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27-49-3
Section 27-49-3 Definitions. As used in this chapter, the following terms shall have
the following meanings: (1) HEALTH BENEFIT PLAN. Any individual or group plan, policy, or
contract for health care services issued, delivered, issued for delivery, 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, purchases, or furnishes health care services
to patients, insureds, or beneficiaries in this state. The term includes, but is not limited
to, entities created pursuant to Article 6 of Chapter 4 of Title 10. For the purposes of this
chapter, a health benefit plan located or domiciled outside of the State of Alabama is deemed
to be subject to the provisions of this chapter if it receives, processes,...
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11-91-7
Section 11-91-7 Validation, etc., of policies issued prior to August 16, 1947, and acts
done and premiums paid in accordance therewith. All contracts and policies of group life,
health, accident, and hospitalization insurance or any one or more of them which have been
issued prior to August 16, 1947, to any municipal corporation, county, city or county board
of education or any state agency or institution of education, learning, training or correction,
or for the delinquent, insane, sick, deaf, dumb, blind, needy, juvenile, or aged for the benefit
of its officers and employees or any portion of them are hereby ratified, confirmed, approved,
and validated. All acts done and all premiums paid by any such municipal corporation, county,
board, agency or institution in accordance with the terms of any such contract or policy are
hereby ratified, confirmed, approved and validated. (Acts 1947, No. 377, p. 269, ยงยง1, 2.)...
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27-1-20
Section 27-1-20 Patient Right to Know Act. (a) This section shall be known and
may be cited as the "Patient Right to Know Act." (b) As used in this section,
unless the context clearly indicates otherwise, the following words shall have the following
meanings: (1) ENROLLEE. A person who purchases individual health care coverage or an employer
who purchases a group health care plan. (2) PROVIDER. A physician, dentist, podiatrist, pharmacist,
optometrist, psychologist, clinical social worker, advanced nurse practitioner, registered
optician, licensed professional counselor, physical therapist, and chiropractor. (c)(1) All
persons, firms, corporations, associations, health maintenance organizations, health insurance
services, or preferred provider organizations, any employer-sponsored health benefit plan,
or any similar organization or entity, providing health, accident, or dental insurance coverage,
either directly or indirectly, shall provide an enrollee with a written description of the...
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27-19-52.1
Section 27-19-52.1 Applicability of article. (a) Except as otherwise specifically provided,
this article shall apply to both of the following: (1) All Medicare supplement policies delivered
or issued for delivery in this state on or after August 1, 2000. (2) All certificates issued
under group Medicare supplement policies, which certificates have been delivered or issued
for delivery in this state. (b) This article shall not apply to a policy of one or more employers
or labor organizations, or of the trustees of a fund established by one or more employees
or labor organizations, or combination thereof, for employees or former employees or a combination
thereof, or for members or former members, or a combination thereof, of the labor organizations.
(c) Except as otherwise specifically provided in subsection (d) of Section 27-19-56,
this article is not intended to prohibit or apply to insurance policies or health care benefit
plans, including group conversion policies, provided to...
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27-54-2
Section 27-54-2 Definitions. For purposes of this chapter, the following terms have
the following meanings: (1) DAY TREATMENT SERVICES. Includes, but is not limited to: Physiological,
psychological, and psychosocial concepts, techniques, and processes necessary to maintain
or develop functional skills of clients, provided to individuals and groups for periods of
more than two hours but less than 24 hours a day. (2) HEALTH BENEFIT PLAN. A health care service
plan governed by the provisions of Article 6, Chapter 4, Title 10, and a group health insurance
policy, including an employee welfare health benefit plan, that covers hospital, medical,
or surgical expenses, issued by insurers, health maintenance organizations, preferred provider
organizations, medical service organizations, physician-hospital organizations, or any other
person, firm, corporation, joint venture, or other similar business entity that pays for,
purchases, or furnishes health care services to patients, insureds, or...
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11-91-1
Section 11-91-1 Provision by governing bodies of counties and municipalities for group
life, health, accident, etc., insurance, etc., for officers and employees authorized. (a)
The council, commission, or similar governing body of each municipal corporation, the board
of directors of each incorporated municipal board, the county commission of each county, the
board of education of each city and the board of education of each county, now existing or
established after August 16, 1947, shall have power and authority to contract for and obtain
and maintain policies of group life, health, accident, and hospitalization insurance or any
one or more of them and shall have power and authority to contract for and obtain and maintain
individual annuity contracts, retirement income policies or group annuity contracts to provide
a retirement plan for the benefit of such of the officers and employees of such municipality,
incorporated municipal board, county, or board as may be determined by such...
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16-25A-5
Section 16-25A-5 Authorization for health insurance plan; election of optional or supplemental
coverage. (a) The board is hereby empowered and authorized to establish a fully insured or
self-insured health insurance plan for employees and, under certain conditions, retired employees
and to adopt and promulgate rules and regulations for the administration of such plan subject
to such limitations as may be contained in this article. Such plan may provide for group hospitalization,
surgical, medical, cancer, cash indemnity, and dental insurance against the financial costs
of hospitalization, surgical, and medical treatment and care and may also include, among other
things, prescribed drugs, medicines, prosthetic appliances, hospital inpatient and outpatient
service benefits, and hospital/medical expenses indemnity benefits, including major medical
benefits or such other coverage or benefits as may be deemed appropriate and desirable by
the board, within the limits of such funds as may be...
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27-19-56
Section 27-19-56 Outline of coverage; disclosure of information. (a) In order to provide
for full and fair disclosure in the sale of Medicare supplement policies, no Medicare supplement
policy shall be delivered or issued for delivery in this state and no certificate shall be
delivered pursuant to a group Medicare supplement policy delivered or issued for delivery
in this state unless an outline of coverage is delivered to the applicant at the time application
is made. (b) The commissioner shall prescribe the format and content of the outline of coverage
required by subsection (a) of this section. For purposes of this section, "format"
means style, arrangements, and overall appearance, including, but not limited to, the size,
color, and prominence of type and the arrangement of text and captions. This outline of coverage
shall include all of the following: (1) A description of the principal benefits and coverage
provided in the policy. (2) A statement of the renewal provisions...
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22-13-70
Section 22-13-70 Standardized summary of treatment methods, reconstruction options,
and availability of coverage. (a) The Alabama Department of Public Health shall develop a
standardized written summary, in plain nontechnical language, which shall contain all of the
following: (1) An explanation of the alternative medically viable methods of treating breast
cancer including, but not limited to, hormonal, radiological, chemotherapeutic, or surgical
treatments, or combinations thereof. (2) Information on breast reconstructive surgery including,
but not limited to, the use of breast implants, their side effects, risks, and other pertinent
information to aid a person in deciding on a course of treatment. (3) An explanation of the
special provisions relating to mastectomy, lymph node dissection, lumpectomy, and breast reconstructive
surgery coverage, and second opinion coverage, including out-of-network options, under the
insurance law, Section 22-6-10, Section 22-6-11, and Chapter 50,...
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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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