25-5-8
Section 25-5-8 Employers' options to secure payment of compensation. (a) Option to insure risks.
An employer subject to this chapter may secure the payment of compensation under this chapter
by insuring and keeping insured his or her liability in some insurance corporation, association,
organization, insurance association, corporation, or association formed of employers and workers
or formed by a group of employers to insure the risks under this chapter, operating by mutual
assessment or other plans or otherwise. Notwithstanding the foregoing, the insurance association,
organization, or corporation shall have first had its contract and plan of business approved
in writing by the Commissioner of the Department of Insurance of Alabama and have been authorized
by the Department of Insurance to transact the business of workers' compensation insurance
in this state and under the plan. Notwithstanding any other provision of the law to the contrary,
the obligations of employers under law for...
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27-1-19
Section 27-1-19 Reimbursement of health care providers. (a) The insured, or health or dental
plan beneficiary may assign reimbursement for health or dental care services directly to the
provider of services. Health benefits include medical, pharmacy, podiatric, chiropractic,
optometric, durable medical equipment, and home care services. The company or agency, when
authorized by the insured, or health or dental plan beneficiary, shall pay directly to the
health care provider the amount of the claim, under the same criteria and payment schedule
that would have been reimbursed directly to the contract provider, and any applicable interest.
This amount only applies to assigned claims. Any company or agency making a payment to the
insured, or health or dental plan beneficiary, after the rights of reimbursement have been
assigned to the provider of services, shall be liable to the provider for the payment. If
the company or agency fails to reimburse the provider in accordance with the terms...
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36-29-14
Section 36-29-14 Health insurance coverage under State Employees' Insurance Board; operation
of board. (a) Any agency of the state, or any governmental entity, body, or subdivision thereto,
any county, any municipality, any municipal foundation, any fire or water district, authority,
or cooperative, any regional planning and development commission established pursuant to Sections
11-85-50 through 11-85-73, that is not and was not for the 12 months immediately preceding
the date of application to participate in any plan created pursuant to the provisions of this
article a member of an existing government sponsored health insurance program, formed under
the provisions of Section 11-26-2, the Association of County Commissions of Alabama or the
Alabama League of Municipalities, the Alabama Retired State Employees' Association, the Alabama
State Employees Credit Union, Easter Seals Alabama, Alabama State University, the Alabama
Rural Water Association, Rainbow Omega, Incorporated, The Arc...
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22-30A-5
Section 22-30A-5 Identification of inactive or abandoned sites and liable parties by director;
development and implementation of cleanup plan; public comment period; orders; notice and
hearing; payment and reimbursement of expenses; appeal; recovery of expenses by order or civil
action; penalties. (a) The director shall identify inactive or abandoned hazardous substance
sites, as defined herein, within the State of Alabama. Once identified the director shall
refer to the most current national priorities list ("NPL") of the United States
Environmental Protection Agency under the Comprehensive Environmental Response, Compensation
and Liability Act of 1980, ("CERCLA") 42 U.S.C. §9601 et seq. Any Alabama site
identified by the director that also appears on the NPL shall not be subject to this chapter,
except for the matching funds provision of Section 22-30A-3(c). (b) For all sites so identified
by the director, not appearing on the NPL, the director shall attempt to identify all...
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22-30D-4
Section 22-30D-4 Election of coverage; administration of chapter; rules and regulations. (a)(1)
All owners and operators and all wholesale distributors shall elect by May 24, 2001, to be
covered or not to be covered by this chapter and shall do so by notifying the department in
writing that such owner or operator or wholesale distributor elects to be covered or not to
be covered by this chapter. Following May 24, 2001, any owner or operator or wholesale distributor
who may have initially elected not to be covered by this chapter or who may have inadvertently
failed to notify the department may notify the department that such owner or operator or wholesale
distributor has reconsidered and desires to be covered by the fund, but any such owner or
operator or wholesale distributor shall, with its notice of request for coverage, be required
to pay to the Department of Revenue the registration fees which would otherwise have been
due to the fund had such owner or operator or wholesale...
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27-52-2
Section 27-52-2 Authority. The plan shall have the general powers and authority granted under
the laws of this state to health insurers and in addition thereto, the specific authority
to do all of the following: (1) Enter into contracts as are necessary or proper to carry out
the provisions and purposes of this article, including the authority, with the approval of
the commissioner, to enter into contracts with similar plans of other states for the joint
performance of common administrative functions, or with persons or other organizations for
the performance of administrative functions. (2) Sue or be sued, including taking any legal
actions necessary or proper to recover or collect assessments due the plan. (3) Take legal
action as necessary to do any of the following: a. To avoid the payment of improper claims
against the plan or the coverage provided by or through the plan. b. To recover any amounts
erroneously or improperly paid by the plan. c. To recover any amounts paid by the...
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34-23-184
Section 34-23-184 Audit procedures; report. (a) The entity conducting an audit shall follow
these procedures: (1) The pharmacy contract shall identify and describe in detail the audit
procedures. (2) The entity conducting the on-site audit shall give the pharmacy written notice
at least two weeks before conducting the initial on-site audit for each audit cycle. If the
pharmacy benefit manager does not include their auditing guidelines within their provider
manual, then the notice must include a documented checklist of all items being audited and
the manual, including the name, date, and edition or volume, applicable to the audit and auditing
guidelines. For on-site audits a pharmacy benefit manager shall also provide a list of material
that is copied or removed during the course of an audit to the pharmacy. The pharmacy benefit
manager may document this material on either a checklist or on an audit acknowledgement form.
The pharmacy shall produce any items during the course of the...
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36-29-19.7
Section 36-29-19.7 Retiree contribution based on years of service. (a) The board shall set
forth the employer contribution to the health insurance premium for each retiree class. (b)
For employees who retire other than for disability after September 30, 2005, but before January
1, 2012, the employer contribution to the health insurance premium set forth by the board
for each retiree class shall be reduced by two percent for each year of service less than
25 and increased by two percent for each year of service over 25, subject to adjustment by
the board for changes in Medicare premium costs required to be paid by a retiree. In no case
shall the employer contribution of the health insurance premium exceed 100 percent of the
total health insurance premium cost for the retiree. (c)(1) Except as provided in subdivision
(2), for employees who retire after December 31, 2011, the employer contribution to the health
insurance premium set forth by the board for each retiree class shall be...
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10A-20-6.16
Section 10A-20-6.16 Applicability of insurance laws. (a) No statute of this state applying
to insurance companies shall be applicable to any corporation organized under this article
and amendments thereto or to any contract made by the corporation; except the corporation
shall be subject to the following: (1) The provisions regarding annual premium tax to be paid
by insurers on insurance premiums. (2) Chapter 55 of Title 27. (3) Article 2 and Article 3
of Chapter 19 of Title 27. (4) Section 27-1-17. (5) Chapter 56 of Title 27. (6) Rules promulgated
by the Commissioner of Insurance pursuant to Sections 27-7-43 and 27-7-44. (7) Chapter 54
of Title 27. (8) Chapter 57 of Title 27. (9) Chapter 58 of Title 27. (10) Chapter 59 of Title
27. (11) Chapter 54A of Title 27. (12) Chapter 12A of Title 27. (13) Chapter 2B of Title 27.
(14) Chapter 29 of Title 27. (15) Chapter 62 of Title 27. (b) The provisions in subsection
(a) that require specific types of coverage to be offered or provided shall...
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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...
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