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27-59-1
Section 27-59-1 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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36-1A-5
Section 36-1A-5 Participation limited to voluntary, charitable, health and human care federations
and agencies with a substantial local presence. (a) Participation in the Alabama State Employee
Combined Charitable Campaign shall be limited to voluntary, charitable, health and human care
federations and agencies with a substantial local presence that provide or support direct
health and welfare services to individuals or their families and meet the criteria set forth
in this section. "Substantial local presence" is defined as a facility, staffed
by professionals or volunteers, available to provide its services and open at least 15 hours
a week. Such services must be available to state employees in the local campaign community,
unless they are rendered to needy persons overseas. Such services must directly benefit human
beings, whether children, youth, adults, the aged, the ill and infirm, or the mentally or
physically handicapped. Such services must consist of care, research, or...
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27-1-19
Section 27-1-19 Reimbursement of health care providers. (a) The insured, or health or dental
plan beneficiary may assign reimbursement for health or dental care services directly to the
provider of services. Health benefits include medical, pharmacy, podiatric, chiropractic,
optometric, durable medical equipment, and home care services. The company or agency, when
authorized by the insured, or health or dental plan beneficiary, shall pay directly to the
health care provider the amount of the claim, under the same criteria and payment schedule
that would have been reimbursed directly to the contract provider, and any applicable interest.
This amount only applies to assigned claims. Any company or agency making a payment to the
insured, or health or dental plan beneficiary, after the rights of reimbursement have been
assigned to the provider of services, shall be liable to the provider for the payment. If
the company or agency fails to reimburse the provider in accordance with the terms...
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27-29-1
Section 27-29-1 Definitions. For purposes of this chapter, unless otherwise stated, the following
terms shall have the meanings respectively ascribed to them by this section: (1) AFFILIATE.
The term shall include an affiliate of, or person affiliated with, a specific person, and
shall mean a person that directly, or indirectly through one or more intermediaries, controls,
or is controlled by, or is under common control with, the person specified. (2) COMMISSIONER.
The Commissioner of Insurance, his or her deputies, or the Insurance Department as appropriate.
(3) CONTROL. The term shall include controlling, controlled by, or under common control with
and shall mean the possession, direct or indirect, of the power to direct or cause the direction
of the management and policies of a person, whether through the ownership of voting securities,
by contract other than a commercial contract for goods or nonmanagement services, or otherwise,
unless the power is the result of an official...
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27-42-12
Section 27-42-12 Exhaustion of rights; nonduplication of recovery. (a) Any person having a
claim under an insurance policy, whether or not it is a policy issued by a member insurer,
where the claim under the other policy arises from the same facts, injury, or loss that gave
rise to the covered claim against the association, shall be required first to exhaust all
coverage provided by any such policy. Any amount payable on a covered claim under this chapter
shall be reduced by the full applicable limits stated in the other insurance policy and the
association shall receive a full credit for the stated limits, or, where there are no applicable
stated limits, the claim shall be reduced by the total recovery. Notwithstanding the foregoing,
no person shall be required to exhaust any right under the policy of an insolvent insurer.
(1) A claim under a policy providing liability coverage to a person who may be jointly and
severally liable with, or a joint tortfeasor with, the person covered...
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11-50B-4
Section 11-50B-4 Municipal authority to furnish cable service; rules and regulations. Notwithstanding
any other provision of this chapter, so long as a municipality has by virtue of the provisions
of any franchise, jurisdiction, authority, or a right, to approve or disapprove the subscriber
rates, fees, or charges of private providers of cable service furnishing cable service to
subscribers in the municipality and has not either relinquished the same, or adopted procedures
pursuant to which private providers of cable service are permitted to increase or decrease
their rates to subscribers upon not less than 30 days notice freely, so long as the rates
charged subscribers reflect all direct costs and indirect costs of providing the cable service,
neither the municipality nor any municipal instrumentality whose organization the municipality
has authorized, may exercise the authority to furnish cable service granted elsewhere in this
chapter. Notwithstanding the foregoing, nothing...
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27-21A-12
Section 27-21A-12 Protection against insolvency. (a) Unless otherwise provided below, each
health maintenance organization shall deposit with the commissioner, or with any organization
or trustee acceptable to him through which a custodial or controlled account is utilized,
cash, securities, or any combination of these or other measures acceptable to him in the amount
set forth in this section. (b) The amount for an organization that is beginning operation
shall be the greater of: (1) five percent of its estimated expenditures for health care services
for its first year of operation, (2) twice its estimated average monthly uncovered expenditures
for its first year of operation, or (3) $100,000. At the beginning of each succeeding year,
unless not applicable, the organization shall deposit with the commissioner, or organization,
or trustee, cash, securities, or any combination of these or other measures acceptable to
the commissioner, in an amount equal to four percent of its estimated...
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27-57-2
Section 27-57-2 Coverage; applicability. (a) All group health benefit plans, policies, contracts,
and certificates executed, delivered, issued for delivery, continued, or renewed in this state
on or after August 1, 2004, shall offer, at the time of proposal, sale, or renewal of a policy
subject to this chapter, to include colorectal cancer examinations within the coverage. Such
offer of coverage shall include colorectal cancer examinations for covered persons who are
50 years of age or older, or for covered persons who are less than 50 years of age and at
high risk for colorectal cancer according to current American Cancer Society colorectal cancer
screening guidelines. (b) This chapter shall apply to group accident and sickness insurance
policies issued by a fraternal benefit society, a nonprofit hospital service corporation,
a nonprofit medical service corporation, a group health care plan, a health maintenance organization,
or any similar entity. (Act 2004-502, p. 969, ยง2.)...
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45-42-162.17
Section 45-42-162.17 Transition. (a) The transition period shall be directed by the provisions
contained herein. The level of services during transition shall not be below the level of
service previously provided by the respective government. (b)(1) Not later than six months
after assuming office, the commission shall adopt a plan for the reorganization of service
operations on a countywide basis, so that the general service district shall receive services,
(including, but not limited to: streets and roads, refuse disposal, police, parks, and recreation),
which are customarily furnished by a county government in a metropolitan area, and the urban
service district shall receive services, (including, but not limited to: additional police
protection, additional transportation, street lighting, and street cleaning) which are customarily
furnished by a city in a metropolitan area. The plan to combine services and functions should
aim toward effectiveness, efficiency, and equity in the...
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22-8B-3
Section 22-8B-3 Definitions. As used in this chapter, the following terms shall have the following
meanings: (1) AID IN DYING. The act of a person providing the means or manner for another
person to be able to commit suicide, with actual knowledge that the person deliberately intends
on committing suicide by that means or manner. (2) ARTIFICIALLY PROVIDED NUTRITIONAL HYDRATION.
A medical treatment consisting of the administration of food and water through a tube or intravenous
line, where the recipient is not required to chew or swallow voluntarily. Artificially provided
nutrition and hydration does not include assisted feeding, such as spoon or bottle feeding.
(3) DELIBERATELY. More than knowing the consequences of an act or action; meaning to consider
carefully; done on purpose; intentional; requiring premeditation; with intent to cause the
death of a person. (4) HEALTH CARE PROVIDER. Any individual who may be asked to participate
in any way in a health care service, including, but...
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