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16-25A-5
Section 16-25A-5 Authorization for health insurance plan; election of optional or supplemental
coverage. (a) The board is hereby empowered and authorized to establish a fully insured or
self-insured health insurance plan for employees and, under certain conditions, retired employees
and to adopt and promulgate rules and regulations for the administration of such plan subject
to such limitations as may be contained in this article. Such plan may provide for group hospitalization,
surgical, medical, cancer, cash indemnity, and dental insurance against the financial costs
of hospitalization, surgical, and medical treatment and care and may also include, among other
things, prescribed drugs, medicines, prosthetic appliances, hospital inpatient and outpatient
service benefits, and hospital/medical expenses indemnity benefits, including major medical
benefits or such other coverage or benefits as may be deemed appropriate and desirable by
the board, within the limits of such funds as may be...
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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...
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16-25A-8
Section 16-25A-8 Funding of health insurance plan; participation; Public Education Employees'
Health Insurance Fund. (a) The Public Education Employees' Health Insurance Board is hereby
authorized to provide under the contract or contracts entered into under the provisions of
this article an insurance benefit plan for each covered employee and, under certain conditions,
retired employees; the cost of such plan may be funded in part or in full through monthly
premiums per active employee from the same source of funds as those used for the payment of
salaries of active members and in part from other funds. (b) On or before January 1 next preceding
each regular meeting of the Legislature, the board shall certify to the Governor and to the
Legislature the amount or amounts necessary to fund coverage for benefits authorized by this
article for the following fiscal year for employees and for retired employees as a monthly
premium per active member per month. The Legislature shall set the...
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36-29-19.2
Section 36-29-19.2 The State Employees' Insurance Board may offer supplemental coverage. The
board may no later than January 1, 2006, offer employees a supplemental coverage to other
employer group health insurance coverage. (1) For employees who have spouses with other employer
group health insurance coverage available to them through their employer, or previous employer,
the board may provide such employees with a supplemental coverage to the other employer group
health insurance coverage in lieu of coverage in the basic medical plan of the State Employees'
Health Insurance Plan. (2) An employer that provides its employees and their spouses with
other employer group health insurance coverage may not exclude an employee, as defined under
Section 36-29-1, or his or her spouse from coverage by application of a provision which does
not also apply on the same terms and conditions to other employees or their spouses. No provision
of this section requires an employer to amend its plan to...
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16-25A-5.1
Section 16-25A-5.1 Supplemental policy to provide secondary coverage for employees. The board
may, no later than January 1, 2006, offer employees a supplemental policy that provides secondary
coverage to other employer group coverage. (1) For employees who have spouses with other employer
group health insurance coverage available to them through their employer or previous employer,
the board may provide such employees and retirees with a supplemental coverage policy to the
other employer group health insurance coverage in lieu of full basic medical plan coverage
through the plan. (2) An employer that provides its employees and their spouses with other
employer group health insurance coverage may not exclude an employee, as defined under Section
16-25A-1(1), or his or her spouse from coverage by application of a provision which does not
also apply on the same terms and conditions to other employees or their spouses. No provision
of this section requires an employer to amend its plan to...
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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...
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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...
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16-25A-6
Section 16-25A-6 Exclusions. Such health insurance shall not include the following: (1) Expenses
incurred by or on account of an individual prior to the effective date of the plan as to him;
(2) Hearing aids and examinations for the prescription or fitting thereof; (3) Cosmetic surgery
or treatment, except to the extent necessary for correction of damage caused by accidental
injury while covered by the plan or as a direct result of disease covered by the plan; (4)
Services received in a hospital owned or operated by the United States government for which
no charge is made; (5) Services received for injury or sickness due to war or any act of war,
whether declared or undeclared, which war or act of war shall have occurred after the effective
date of this plan; (6) Expenses for which the individual is not required to make payment;
(7) Expenses to the extent of benefits provided under any employer group plan other than this
plan in which the state participates in the cost thereof; (8)...
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27-44-5
Section 27-44-5 Definitions. As used in this chapter, the following terms shall have the following
meanings, respectively, unless the context clearly indicates otherwise: (1) ACCOUNT. Either
of the three accounts created under Section 27-44-6. (2) ASSOCIATION. The Alabama Life and
Disability Insurance Guaranty Association created under Section 27-44-6. (3) AUTHORIZED ASSESSMENT
or the term AUTHORIZED when used in the context of assessments. A resolution by the board
of directors has been passed whereby an assessment will be called immediately or in the future
from member insurers for a specified amount. An assessment is authorized when the resolution
is passed. (4) BENEFIT PLAN. A specific employee, union, or association of natural persons
benefit plan. (5) CALLED ASSESSMENT or the term CALLED when used in the context of assessments.
A notice that has been issued by the association to member insurers requiring that an authorized
assessment be paid within the time frame set forth within...
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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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