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22-21-361
Section 22-21-361 Definitions. The following terms shall have the meanings respectively ascribed
by this section unless the context clearly indicates otherwise: (1) COMMISSIONER. The commissioner
of insurance of this state. (2) DENTAL SERVICE PLAN or PLAN. Any plan or other arrangement
whereby dental services are provided in whole or in part through a dental service corporation
by dentists participating in the plan to provide dental services to those members of the public
who become subscribers to the plan under a contract with such corporation. The terms "dental
service plan" or "plan" do not include an insurer authorized by the insurance
department to transact insurance in this state or to a nonprofit health insurance plan organized
pursuant to Section 10-4-100, or to any policy of insurance or contract which includes dental
benefits issued by such insurer or nonprofit health insurance plan. (3) DEPARTMENT. The Department
of Insurance. (4) LICENSE. The certificate of authority issued...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-21-361.htm - 1K - Match Info - Similar pages
22-21-375
Section 22-21-375 Issuance of license; revocation; procedures for review and mediation of complaints.
(a) The Department of Insurance shall issue a license to each applicant upon payment of the
prescribed fees and upon being satisfied that: (1) The applicant has been organized in a bona
fide manner for the purpose of establishing, maintaining, and operating a dental service plan.
(2) Each contract executed, or proposed to be executed, by the applicant and a dentist obligates,
or will when executed obligate, such dentist to render the service or accept payment for the
service to which each subscriber may be entitled under the terms of the contract issued to
the subscriber. (3) Each contract issued, or proposed to be issued, to subscribers is in a
form approved by the department and that the rates charged, or proposed to be charged, for
each form of such contract and benefits to be provided pursuant thereto are fair and reasonable
and are actuarially sound. (4) No contributions to the...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-21-375.htm - 4K - 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
22-21-371
Section 22-21-371 Individual, group, blanket or franchise contracts authorized; certificates
of coverage; filing and approval of contracts and certificates; requirements; grounds for
disapproval. (a) Dental service plan contracts may be written on individual, group, blanket
or franchise basis. Each contractual obligation for such dental service(s) must be evidenced
by a contract. Each person covered under a group contract must be issued a certificate of
coverage. (b) No contract or certificate of dental service benefits may be issued in this
state unless a copy of the form has been filed and approved by the commissioner. (c) The commissioner
may not approve any form that does not meet the following requirements: (1) Contracts must
contain a list and description of the dental service payments promised or the dental work
for which expenses are to be reimbursed, and any limits on the amounts to be paid or reimbursed;
(2) Contracts and certificates must indicate the name of the dental...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-21-371.htm - 3K - Match Info - Similar pages
27-55-2
Section 27-55-2 Definitions. As used in this chapter, these terms shall have the following
meanings: (1) ABUSE. The occurrence of one or more of the following acts by a family or household
member, as defined by subdivision (3) of subsection (b) of Section 15-10-3: a. Attempting
to cause or intentionally, knowingly, or recklessly causing another person, including a minor
child, bodily injury, severe emotional injury, or psychological trauma or conduct which constitutes
the crime of rape. b. Intentionally following another person, including a minor child, without
proper authority, under circumstances that place the person in reasonable fear of bodily injury
or physical harm. c. Subjecting another person, including a minor child, to false imprisonment
or kidnapping. d. Attempting to cause or intentionally, knowingly, or recklessly causing damage
to property to intimidate or attempt to control the behavior of another person, including
a minor child. e. Assault, child abuse, criminal...
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22-21-366
Section 22-21-366 Subscriber rates subject to approval of department; provisions in contract
between corporation and dentist. (a) The rates charged by a dental service plan corporation
to the subscribers for dental services shall at all times be subject to the approval of the
department. (b) Every contract between a dental service plan corporation and a dentist, whereby
the plan provides for payment of a fee or fees to the dentist for dental services rendered
by the dentist to subscribers, shall contain a clause stating that the dental service plan
corporation shall be liable for such fee or fees rather than the subscribers receiving said
dental services. Such contract shall also contain a clause whereby, upon termination of the
contract by either party or upon expiration thereof, a dentist is obligated to complete any
procedure which he has undertaken upon any subscriber. (Acts 1982, No. 82-463, p. 741, ยง7.)...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-21-366.htm - 1K - Match Info - Similar pages
22-21-386
Section 22-21-386 Examination and investigation of corporations by department; power to summon
and examine witnesses; payment of expenses. (a) The Department of Insurance, any agent or
examiner of the department, or any other person appointed by the department shall have the
power of visitation and examination into the affairs, transactions, accounts, business records,
and assets of any such dental service plan corporation, shall have free access to all of the
books, papers, and documents that relate to the business of the corporation, may summon and
qualify witnesses under oath, and may examine its officers, agents, and employees or other
relative persons regarding the affairs, transactions, and condition of the corporation. The
corporation whose affairs are examined shall pay to the department for deposit into the State
Treasury the traveling expenses and any other expenses of the examiner or other person making
the examination which shall be credited as provided by Section...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-21-386.htm - 2K - 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
22-21-363
Section 22-21-363 Application for certificate of authority; contents. (a) The incorporators
shall file with the commissioner an application for a certificate of authority to do business
upon a form to be furnished by the department, which shall include or have attached the following:
(1) The names, and for the preceding 10 years, all addresses and all occupations of all incorporators
and proposed directors and officers; (2) A certified copy of the corporate articles and bylaws
and all amendments thereto, a list of the names, addresses, and occupations of all directors
and principal officers and, if previously incorporated, for the three most recent years, the
corporation annual statements and reports; (3) All agreements relating to the corporation
to which any incorporator or proposed director or officer is a party; (4) A statement of the
amount and sources of the funds available for organization expenses and the proposed arrangements
for reimbursement and compensation of incorporators...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-21-363.htm - 2K - Match Info - Similar pages
11-95-7
Section 11-95-7 Powers of corporation. In addition to all other powers granted elsewhere in
this chapter, a corporation shall have the following powers, together with all powers incidental
thereto or necessary to the discharge thereof in corporate form: (1) To have succession by
its corporate name for the duration of time (which may be perpetuity, subject to the provisions
of Section 11-95-19) specified in its certificate of incorporation; (2) To sue and be sued
in its own name in civil suits and actions, and to defend suits against it; (3) To adopt and
make use of a corporate seal and to alter the same at pleasure; (4) To adopt and alter bylaws
for the regulation and conduct of its affairs and business; (5) To acquire, construct, equip,
enlarge, improve, maintain, and operate hospital facilities in the authorizing county and
to do all things necessary to that end; (6) To receive, acquire, take and hold, whether by
purchase, gift, lease, devise, or otherwise, real and personal property...
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