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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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16-25A-17
Section 16-25A-17 Partial funding of health insurance coverage for retired employees; method
of determining amount; provisions supplemental. (a)(1) Any premiums paid to the Public Education
Employees' Health Insurance Board for active employees shall include an amount to partially
fund the cost of coverage for retired employees. Notwithstanding the foregoing, if the plan
becomes fully funded pursuant to this article, this section shall not apply. (2) The amount
authorized by subdivision (1) of this subsection shall not be less than an amount determined
by multiplying the number of retired employees by an individual retired employee rate. The
individual retired employee rate shall be determined by multiplying the full cost of coverage
for a retired employee eligible to receive benefits under the federal Medicare program times
the fractional amount derived by dividing the current individual premium for an employee not
eligible for benefits under the federal Medicare program by the full...
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22-50-17
Section 22-50-17 Operation of a facility for care or treatment of mental or emotional illness
or substance abuse, or services to persons with an intellectual disability. (a) No person,
partnership, corporation, or association of persons shall operate a facility or institution
for the care or treatment of any kind of mental or emotional illness or substance abuse or
for providing services to persons with an intellectual disability as defined in this chapter,
without being certified by the department or licensed by the State Board of Health; provided
that nothing in this section shall be construed so as to require a duly authorized physician,
psychiatrist, psychologist, social worker, licensed professional counselor operating under
the scope of his or her license, or Christian Science practitioner to obtain a license for
treatment of patients in his private office, unless he keeps two or more patients in his office
for continuous periods of 24 hours or more in one week, or that a church...
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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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27-19-28
Section 27-19-28 Exclusion of hospitalization benefits for mental patients in tax-supported
institutions. (a) No policy of health, sickness, or accident insurance delivered, or issued
for delivery, in this state, including both individual and group policies, which provide coverage
for psychiatric treatment or mental illness shall exclude hospitalization benefits for mental
patients in tax-supported institutions of the State of Alabama, or any county or municipality
thereof. (b) The provisions of this section shall not apply to any policy of insurance in
effect prior to September 20, 1971, nor shall the provisions of this section apply to any
employee benefit plan providing hospital benefits for mental patients where such employee
benefit plan is established by the employer and contributions to the plan are provided by
the employer and the employee, or either of them, and such plan is not evidenced by individual,
or group or blanket policies of health, sickness, or accident insurance...
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11-91A-2
Section 11-91A-2 Local Government Health Insurance Board; governance and administration of
program. (a) The Local Government Health Insurance Board shall govern and administer the Local
Government Health Insurance Program currently governed and administered by the State Employees'
Insurance Board (SEIB) pursuant to Chapter 29 of Title 36. The transfer of the governance
and administration to the board shall take effect at 12:01 a.m. on January 1, 2015, and thereafter
the board shall take all control and responsibility for the program under procedures and authority
set out in this chapter. (b) The program governed and administered by the board shall provide
a reasonable relationship between the health care benefits to be included and the expected
health care expenses to be incurred by affected employees, retirees, and their dependents.
The board may establish a fully insured or self-insured health care plan for employees and
retirees as defined in this chapter and may adopt rules for the...
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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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27-12-10
Section 27-12-10 Financial inducements to purchase insurance. (a) No person shall issue or
deliver, or permit its agents, officers, or employees to issue or deliver, agency company
stock or other capital stock, or benefit certificates or shares in any common-law corporation,
or securities, or any special or advisory board contract or other contract of any kind promising
returns and profits as an inducement to insurance. The commissioner shall refuse to issue
a certificate of authority or license to any insurer or other person that is in violation
of this section and shall revoke the certificate of authority or license of any such violating
insurer or person if such authority or license is already outstanding. (b) No person shall
issue or deliver, or permit its agents, officers, or employees to issue or deliver, in this
state, any life insurance policy or contract of annuity in which are used such words as "investment
plan," "expansion plan," "profit-sharing," "charter plan,"
"founders'...
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34-19-16
Section 34-19-16 Where care may be performed; required forms an duties of licensed midwife.
(a) A licensed midwife may provide midwifery care in the setting of the client's choice, except
a hospital. (b) A licensed midwife shall ensure that the client has signed a midwife disclosure
form provided by the board indicating receipt of a written statement that includes all of
the following information: (1) A description of the licensed midwife's education, training,
and experience in midwifery. (2) Antepartum, intrapartum, and postpartum conditions requiring
medical referral, transfer of care, and transport to a hospital. (3) A plan for medical referral,
transfer of care, and transport of the client or newborn or both when indicated by specific
antepartum, intrapartum, or postpartum conditions. (4) Instructions for filing a complaint
against a licensed midwife. (5) A statement that the licensed midwife must comply with the
federal Health Insurance Portability and Accountability Act. (6) The...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/34-19-16.htm - 4K - Match Info - Similar pages
27-15-52
Section 27-15-52 Definitions. The following terms shall have the following meanings: (1) COMMERCIALLY
REASONABLE EFFORT. The plans, processes, or procedures necessary to confirm the death of the
insured, contract owner or annuitant, or retained asset account holder against other available
records and information and, as applicable, to locate the beneficiary or beneficiaries or
other person entitled to payment pursuant to the terms of the policy or contract which have
been developed by each insurer and submitted to and approved by the department. (2) CONTRACT.
An annuity contract. The term contract shall not include an annuity used to fund an employment-based
retirement plan or program where the insurer is not committed by terms of the annuity contract
to pay death benefits to the beneficiaries of specific plan participants. (3) DEATH MASTER
FILE. The United States Social Security Administration's Death Master File or any other database
or service that is at least as comprehensive as...
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