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27-57-2
Section 27-57-2 Coverage; applicability. (a) All group health benefit plans, policies,
contracts, and certificates executed, delivered, issued for delivery, continued, or renewed
in this state on or after August 1, 2004, shall offer, at the time of proposal, sale, or renewal
of a policy subject to this chapter, to include colorectal cancer examinations within the
coverage. Such offer of coverage shall include colorectal cancer examinations for covered
persons who are 50 years of age or older, or for covered persons who are less than 50 years
of age and at high risk for colorectal cancer according to current American Cancer Society
colorectal cancer screening guidelines. (b) This chapter shall apply to group accident and
sickness insurance policies issued by a fraternal benefit society, a nonprofit hospital service
corporation, a nonprofit medical service corporation, a group health care plan, a health maintenance
organization, or any similar entity. (Act 2004-502, p. 969, §2.)...
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27-57-1
Section 27-57-1 Definitions. As used in this chapter, the following words and terms
shall have the following meanings: (1) COLORECTAL CANCER EXAMINATIONS. Examinations and laboratory
tests specified in current American Cancer Society guidelines for colorectal cancer screening
of asymptomatic individuals. (2) HEALTH BENEFIT PLAN. A group health insurance policy that
covers hospital, medical, or surgical expenses, 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 beneficiaries
in this state. 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 this chapter if it receives, processes,
adjudicates, pays, or denies claims for health care services submitted...
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27-57-6
Section 27-57-6 Additional benefit costs. (a) The issuer of a group health benefit plan,
policy, or contract may either disclose the additional premium for such additional colorectal
examination benefits to the prospective contract holder and allow the contract holder to elect
such additional benefits on an optional basis; or conform its policies, contracts, or certificates
issued on or after August 1, 2004, and adjust its premium cost to reflect the additional benefit
cost. (b) Employer sponsors of group health benefit plans are not required to purchase the
additional benefits for colorectal examinations that are offered pursuant to this chapter.
(Act 2004-502, p. 969, §6.)...
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27-20A-2
Section 27-20A-2 Chapter applicable to group, etc., policies. No group, blanket, franchise,
or association health insurance policy providing coverage on an expense incurred basis, nor
group, blanket, franchise, or association service or indemnity type contract issued by a nonprofit
corporation, nor group-type self insurance plan providing protection, insurance, or indemnity
against hospital, medical, or surgical expenses, nor health maintenance organization plan
shall be issued, delivered, executed, or renewed in this state, or approved for issuance or
renewal in this state by the Commissioner of Insurance after 90 days beyond the effective
date of this chapter, unless such policy, contract, or plan, at the option of the policyholder
or sponsor, provides benefits to any insured, subscriber, or other person covered under the
policy, contract, or plan for expenses incurred in connection with the treatment of alcoholism
when such treatment is prescribed by a duly licensed doctor of...
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27-54-4
Section 27-54-4 Illnesses covered; requirements of benefit plans, etc. (a) All group
health benefit plans shall offer to provide, at a minimum, additional benefits according to
this chapter for a person receiving medical treatment for any of the following mental illnesses
diagnosed by an appropriately licensed provider. (1) Schizophrenia, schizophrenia form disorder,
schizo affective disorder. (2) Bipolar disorder. (3) Panic disorder. (4) Obsessive-compulsive
disorder. (5) Major depressive disorder. (6) Anxiety disorders. (7) Mood disorders. (8) Any
condition or disorder involving mental illness, excluding alcohol and substance abuse, that
falls under any of the diagnostic categories listed in the mental disorders section
of the International Classification of Disease, as periodically revised. (b) All group health
benefit plans, policies, contracts, and certificates executed, delivered, issued for delivery,
continue, or renewed in this state on or after January 1, 2001, shall offer, at...
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27-58-1
Section 27-58-1 Definitions. As used in this chapter, the following terms shall have
the following meanings: (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 chapter if it receives, processes, adjudicates,
pays, or denies claims for health care services submitted by or on...
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27-19-103
Section 27-19-103 Definitions. Unless the context requires otherwise, the definitions
in this section apply throughout this article. (1) APPLICANT. In the case of: a. An
individual long-term care insurance policy, the person who seeks to contract for benefits.
b. A group long-term care insurance policy, the proposed certificate holder. (2) CERTIFICATE.
Any certificate issued under a group long-term care insurance policy, which policy has been
delivered or issued for delivery in this state. (3) COMMISSIONER. The Alabama Commissioner
of Insurance. (4) GROUP LONG-TERM CARE INSURANCE. A long-term care insurance policy which
is delivered or issued for delivery in this state and issued to any of the following: a. One
or more employers or labor organizations, or to a trust or to the trustees of a fund established
by one or more employers or labor organizations, or a combination thereof, for employees or
former employees or a combination thereof, or for members or former members or a...
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27-14-11.1
Section 27-14-11.1 Contents of policies - Denial or reduction of benefits due to Medicaid
eligibility void. (a) For purposes of this section, "private insurer" is
defined as any of the following: (1) Any commercial insurance company offering health or casualty
insurance to individuals or groups, including both experience-rated contracts and indemnity
contracts. (2) Any profit or nonprofit prepaid plan offering either medical services or full
or partial payment for the diagnosis or treatment of an injury, disease, or disability. (3)
Any organization administering health or casualty insurance plans for professional associations,
unions, fraternal groups, employer-employee benefit plans, and any similar organization offering
these payments or services, including self-insured and self-funded plans. (4) Any health insurer,
including group health plans, as defined in Section 607(1) of the Employee Retirement
Income Security Act of 1974, self-insured plans, service benefit plans, managed care...
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16-25A-6
Section 16-25A-6 Exclusions. Such health insurance shall not include the following:
(1) Expenses incurred by or on account of an individual prior to the effective date of the
plan as to him; (2) Hearing aids and examinations for the prescription or fitting thereof;
(3) Cosmetic surgery or treatment, except to the extent necessary for correction of damage
caused by accidental injury while covered by the plan or as a direct result of disease covered
by the plan; (4) Services received in a hospital owned or operated by the United States government
for which no charge is made; (5) Services received for injury or sickness due to war or any
act of war, whether declared or undeclared, which war or act of war shall have occurred after
the effective date of this plan; (6) Expenses for which the individual is not required to
make payment; (7) Expenses to the extent of benefits provided under any employer group plan
other than this plan in which the state participates in the cost thereof; (8)...
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16-6F-7
Section 16-6F-7 Applicant proposals; conversion to public charter school; terms of charters;
contracts. (a) Request for proposals. (1) To solicit, encourage, and guide the development
of quality public charter school applications, every local school board, in its role as public
charter school authorizer, shall issue and broadly publicize a request for proposals for public
charter school applications by July 17, 2015, and by November 1 in each subsequent year. The
content and dissemination of the request for proposals shall be consistent with the purposes
and requirements of this act. (2) Public charter school applicants may submit a proposal for
a particular public charter school to no more than one local school board at a time. (3) The
department shall annually establish and disseminate a statewide timeline for charter approval
or denial decisions, which shall apply to all authorizers in the state. (4) Each local school
board's request for proposals shall present the board's strategic...
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