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36-29-15
Section 36-29-15 Coverage of members of Legislature, Lieutenant Governor and dependents; limitation
of benefits; payment of premiums; rules and regulations. (a) Any member of the Legislature
and the Lieutenant Governor, during their term of office, and their dependents, shall be eligible
for coverage under the State Employees' Health Insurance Plan and upon expiration of their
term of office may continue such coverage for a maximum of 36 months. (b) Preexisting conditions
shall not be covered until the insured has been covered under the plan for a period of 12
months, provided, however, that any legislator enrolling within 30 days of April 23, 1990
or within 30 days of the beginning of any calendar year thereafter shall not be subject to
this limitation of benefits. A preexisting condition is any condition for which the insured
or their covered dependent received medical treatment, advice or consultation or received
any prescribed medication within 12 months of the effective date of...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/36-29-15.htm - 1K - Match Info - Similar pages
36-29-17
Section 36-29-17 Election by employees and officers of Alabama Sports Hall of Fame Board to
receive coverage. (a) Notwithstanding the provisions of Section 36-29-1, an employee or executive
officer of the Alabama Sports Hall of Fame Board and his or her dependents shall be eligible
for coverage under the State Employees' Health Insurance Plan and upon the expiration of the
employment may continue the coverage for a maximum of 36 months. (b) Preexisting conditions
shall not be covered until the insured has been covered under the plan for a period of 12
months. An employee enrolling within 30 days of August 7, 1995 or within 30 days of the beginning
of a calendar year thereafter shall not be subject to this limitation of benefits. A preexisting
condition is a condition for which the insured or their covered dependent received medical
treatment, advice, or consultation, or received a prescribed medication within 12 months of
the effective date of the insured's coverage under the plan. (c)...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/36-29-17.htm - 1K - Match Info - Similar pages
27-19-105
Section 27-19-105 Regulations for long-term care policies; outline of coverage, policy summary,
and monthly report. (a) The commissioner may adopt regulations that include standards for
full and fair disclosure setting forth the manner, content, and required disclosures for the
sale of long-term care insurance policies, terms of renewability, initial and subsequent conditions
of eligibility, nonduplication of coverage provisions, coverage of dependents, preexisting
conditions, termination of insurance, continuation or conversion, probationary periods, limitations,
exceptions, reductions, elimination periods, requirements for replacement, recurrent conditions,
and definitions of terms. Regulations under this subsection should recognize the developing
and unique nature of long-term care insurance and the distinction between group and individual
long-term insurance policies. (b) No long-term care insurance policy may do any of the following:
(1) Be cancelled, nonrenewed, or otherwise...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-19-105.htm - 11K - Match Info - Similar pages
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...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/11-91A-2.htm - 5K - 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...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/25-5-8.htm - 14K - Match Info - Similar pages
27-54A-2
Section 27-54A-2 Treatment under certain policies and contracts. (a) As used in this section,
the following words have the following meanings: (1) APPLIED BEHAVIOR ANALYSIS. The design,
implementation, and evaluation of environmental modifications, using behavioral stimuli and
consequences, to produce socially significant improvement in human behavior, including the
use of direct observation, measurement, and functional analysis of the relationship between
environment and behavior. (2) AUTISM SPECTRUM DISORDER. Any of the pervasive developmental
disorders or autism spectrum disorders as defined by the most recent edition of the Diagnostic
and Statistical Manual of Mental Disorders (DSM) or the edition that was in effect at the
time of diagnosis. (3) BEHAVIORAL HEALTH TREATMENT. Counseling and treatment programs, including
applied behavior analysis that are both of the following: a. Necessary to develop, maintain,
or restore, to the maximum extent practicable, the functioning of an...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-54A-2.htm - 10K - Match Info - Similar pages
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...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-14-11.1.htm - 3K - 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
22-7A-1
Section 22-7A-1 Physician agreements; dentist agreements. (a) For the purposes of this chapter,
the following words shall have the following meanings: (1) DENTIST. A person licensed to practice
dentistry in this state. (2) DENTIST AGREEMENT or AGREEMENT. A contract between a dentist
and a patient or his or her legal representative in which the dentist or the dentist's medical
practice agrees to provide dental services to the patient for an agreed upon fee and period
of time. (3) DENTIST PRACTICE. A dentist or a dental practice of a dentist that charges a
periodic fee for dental services and which does not bill a third party any additional fee
for services for patients covered under a dental agreement. The per visit charge of the practice
shall be less than the monthly equivalent of the periodic fee. (4) PHYSICIAN. A person licensed
to practice medicine in this state. (5) PHYSICIAN AGREEMENT or AGREEMENT. A contract between
a physician and a patient or his or her legal representative in...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-7A-1.htm - 5K - 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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