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27-14-11.1
Section 27-14-11.1 Contents of policies - Denial or reduction of benefits due to Medicaid eligibility
void. (a) For purposes of this section, "private insurer" is defined as any of the
following: (1) Any commercial insurance company offering health or casualty insurance to individuals
or groups, including both experience-rated contracts and indemnity contracts. (2) Any profit
or nonprofit prepaid plan offering either medical services or full or partial payment for
the diagnosis or treatment of an injury, disease, or disability. (3) Any organization administering
health or casualty insurance plans for professional associations, unions, fraternal groups,
employer-employee benefit plans, and any similar organization offering these payments or services,
including self-insured and self-funded plans. (4) Any health insurer, including group health
plans, as defined in Section 607(1) of the Employee Retirement Income Security Act of 1974,
self-insured plans, service benefit plans, managed care...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-14-11.1.htm - 3K - Match Info - Similar pages
27-45-3
Section 27-45-3 Choice of pharmaceutical services; right to participate as contracting provider.
No health insurance policy or employee benefit plan which is delivered, renewed, issued for
delivery, or otherwise contracted for in this state shall: (1) Prevent any person who is a
party to or beneficiary of any such health insurance policy or employee benefit plan from
selecting the pharmacy or pharmacist of his choice to furnish the pharmaceutical services,
including without limitation, prescription drugs, offered by said policy or plan or interfere
with said selection provided the pharmacy or pharmacist is licensed to furnish such pharmaceutical
services in this state; or (2) Deny any pharmacy or pharmacist the right to participate as
a contracting provider for such policy or plan provided the pharmacist is licensed to furnish
pharmaceutical services, including without limitation, prescription drugs offered by said
policy or plan. (Acts 1988, No. 88-379, p. 565, §3.)...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-45-3.htm - 1K - Match Info - Similar pages
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
36-29-51
Section 36-29-51 Health reimbursement arrangement. (a) As used in this section, the term health
reimbursement arrangement or HRA means a plan qualifying as a health reimbursement arrangement
as that term is defined under IRS Notice 2002-45 and a medical reimbursement plan under Sections
105 and 106 of the Internal Revenue Code of 1986, as amended. (b) The State Employees' Insurance
Board may offer a health reimbursement arrangement to eligible active and retired state employees
and their dependents. The terms and conditions of the HRA shall be established by the board
in accordance with federal requirements and limitations. (c) Participants in the HRA are eligible
to receive an employer contribution into the participant's HRA from the State Employees Insurance
Fund in an amount to be determined by the board. Employer contributions into the participant's
HRA shall not constitute compensation to an employee for the purposes of any statute fixing
or limiting the compensation of the...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/36-29-51.htm - 1K - Match Info - Similar pages
12-5A-9
Section 12-5A-9 Participation of eligible employees in Employees' Retirement System; creditable
service; formal leave accounting system; inclusion in health insurance plan. (a) Class specifications
and rates of compensation for employees covered by this chapter, juvenile probation officers,
juvenile probation professional staff, and clerical staff, hereafter called "eligible
employees," and any future employees occupying those positions shall be established by
the Administrative Director of Courts. Notwithstanding the foregoing, the compensation of
any employee shall not be diminished as a result of his or her inclusion in the state court
system personnel system. (b) Eligible employees included in the state court system personnel
system pursuant to this chapter shall, on October 1 of the year their county transitions,
be covered by the Employees' Retirement System. An employee who on that date is participating
in a local retirement plan other than a unit administered by the Employees'...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/12-5A-9.htm - 11K - Match Info - Similar pages
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,...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-49-3.htm - 2K - Match Info - Similar pages
27-19A-12
Section 27-19A-12 Dental services - Coverages; fees; exceptions. (a) As used in this section,
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) COVERED SERVICES. Dental care
services for which a reimbursement is available under an enrollee's plan contract, or for
which a reimbursement would be available but for the application of contractual limitations
such as deductibles, copayments, coinsurance, waiting periods, annual or lifetime maximums,
frequency limitations, alternative benefit payments, or any other limitation. (3) DENTAL CARE
PROVIDER. A licensed dentist. (4) DENTAL PLAN. Includes any policy of insurance which is issued
by a health care service contractor which provides for coverage of...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-19A-12.htm - 2K - Match Info - Similar pages
27-52-3
Section 27-52-3 Additional powers; guidelines. (a) The commissioner shall, by regulation, establish
additional powers and duties of the plan and may adopt such rules as are necessary and proper
to implement this article. For the purpose of this section, the term "insurer" means
any entity covered by the Health Insurance Portability Act, including, but not limited to,
as the terms are defined in the Health Insurance Portability Act, a health insurance issuer,
a health maintenance organization and, notwithstanding Section 10-4-115, any health benefit
plan. In the case of a self-funded health benefit plan operating through a third party administrator,
the third party administrator shall be the insurer for the purpose of this section. The commissioner
may, by regulation, define health insurance premiums consistent with the purpose of this section.
(b) The regulations shall set forth coverage eligibility criteria consistent with the requirements
of Health Insurance Portability and...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-52-3.htm - 2K - Match Info - Similar pages
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, §4.)...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/34-19-21.htm - 1K - Match Info - Similar pages
36-26-121
Section 36-26-121 Annual itemized statement of employee and retirement benefits, and total
employer contributions to retirement systems and health insurance plans. (a) As used in this
article, the following words have the following meanings: (1) EMPLOYEE BENEFIT. Any benefit
a public employee received or accrued from his or her employer, including, but not limited
to, salary or wages; insurance; allowance for days off such as vacation, holidays, sick leave,
or personal days; and contributions toward retirement or pension benefits. (2) HEALTH INSURANCE
PLAN. Either of the following health insurance plans as it applies to an individual public
employee or retiree: a. The State Employees' Health Insurance Plan. b. The Public Education
Employees' Health Insurance Plan. (3) RETIREE. A retiree or a beneficiary of a deceased retiree
who receives an employee benefit or pension benefit from a retirement system, as defined in
this section. (4) RETIREMENT SYSTEM. One of the following as it applies...
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