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27-21A-15
Section 27-21A-15 Powers of insurers and health care service plans. (a) An insurance company
licensed in this state, or a health care service plan authorized to do business in this state,
may either directly or through a subsidiary or affiliate organize and operate a health maintenance
organization under the provisions of this chapter. Notwithstanding any other law which may
be inconsistent herewith, any two or more such insurance companies, health care service plans,
or subsidiaries or affiliates thereof, may jointly organize and operate a health maintenance
organization. The business of insurance is deemed to include the providing of health care
by a health maintenance organization owned or operated by an insurer or a subsidiary thereof.
(b) Notwithstanding any provision of insurance and health care service plan laws, Title 10,
Chapter 4, Article 6 and Title 27, an insurer or a health care service plan may contract with
a health maintenance organization to provide insurance or...
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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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27-54-2
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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22-21-386
Section 22-21-386 Examination and investigation of corporations by department; power to summon
and examine witnesses; payment of expenses. (a) The Department of Insurance, any agent or
examiner of the department, or any other person appointed by the department shall have the
power of visitation and examination into the affairs, transactions, accounts, business records,
and assets of any such dental service plan corporation, shall have free access to all of the
books, papers, and documents that relate to the business of the corporation, may summon and
qualify witnesses under oath, and may examine its officers, agents, and employees or other
relative persons regarding the affairs, transactions, and condition of the corporation. The
corporation whose affairs are examined shall pay to the department for deposit into the State
Treasury the traveling expenses and any other expenses of the examiner or other person making
the examination which shall be credited as provided by Section...
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27-12A-2
Section 27-12A-2 Insurance fraud - definition. A person commits the crime of insurance fraud
if, knowingly and with intent to defraud, he or she commits, or conceals any material information
concerning, one or more of the following acts: (1) The solicitation or acceptance of new or
renewal insurance risks on behalf of an insurer, reinsurer, or other person engaged in the
transaction of the business of insurance, by a person who knows the insurer, reinsurer, or
other person responsible for the risk is financially unable to pay its claims at the time
of the transaction. (2) The removal, concealment, alteration, or destruction of the assets
or records relating to the transaction of the business of insurance of an insurer, reinsurer,
or other person engaged in the transaction of the business of insurance. This section does
not prohibit an insurer, reinsurer, or other person engaged in the transaction of the business
of insurance from destroying records or documents relating to the...
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34-23-181
Section 34-23-181 Definitions. The following words shall have the following meanings as used
in this article: (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 article if it receives, processes, adjudicates,
pays, or denies claims for health care services submitted by or...
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7-9A-102
Section 7-9A-102 Definitions and index of definitions. (a) Article 9A definitions. In this
article: (1) "Accession" means goods that are physically united with other goods
in such a manner that the identity of the original goods is not lost. (2) "Account,"
except as used in "account for," means a right to payment of a monetary obligation,
whether or not earned by performance, (i) for property that has been or is to be sold, leased,
licensed, assigned, or otherwise disposed of, (ii) for services rendered or to be rendered,
(iii) for a policy of insurance issued or to be issued, (iv) for a secondary obligation incurred
or to be incurred, (v) for energy provided or to be provided, (vi) for the use or hire of
a vessel under a charter or other contract, (vii) arising out of the use of a credit or charge
card or information contained on or for use with the card, or (viii) as winnings in a lottery
or other game of chance operated or sponsored by a State, governmental unit of a State, or...
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8-33-6
Section 8-33-6 Conditions for policies. No warranty reimbursement insurance policy shall be
issued, sold, or offered for sale in this state unless the policy meets the following conditions:
(1) The policy states that the issuer of the policy will reimburse or pay on behalf of the
vehicle protection product warrantor all covered sums which the warrantor is legally obligated
to pay or will provide all service that the warrantor is legally obligated to perform according
to the warrantor's contractual obligations under the provisions of the insured warranties
sold by the warrantor. (2) The policy states that in the event payment due under the terms
of the warranty is not provided by the warrantor within 60 days after proof of loss has been
filed according to the terms of the warranty by the warranty holder, the warranty holder may
file directly with the warranty reimbursement insurance company for reimbursement. (3) The
policy provides that a warranty reimbursement insurance company that...
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27-23-20
Section 27-23-20 Definitions. For the purposes of this article, the following terms shall have
the meanings respectively ascribed to them by this section: (1) POLICY OF AUTOMOBILE LIABILITY
INSURANCE. A policy delivered, or issued for delivery, in this state insuring a natural person
as named insured or one or more related individuals, resident of the same household, and under
which the insured vehicles therein designated are of the following types only: a. A motor
vehicle of the private passenger or station type that is not used as a public or livery conveyance
for passengers nor rented to others; or b. Any other four-wheel motor vehicle with a load
capacity of 1,500 pounds or less which is not used in the occupation, profession, or business
of the insured; provided, however, that this article shall not apply: 1. To policies of automobile
liability insurance issued under an automobile assigned risk plan; 2. To any policy insuring
more than four automobiles; nor 3. To any policy...
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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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