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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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27-54-4
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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27-7-1
Section 27-7-1 Definitions. For the purposes of this chapter, the following terms shall have
the meanings respectively ascribed to them by this section: (1) BUSINESS ENTITY. A corporation,
association, partnership, limited liability company, limited liability partnership, or other
legal entity. (2) COMMISSIONER. The Alabama Commissioner of Insurance. (3) HOME STATE. The
District of Columbia and any state or territory of the United States in which an insurance
producer maintains his or her principal place of residence or principal place of business
and is licensed to act as an insurance producer. (4) INSURANCE. As defined in Section 27-1-2.
(5) INSURANCE PRODUCER or PRODUCER. A person required to be licensed under the laws of this
state to sell, solicit, or negotiate insurance. (6) INSURER. As defined in Section 27-1-2.
For the purposes of this chapter, insurer shall also mean an insurance company licensed pursuant
to Chapter 3, commencing with Section 27-3-1 of this title; a health...
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27-1-10.1
Section 27-1-10.1 Insurance coverage for drugs to treat life-threatening illnesses. (a) The
Legislature finds and declares the following: (1) The citizens of this state rely upon health
insurance to cover the cost of obtaining health care and it is essential that the citizens'
expectation that their health care costs will be paid by their insurance policies is not disappointed
and that they obtain the coverage necessary and appropriate for their care within the terms
of their insurance policies. (2) Some insurers deny payment for drugs that have been approved
by the Federal Food and Drug Administration, hereafter referred to as FDA, when the drugs
are used for indications other than those stated in the labelling approved by the FDA, off-label
use, while other insurers with similar coverage terms do pay for off-label use. (3) Denial
of payment for off-label use can interrupt or effectively deny access to necessary and appropriate
treatment for a person being treated for a...
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11-91A-7
Section 11-91A-7 Jurisdiction of board; funding; powers of board. The board shall have full,
complete, and exclusive jurisdiction over the program and shall allocate funds from its treasury
for the fulfillment and accomplishment of its duties and responsibilities in a manner as may
be necessary and appropriate to carry out the purposes of this chapter. The board shall have
the general powers and authority granted under the laws of this state for health insurers,
and in addition thereto, the specific authority to do all of the following: (a) Subject to
compliance with Section 11-91A-8 where applicable, execute a contract or contracts to provide
for the administration of the program in accordance with this chapter. The contract or contracts
may be executed with one or more agencies or corporations licensed to transact or administer
group health care business in this state with similar plans of the state for the joint performance
of common administrative functions. (b) Establish, and...
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36-29-1
Section 36-29-1 Definitions. When used in this chapter, the following terms shall have the
following meanings, respectively, unless the context clearly indicates otherwise: (1) BOARD.
The State Employees' Insurance Board. (2) CLASS. An employee or retiree shall be included
in one of the following classes: (i) active employee single, (ii) active employee family,
(iii) non-Medicare retiree single, (iv) non-Medicare retiree family, (v) Medicare retiree
single, (vi) Medicare retiree family, (vii) non-Medicare retiree with Medicare eligible dependent(s),
or (viii) Medicare retiree with non-Medicare dependent(s). (3) EMPLOYEE. A person who works
full time for the State of Alabama or for a county health department and who receives his
or her full compensation on a monthly basis through means of a state warrant drawn upon the
State Treasury or by check drawn by the Treasurer of the Alabama State Port Authority or by
check drawn by the treasurer of the Alabama state agency for surplus property...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/36-29-1.htm - 11K - Match Info - Similar pages
34-24-125
Section 34-24-125 Chiropractic agreements. (a) For the purposes of this section, the following
words shall have the following meanings: (1) CHIROPRACTOR. A person licensed to practice chiropractic
in this state. (2) CHIROPRACTIC AGREEMENT or AGREEMENT. A contract between a chiropractor
and a patient or his or her legal representative in which the chiropractor or the chiropractor's
chiropractic practice agrees to provide chiropractic services to the patient for an agreed
upon fee and period of time. (3) CHIROPRACTIC PRACTICE. A chiropractor or a chiropractic practice
of a chiropractor that charges a periodic fee for chiropractic services and which does not
bill a third party any additional fee for services for patients covered under a chiropractic
agreement. The per visit charge of the practice shall be less than the monthly equivalent
of the periodic fee. (b) A chiropractic agreement is not insurance, may not be deemed an insurance
arrangement, and is not subject to state insurance...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/34-24-125.htm - 4K - Match Info - Similar pages
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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27-52-2
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...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-52-2.htm - 3K - Match Info - Similar pages
22-6-151
Section 22-6-151 Regional care organizations; governing board of directors; citizen's advisory
committee; solvency and financial requirements; reporting; provider standards committee. (a)
A regional care organization shall serve only Medicaid beneficiaries in providing medical
care and services. (b) Notwithstanding any other provision of law, a regional care organization
shall not be deemed an insurance company under state law. (c)(1) A regional care organization
and an organization with probationary regional care organization certification shall have
a governing board of directors composed of the following members: a. Twelve members shall
be persons representing risk-bearing participants in the regional care organization or organization
with probationary certification. A participant bears risk by contributing cash, capital, or
other assets to the regional care organization. A participant also bears risk by contracting
with the regional care organization to treat Medicaid beneficiaries...
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