Code of Alabama

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27-44-3
Section 27-44-3 Scope of chapter. (a) This chapter shall provide coverage for the policies
and contracts specified in subsection (b) as follows: (1) To persons who, regardless of where
they reside (except for non-resident certificate holders under group policies or contracts),
are the beneficiaries, assignees, or payees of the persons covered under subdivision (2).
(2) To persons who are owners of or certificate holders under the policies or contracts, other
than structured settlement annuities, and in each case who are either of the following: a.
Residents b. Not residents, but only under all of the following conditions: 1. The insurer
that issued the policies or contracts is domiciled in this state. 2. The states in which the
persons reside have associations similar to the association created by this chapter. 3. The
persons are not eligible for coverage by an association in any other state due to the fact
the insurer was not licensed in the state at the time specified in the state's...
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41-15B-2.2
Section 41-15B-2.2 Allocation of trust fund revenues. (a) For each fiscal year, beginning October
1, 1999, contingent upon the Children First Trust Fund receiving tobacco revenues and upon
appropriation by the Legislature, an amount of up to and including two hundred twenty-five
thousand dollars ($225,000), or equivalent percentage of the total fund, shall be designated
for the administration of the fund by the council and the Commissioner of Children's Affairs.
(b) For the each fiscal year, beginning October 1, 1999, contingent upon the Children First
Trust Fund receiving tobacco revenues, the remainder of the Children First Trust Fund, in
the amounts provided for in Section 41-15B-2.1, shall be allocated as follows: (1) Ten percent
of the fund shall be allocated to the Department of Public Health for distribution to one
or more of the following: a. The Children's Health Insurance Program. b. Programs for tobacco
control among children with the purpose being to reduce the consumption...
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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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27-49-3
Section 27-49-3 Definitions. As used in this chapter, the following terms shall have the following
meanings: (1) HEALTH BENEFIT PLAN. Any individual or group plan, policy, or contract for health
care services issued, delivered, issued for delivery, 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, purchases, or furnishes health care services to patients, insureds,
or beneficiaries in this state. The term includes, but is not limited to, entities created
pursuant to Article 6 of Chapter 4 of Title 10. For the purposes of this chapter, a health
benefit plan located or domiciled outside of the State of Alabama is deemed to be subject
to the provisions of this chapter if it receives, processes,...
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27-58-1
Section 27-58-1 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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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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34-19-21
Section 34-19-21 Coverage or reimbursement for services not required. Nothing contained in
this chapter shall be construed to create a requirement that any health benefit plan, group
insurance plan, policy, or contract for health care services that covers hospital, medical,
or surgical expenses, health maintenance organizations, preferred provider organizations,
medical service organizations, physician-hospital organizations, or any other person, firm,
corporation, joint venture, or other similar business entity that pays for, purchases, or
furnishes group health care services to patients, insureds, or beneficiaries in this state,
including entities created pursuant to Article 6, commencing with Section 10A-20-6.01, of
Chapter 20, Title 10A, provide coverage or reimbursement for the services described or authorized
in this chapter. (Act 2017-383, ยง4.)...
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27-54-4
Section 27-54-4 Illnesses covered; requirements of benefit plans, etc. (a) All group health
benefit plans shall offer to provide, at a minimum, additional benefits according to this
chapter for a person receiving medical treatment for any of the following mental illnesses
diagnosed by an appropriately licensed provider. (1) Schizophrenia, schizophrenia form disorder,
schizo affective disorder. (2) Bipolar disorder. (3) Panic disorder. (4) Obsessive-compulsive
disorder. (5) Major depressive disorder. (6) Anxiety disorders. (7) Mood disorders. (8) Any
condition or disorder involving mental illness, excluding alcohol and substance abuse, that
falls under any of the diagnostic categories listed in the mental disorders section of the
International Classification of Disease, as periodically revised. (b) All group health benefit
plans, policies, contracts, and certificates executed, delivered, issued for delivery, continue,
or renewed in this state on or after January 1, 2001, shall offer, at...
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27-49-4
Section 27-49-4 Obstetricians and gynecologists as primary care physicians; direct access to
obstetrician and gynecologist not used as primary care physicians. (a) Each health benefit
plan which is issued, delivered, issued for delivery, or renewed in this state on or after
October 1, 1996, shall allow obstetricians and gynecologists as primary care physicians. This
subsection shall not be construed to require an individual obstetrician or gynecologist to
accept primary care physician status if the obstetrician or gynecologist does not wish to
be designated as a primary care physician, nor to interfere with the credentialing and other
selection criteria usually applied by a health benefit plan with respect to other physicians
within its network. (b) For women not using an obstetrician or gynecologist as their primary
care physician, no health benefit plan which is issued, delivered, issued for delivery, or
renewed in this state on or after October 1, 1996, shall require as a condition...
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27-54-2
Section 27-54-2 Definitions. For purposes of this chapter, the following terms have the following
meanings: (1) DAY TREATMENT SERVICES. Includes, but is not limited to: Physiological, psychological,
and psychosocial concepts, techniques, and processes necessary to maintain or develop functional
skills of clients, provided to individuals and groups for periods of more than two hours but
less than 24 hours a day. (2) HEALTH BENEFIT PLAN. A health care service plan governed by
the provisions of Article 6, Chapter 4, Title 10, and a group health insurance policy, including
an employee welfare health benefit plan, that covers hospital, medical, or surgical expenses,
issued by insurers, health maintenance organizations, preferred provider organizations, medical
service organizations, physician-hospital organizations, or any other person, firm, corporation,
joint venture, or other similar business entity that pays for, purchases, or furnishes health
care services to patients, insureds, or...
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