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27-3A-3
Section 27-3A-3 Definitions. As used in this chapter, the following words and phrases shall
have the following meanings: (1) DEPARTMENT. The Alabama Department of Public Health. (2)
ENROLLEE. An individual who has contracted for or who participates in coverage under an insurance
policy, a health maintenance organization contract, a health service corporation contract,
an employee welfare benefit plan, a hospital or medical services plan, or any other benefit
program providing payment, reimbursement, or indemnification for health care costs for the
individual or the eligible dependents of the individual. (3) PROVIDER. A health care provider
duly licensed or certified by the State of Alabama. (4) UTILIZATION REVIEW. A system for prospective
and concurrent review of the necessity and appropriateness in the allocation of health care
resources and services given or proposed to be given to an individual within this state. The
term does not include elective requests for clarification of...
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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...
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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...
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27-1-20
Section 27-1-20 Patient Right to Know Act. (a) This section shall be known and may be cited
as the "Patient Right to Know Act." (b) As used in this section, unless the context
clearly indicates otherwise, the following words shall have the following meanings: (1) ENROLLEE.
A person who purchases individual health care coverage or an employer who purchases a group
health care plan. (2) PROVIDER. A physician, dentist, podiatrist, pharmacist, optometrist,
psychologist, clinical social worker, advanced nurse practitioner, registered optician, licensed
professional counselor, physical therapist, and chiropractor. (c)(1) All persons, firms, corporations,
associations, health maintenance organizations, health insurance services, or preferred provider
organizations, any employer-sponsored health benefit plan, or any similar organization or
entity, providing health, accident, or dental insurance coverage, either directly or indirectly,
shall provide an enrollee with a written description of the...
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27-19A-2
Section 27-19A-2 Definitions. As used in this chapter, the following terms shall have the respective
meanings herein set forth, unless the context shall otherwise require: (1) ALABAMA INSURANCE
CODE. Title 27 of the Code of Alabama 1975. (2) INSURER. Such term shall have the meaning
ascribed in Section 27-1-2. (3) PERSON. Such term shall have the meaning ascribed in Section
27-1-2. (4) COMMISSIONER and DEPARTMENT. Such terms, respectively, shall have the meanings
ascribed in Section 27-1-2. (5) CONTRACTUAL OBLIGATION. Any obligation under covered policies
or employee benefit plans. (6) COVERED POLICY OR PLAN. Any policy, employee benefit plan,
or contract within the scope of this chapter. (7) HEALTH INSURANCE POLICY. Any individual,
group, blanket, or franchise insurance policy, insurance agreement, or group hospital service
contract providing benefits for dental care expenses incurred as a result of an accident or
sickness. (8) EMPLOYEE BENEFIT PLAN. Any plan, fund, or program...
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27-2B-2
Section 27-2B-2 Definitions. As used in this chapter, these terms shall have the following
meanings: (1) ADJUSTED RBC REPORT. An RBC report which has been adjusted by the commissioner
in accordance with subsection (e) of Section 27-2B-3. (2) CORRECTIVE ORDER. An order issued
by the commissioner specifying corrective actions which the commissioner has determined are
required. (3) DOMESTIC INSURER. Any insurer domiciled in this state. (4) FOREIGN INSURER.
Any insurer which is licensed to do business in this state but not domiciled in this state.
(5) FRATERNAL BENEFIT SOCIETY. Any insurer licensed under Chapter 34. (6) HEALTH ORGANIZATION.
Any health care service plan, health maintenance organization, limited health service organization,
dental services corporation, or other managed care organization licensed under this title.
This term does not include any life and disability insurer or property and casualty insurer.
(7) INSURER. As defined in Section 27-1-2, including, without...
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22-27-3
Section 22-27-3 Authority of local governing bodies as waste collections and disposal; household
exemptions; state regulatory program. (a) Generally. (1) The county commission or municipal
governing body may, and is hereby authorized to, make available to the general public collection
and disposal facilities for solid wastes in a manner acceptable to the department. The county
commission or municipal governing body may provide such collection or disposal services by
contract with private or other controlling agencies and may include house-to-house service
or the placement of regularly serviced and controlled bulk refuse receptacles within reasonable
(generally less than eight miles) distance from the farthest affected household and the wastes
managed in a manner acceptable to the department. (2) Any county commission or municipal governing
body providing services to the public under this article shall have the power and authority
by resolution or ordinance to adopt rules and...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-27-3.htm - 11K - Match Info - Similar pages
27-1-16
Section 27-1-16 Standard health insurance claim form; electronic claims form; various claim
forms. (a)(1) The Commissioner of the Department of Insurance shall prescribe a standard health
insurance claim form to be used by all hospitals. The forms shall be prescribed in a format
which allows for the use of generally accepted diagnosis and treatment coding systems by providers
of health care and payors. The standard form shall be accepted and used by all insurers doing
business in the State of Alabama and by all state agencies which pay providers of health care
for hospital services. (2) The Commissioner of the Department of Insurance shall also prescribe
a format for all health insurance claims transmitted or submitted for payment by electronic
or electro-mechanical means. Such a format shall be used by all insurers doing business in
the State of Alabama and by all state agencies which pay providers of health care for hospital
services. (b) An advisory committee of five persons, two...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-1-16.htm - 3K - Match Info - Similar pages
10A-20-6.07
Section 10A-20-6.07 Certificates of authority; contracts with public. Every corporation organized
under this article shall procure from the Commissioner of Insurance a certificate of authority
to do business, for which the corporation shall pay the sum of two hundred dollars ($200),
and the certificates of authority shall be renewed thereafter on or before the first day of
March of each year. The corporation may then enter into contracts with the public, subject
to the restrictions contained in this article, for benefits under its health service plan.
It shall be the duty of the corporation to enter into contracts with and issue certificates
to those of the public who may desire to avail themselves of the benefits of the health service
plan and who, under its rules and regulations, make application and are eligible therefor.
The contracts may provide for more than one class of services or benefits, may designate the
person or persons, or the class of persons, entitled thereto, may...
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27-1-22
Section 27-1-22 Uniform prescription drug information card or technology. (a) Every health
benefit plan that provides coverage for prescription drugs or devices, or administers a plan,
including, but not limited to, third party administrators for self-insured plans and state
administered plans, excluding the Alabama Medicaid Program, shall issue to its insureds a
card or other technology containing prescription drug information. The uniform prescription
drug information card or technology shall be in the format approved by the National Council
for Prescription Drug Programs (NCPDP) and shall include all of the required fields and conform
to the most recent pharmacy ID card or technology implementation guide produced by NCPDP or
conform to a national format acceptable to the Commissioner of Insurance. If a health care
plan includes a conditional or situational field, it shall conform to the most recent pharmacy
information card or technology implementation guide by the NCPDP or conform...
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