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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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27-19A-4
Section 27-19A-4 Required provisions. Any health insurance policy or employee benefit plan
which is delivered, renewed, issued for delivery, or otherwise contracted for in this state
shall, to the extent that it provides benefits for dental care expenses: (1) Disclose, if
applicable, that the benefit offered is limited to the least costly treatment; (2) Define
and explain the standard upon which the payment of benefits or reimbursement for the cost
of dental care services is based, such as "usual and customary," "reasonable
and customary," "usual, customary, and reasonable," fees or words of similar
import or specify in dollars and cents the amount of the payment or reimbursement for dental
care services to be provided. Said payment or reimbursement for a noncontracting provider
dentist shall be the same as the payment or reimbursement for a contracting provider dentist;
provided, however, that the health insurance policy or the employee benefit plan shall not
be required to make...
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27-13-38
Section 27-13-38 Prohibition against premiums not in accord with approved rating systems. No
insurer, or employee thereof, and no broker or agent shall knowingly charge, demand, or receive
a premium for any policy of insurance except in accordance with the respective rating systems
on file with, and approved by, the commissioner. No insurer, or employee thereof, and no broker
or agent shall pay, allow or give, or offer to pay, allow or give, directly or indirectly,
as an inducement to insurance or after insurance has been effected, any rebate, discount,
abatement, credit, or reduction of the premium named in a policy of insurance, or any special
favor or advantage in the dividends, or other benefits to accrue thereon or any valuable consideration
or inducement whatever not specified in the policy of insurance, except to the extent that
such rebate, discount, abatement, credit, reduction, favor, advantage, or consideration may
be provided for in rating systems filed by, or on behalf of,...
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27-13-76
Section 27-13-76 Prohibition against premiums not in accord with approved rating systems. No
insurer, or employee thereof, and no broker or agent shall knowingly charge, demand or receive
a premium for any policy of insurance except in accordance with the respective rating systems
on file with, and approved by, the commissioner. No insurer, or employee thereof, and no broker
or agent shall pay, allow, or give, or offer to pay, allow, or give, directly or indirectly,
as an inducement to insurance, or after insurance has been effected, any rebate, discount,
abatement, credit, or reduction of the premium named in a policy of insurance, or any special
favor or advantage in the dividends or other benefits to accrue thereon or any valuable consideration
or inducement whatever not specified in the policy of insurance, except to the extent that
such rebate, discount, abatement, credit, reduction, favor, advantage, or consideration may
be provided for in rating systems filed by, or on behalf...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-13-76.htm - 2K - Match Info - Similar pages
36-29-7
Section 36-29-7 Payment of employer's contribution; coverage for dependents; changes to contributions;
withholding of employee's contribution; State Employees' Insurance Fund. (a) The board is
hereby authorized to provide under the provisions of this chapter that the employer's contribution
to the cost of such plan for coverage of the employee and retiree shall be paid by the employer.
(b) Each employee and retiree shall be entitled to have his or her spouse and dependent children,
as defined by the rules and regulations of the board, included in the coverage provided upon
agreeing to pay the employee's contribution of the health insurance premium for such dependents.
The board shall adopt regulations governing the discontinuance and resumption by such employees
and retirees of coverage for dependents. (c) Subject to Section 36-29-19.3, any further changes
in employee or retiree contribution to the health insurance premium or other out-of-pocket
expenses including, but not limited to,...
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36-27-50
Section 36-27-50 Temporary legislative employees covered by retirement system and health insurance
plan; limitations; procedure; purchase of prior service. (a) Notwithstanding any provision
of this title to the contrary, any state employee who has worked during at least five regular
sessions of the Legislature since 1971 or any employee who has worked during five consecutive
regular sessions of the Legislature and who is termed "temporary employee" shall
be considered a full-time employee of the State of Alabama and may, at the option of the employee,
be covered as a member of the state Employees' Retirement System and the State Employees'
Health Insurance Plan. Notwithstanding the foregoing, coverage shall continue as if the person
is employed full time. The employee shall pay the full health insurance cost during the time
the employee is not on the legislative payrolls but remains eligible to continue employment
during the next regular or special session of the Legislature. During...
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36-29-13
Section 36-29-13 Appropriations to board; recognition of Medicaid premiums paid by retiree.
(a) There is hereby provided from the funds of the State Employees' Health Insurance Plan
$1,592,605.00 (estimated) for the fiscal year beginning October 1, 1985. The State Employees'
Insurance Board is hereby authorized to expend $22.35 per month per eligible retired employee
towards coverage for said retired employee for the fiscal year beginning October 1, 1985.
(b) It is the intent of the Legislature that subsequent appropriations to the State Employees'
Insurance Board pursuant to this section shall be included in the appropriations made for
active employees from employer funds pursuant to subsection (d) of Section 36-29-7 beginning
with the fiscal year 1986-87 and each year thereafter and shall be increased to fully fund
the employer's portion of the benefits provided for in Section 36-29-10. (c) The board shall
recognize any Medicare premium paid by a retiree in determining any increases...
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36-29-50
Section 36-29-50 High deductible health plan with a federally qualified health savings account.
(a) As used in this section, the following words shall have the following meanings: (1) HEALTH
SAVINGS ACCOUNT or HSA. A savings or other account meeting the requirements for favorable
tax treatment under 26 U.S.C. §223, as amended. (2) HIGH DEDUCTIBLE HEALTH PLAN or HDHP.
That term as defined in 26 U.S.C. §223(c)(2), as amended, and any regulations promulgated
thereunder. (3) PARTICIPANT. An eligible active or retired state employee and his or her dependents
as determined by the State Employees' Insurance Board. (b) The State Employees' Insurance
Board may offer a high deductible health plan with a federally qualified health savings account
(HDHP-HSA) to eligible active and retired state employees and their dependents. A retired
state employee eligible for or entitled to Medicare benefits under Title XVIII of the federal
Social Security Act is not eligible to participate in the HDHP-HSA....
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/36-29-50.htm - 2K - Match Info - Similar pages
27-10-35
Section 27-10-35 Report of, and tax on, independently procured coverages; exceptions. (a) Anyone
who may desire to place his insurance in a foreign insurer not authorized to do business in
this state may place such insurance, and any insured who in this state procures, or causes
to be procured, or continues or renews insurance in an unauthorized foreign insurer or any
self-insurer who in this state so procures or continues excess loss, catastrophe, or other
insurance, upon a subject of insurance resident, located or to be performed within this state,
other than insurance procured through a surplus line broker pursuant to the surplus lines
law of this state or exempted from such law under Section 27-10-34 shall, within 90 days after
the date such insurance was so procured, continued, or renewed, file a written report of the
same with the commissioner on forms designated by the commissioner and furnished to such an
insured upon request. The report shall show the name and address of the...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-10-35.htm - 3K - Match Info - Similar pages
27-1-17
Section 27-1-17 Limitation periods for payment of claims; overdue claims; retroactive denials,
adjustments, etc.; penalties. (a) Each insurer, health service corporation, and health benefit
plan that issues or renews any policy of accident or health insurance providing benefits for
medical or hospital expenses for its insured persons shall pay for services rendered by Alabama
health care providers within 45 calendar days upon receipt of a clean written claim or 30
calendar days upon receipt of a clean electronic claim. If the insurer, health service corporation,
or health benefit plan is denying or pending the claim, the insurer, health service corporation,
or health benefit plan shall, within 45 calendar days for a written claim and 30 calendar
days for an electronic claim, notify the health care provider or certificate holder of the
reason for denying or pending the claim and what, if any, additional information is required
to process the claim. Any undisputed portion of the claim...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-1-17.htm - 17K - Match Info - Similar pages
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