefits provided in this chapter shall
be subject to the same annual deductible or co-insurance 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 may
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 2008-502, p. 1106, §3.)...
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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.)...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-58-4.htm - 1K - Match Info - Similar pages
27-19-105
Section 27-19-105 Regulations for long-term care policies; outline of coverage, policy summary,
and monthly report. (a) The commissioner may adopt regulations that include standards for
full and fair disclosure setting forth the manner, content, and required disclosures for the
sale of long-term care insurance policies, terms of renewability, initial and subsequent conditions
of eligibility, nonduplication of coverage provisions, coverage of dependents, preexisting
conditions, termination of insurance, continuation or conversion, probationary periods, limitations,
exceptions, reductions, elimination periods, requirements for replacement, recurrent conditions,
and definitions of terms. Regulations under this subsection should recognize the developing
and unique nature of long-term care insurance and the distinction between group and individual
long-term insurance policies. (b) No long-term care insurance policy may do any of the following:
(1) Be cancelled, nonrenewed, or otherwise...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-19-105.htm - 11K - Match Info - Similar pages
27-21A-7
Section 27-21A-7 Evidence of coverage and charges for health care services. (a)(1) Every enrollee
residing in this state is entitled to an evidence of coverage. If the enrollee obtains such
coverage through an insurance policy or a contract issued by a health care service plan, the
insurer or the health care service plan shall issue the evidence of coverage. Otherwise, the
health maintenance organization shall issue the evidence of coverage. (2) No evidence of coverage,
or amendment thereto, shall be issued or delivered to any person in this state until a copy
of the basic form of the evidence of coverage, or amendment thereto, has been filed with the
commissioner and the State Health Officer, and approved by the commissioner. (3) An evidence
of coverage shall contain: a. No provisions or statements which encourage misrepresentation,
or which are untrue, misleading, or deceptive as defined in subsection (a) of Section 27-21A-13;
and b. A clear and concise statement, if a contract, or a...
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