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27-55-3
Section 27-55-3 Prohibited practices; disclosure of information. (a) No insurer may: (1) Deny,
refuse to issue, renew, or reissue, cancel, or otherwise terminate, restrict, or exclude coverage
on an insurance policy or health benefit plan on the basis of an applicant's or insured's
abuse status, or on the basis of any association, relationship, or assistance to a subject
of abuse. (2) Exclude or limit coverage for a loss, deny benefits, or deny a claim on the
basis of the insured's abuse status, or on the basis of any association, relationship, or
assistance to a subject of abuse, except as otherwise permitted or required by the laws of
this state relating to acts of abuse committed by a life insurance beneficiary. Notwithstanding
anything to the contrary in this section, a liability insurer may include policy provisions
providing that a payment required by this subsection may be denied or, if paid, recovered
by the insurer from the insured, if the claim arose out of an act of abuse by...
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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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27-56-2
Section 27-56-2 Definitions. As used in this chapter, the following terms shall have the following
meanings: (1) COVERED PERSON. Any individual, family, or family member on whose behalf third-party
payment or prepayment of health or medical expenses is provided under an insurance policy,
plan, or contract providing for third-party payment or prepayment of health care or medical
expenses. (2) EYE CARE PROVIDER. A licensed optometrist or a licensed ophthalmologist. (3)
INSURANCE POLICY, PLAN, OR CONTRACT PROVIDING FOR THIRD-PARTY PAYMENT OR PREPAYMENT OF HEALTH
OR MEDICAL EXPENSES. Includes an individual or group policy for accident or health insurance,
an individual or group hospital or health care service contract, an individual or group health
maintenance organization contract, an organized delivery system contract, or a preferred provider
organization contract, and any other similar policy, plan, or contract. This term shall not
include any employee welfare benefit plan, as defined...
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27-57-1
Section 27-57-1 Definitions. As used in this chapter, the following words and terms shall have
the following meanings: (1) COLORECTAL CANCER EXAMINATIONS. Examinations and laboratory tests
specified in current American Cancer Society guidelines for colorectal cancer screening of
asymptomatic individuals. (2) HEALTH BENEFIT PLAN. A group health insurance policy 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 health care services to patients, insureds, or beneficiaries in this
state. 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 this chapter if it receives, processes,
adjudicates, pays, or denies claims for health care services submitted...
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36-36-3
Section 36-36-3 Definitions. As used in this chapter, the following words and phrases shall
have the following respective meanings: (1) ALABAMA RETIRED EDUCATION EMPLOYEES' HEALTH CARE
TRUST. The Alabama Retired Education Employees' Health Care Trust created by the state and
the Public Education Employees' Health Insurance Board pursuant to this chapter. (2) ALABAMA
RETIRED STATE EMPLOYEES' HEALTH CARE TRUST. The Alabama Retired State Employees' Health Care
Trust created by the state and the State Employees' Insurance Board pursuant to this chapter.
(3) BOARDS. The State Employees' Insurance Board and the Public Education Employees' Health
Insurance Board. (4) DEPENDENTS. The spouse and dependent children, as defined by the rules
and regulations of the respective boards, of a retired employee who are covered by either
the Public Education Employees' Health Insurance Plan pursuant to Chapter 25A of Title 16,
as amended from time to time, or the State Employees' Health Insurance Plan...
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27-7-1
Section 27-7-1 Definitions. For the purposes of this chapter, the following terms shall have
the meanings respectively ascribed to them by this section: (1) BUSINESS ENTITY. A corporation,
association, partnership, limited liability company, limited liability partnership, or other
legal entity. (2) COMMISSIONER. The Alabama Commissioner of Insurance. (3) HOME STATE. The
District of Columbia and any state or territory of the United States in which an insurance
producer maintains his or her principal place of residence or principal place of business
and is licensed to act as an insurance producer. (4) INSURANCE. As defined in Section 27-1-2.
(5) INSURANCE PRODUCER or PRODUCER. A person required to be licensed under the laws of this
state to sell, solicit, or negotiate insurance. (6) INSURER. As defined in Section 27-1-2.
For the purposes of this chapter, insurer shall also mean an insurance company licensed pursuant
to Chapter 3, commencing with Section 27-3-1 of this title; a health...
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27-52-21
Section 27-52-21 Commissioner of Insurance; benefits offered to small employers; "small
employer" defined. (a) The Commissioner of Insurance shall, by regulation, establish
the conditions, restrictions, requirements, and plan of operation of the Alabama Small Employer
Allocation Program consistent with the requirements of the Health Insurance Portability and
Accountability Act of 1996 and any and all federal regulations adopted pursuant thereto, which
plan benefits shall be inclusive of the provisions of Sections 27-1-10 and 27-19-39. The program
shall be patterned after the Small Employer Health Insurance Availability models developed
by the National Association of Insurance Commissioners. (b) All insurers that offer health
benefit plans to small employers in this state on and after August 1, 1997, shall be required
to meet the requirements of the program as a condition of authority to transact business in
this state. (c) For the purposes of this article, a "small employer" means any...
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16-25A-41
Section 16-25A-41 Definitions. The following terms shall have the following meanings, unless
the context clearly indicates otherwise: (1) BOARD. The Public Education Flexible Employees
Benefit Board. (2) EMPLOYEE. Any person employed by a state or local board of education, postsecondary
institution, or other employer with employees as defined by Sections 16-25A-1 and 16-25A-11
participating in a state health insurance program. (3) EMPLOYER. Any local board of education
within the State of Alabama or other public institution of education within the state that
provides instruction at any combination of grades K-14 exclusively, under the auspices of
the State Board of Education, or the Alabama Institute for Deaf and Blind, or entities whose
employees are covered by the Public Education Employees' Health Insurance Plan pursuant to
Section 16-25A-11. (4) INTERNAL REVENUE CODE. The Internal Revenue Code of 1986, as amended.
(5) PARTICIPATING EMPLOYEE. An employee who elects to participate in...
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36-30-50
Section 36-30-50 Supplemental insurance coverage for firefighters with cancer. (a) For the
purposes of this section, the following terms shall have the following meanings: (1) CANCER.
Includes bladder, blood, brain, breast, cervical, esophageal, intestinal, kidney, lymphatic,
lung, prostate, rectum, respiratory tract, skin, testicular, and thyroid cancer, leukemia,
multiple myeloma, Hodgkin's lymphoma, and non-Hodgkin's lymphoma. (2) CAREER FIREFIGHTER.
Any person employed with the state, a county or municipal government, an airport authority,
or a fire district who has obtained certification as a firefighter through and as defined
by the Alabama Firefighters' Personnel Standards and Education Commission, or a firefighter
employed by the Alabama Forestry Commission who has been certified by the State Forester as
having met the wild land firefighter training standard of the National Wildfire Coordinating
Group, and is offered typical employment benefits, including health insurance...
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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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