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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...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/16-25A-1.htm - 6K - Match Info - Similar pages
36-29-6
Section 36-29-6 Authorization and execution of contracts; documentation of benefits. (a) The
board is hereby authorized to execute a contract or contracts to provide the plan determined
in accordance with the provisions of this chapter. Such contract or contracts may be executed
with one or more agencies or corporations licensed to transact or administer group health
insurance business in this state. All of the benefits to be provided under this chapter may
be included in one or more similar contracts issued by the same or different companies. (b)
Before entering into any contract or contracts authorized by subsection (a) of this section,
the board shall invite competitive bids from all qualified entities who may wish to administer
or offer plans for the health insurance coverage desired. The board shall award such contract
or contracts on a competitive basis as determined by the benefits afforded, administrative
costs, the costs to be incurred by employee, retiree, and employer, the...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/36-29-6.htm - 3K - Match Info - Similar pages
16-25A-7
Section 16-25A-7 Authorization and execution of contracts; evidence of coverage; denial of
claims. (a) The board is hereby authorized to execute a contract or contracts to provide for
the benefits or the administration of the plan determined in accordance with the provisions
of this article. Such contract or contracts may be executed with one or more agencies or corporations
licensed to transact or administer group health insurance business in this state. All of the
benefits to be provided under this article may be included in one or more similar contracts
issued by the same or different companies. The board is further authorized to develop a plan
whereby it may become self-insured upon its finding that such arrangement would be financially
advantageous to the state and plan participants. (b) Before entering into any contract or
contracts authorized by subsection (a), the board shall invite competitive bids from all qualified
entities who may wish to administer or offer plans for the...
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25-5-8
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
workers' compensation benefits for injury of employees may be insured by any combination
of life, disability, accident, health, or other insurance provided that the coverages insure
without limitation or exclusion the workers' compensation benefits of this state. (b) Option
to operate as self-insurer. An employer subject to this chapter who elects not to insure his
or her liability thereunder shall furnish satisfactory proof to the secretary of his or her
financial ability to pay directly compensation in the amount and manner and...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/25-5-8.htm - 14K - Match Info - Similar pages
27-14-11.1
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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27-21A-1
organization. (5) EVIDENCE OF COVERAGE. Any certificate, agreement, or contract issued to an
enrollee setting out the coverage to which he is entitled. (6) HEALTH CARE SERVICES. Any services
included in the furnishing to any individual of medical or dental care, or hospitalization
or incident to the furnishing of such care or hospitalization, as well as the furnishing to
any person of any and all other services for the purpose of preventing, alleviating, curing,
or healing human illness, injury, or physical disability. (7) HEALTH MAINTENANCE ORGANIZATION.
Any person that undertakes to provide or arrange for basic health care services through an
organized system which combines the delivery and financing of health care to enrollees. The
organization shall provide physician services directly through physician employees or under
contractual arrangements with either individual physicians or a group or groups of physicians.
The organization shall provide basic health care services...
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11-91A-7
care plan under Chapter 29 of Title 36, and in the State Employees' Retirement System under
Chapter 27 of Title 36. (j) Acquire property by purchase or lease. (k) Provide for reinsurance
of risks incurred by the program. (l)(1) Provide additional types of optional health care
coverages or services including, but not limited to, providing for the administration of the
payment of health care services on behalf of employer participants whose eligible employees
or officials suffer on-the-job injury, under such terms and conditions as the board
shall determine. (2) Participation in any service established for the administration of the
payment of health care services on behalf of an employer participant relating to on-the-job
injury shall be at the sole option of the employer participant. Refusal to participate
by an employer participant shall not affect eligibility for the program or factor into the
establishment of rates as authorized in subsection (b). (m) Adopt bylaws, policies, and...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/11-91A-7.htm - 5K - Match Info - Similar pages
25-4-10
situations); (v) In a position which, under or pursuant to the laws of this state or of an
Indian tribe, is designated as a major nontenured policymaking or advisory position or a policymaking
or advisory position the performance of the duties of which ordinarily does not require more
than 8 hours per week; or d. In a facility conducted for the purpose of carrying out a program
of rehabilitation for individuals whose earning capacity is impaired by age or physical or
mental deficiency or injury or providing remunerative work for individuals who because
of their impaired physical or mental capacity cannot be readily absorbed in the competitive
labor market by an individual receiving such rehabilitation or remunerative work; provided
however, if an individual's employment is otherwise characterized as employment under subsection
(a) and the individual is performing work under the Javits Wagner O'Day Act or a similar set-aside
program under the laws of the United States, the...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/25-4-10.htm - 38K - Match Info - Similar pages
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...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/36-29-14.htm - 5K - Match Info - Similar pages
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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