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22-21-265
Section 22-21-265 Certificates of need - Required for new institutional health service. (a)
On or after July 30, 1979, no person to which this article applies shall acquire, construct,
or operate a new institutional health service, as defined in this article, or furnish or offer,
or purport to furnish a new institutional health service, as defined in this article, or make
an arrangement or commitment for financing the offering of a new institutional health service,
unless the person shall first obtain from the SHPDA a certificate of need therefor. Notwithstanding
any provisions of this article to the contrary, those facilities and distinct units operated
by the Department of Mental Health, and those facilities and distinct units operating under
contract or subcontract with the Department of Mental Health where the contract constitutes
the primary source of income to the facility, shall not be required to obtain a certificate
of need under this article. (b) Notwithstanding all other...
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27-14-3
Section 27-14-3 Insurable interest - Personal insurance; preneed contracts. (a) Insurable interest
with reference to personal insurance is an interest based upon a reasonable expectation of
pecuniary advantage through the continued life, health, or bodily safety of another person
and consequent loss by reason of his or her death or disability or a substantial interest
engendered by love and affection in the case of individuals closely related by blood or by
law. (b) An individual has an unlimited insurable interest in his or her own life, health,
and bodily safety and may lawfully take out a policy of insurance on his or her own life,
health, or bodily safety and have the same made payable to whomsoever he or she pleases, regardless
of whether the beneficiary so designated has an insurable interest. (c) A corporation, foreign
or domestic, has an insurable interest in the life or physical or mental ability of any of
its directors, officers, or employees, or the directors, officers, or...
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27-36A-2
Section 27-36A-2 Definitions. For purposes of this chapter, the following definitions shall
apply on or after the operative date of the valuation manual as defined by Section 27-36A-15:
(1) ACCIDENT AND HEALTH INSURANCE. Contracts that incorporate morbidity risk and provide protection
against economic loss resulting from accident, sickness, or medical conditions and as may
be specified in the valuation manual. (2) APPOINTED ACTUARY. A qualified actuary who is appointed
in accordance with the valuation manual to prepare the actuarial opinion required in subsection
(b) of Section 27-36A-4. (3) COMPANY. An entity, which (i) has written, issued, or reinsured
life insurance contracts, accident and health insurance contracts, or deposit-type contracts
in this state and has at least one such policy in force or on claim or (ii) has written, issued,
or reinsured life insurance contracts, accident and health insurance contracts, or deposit-type
contracts in any state and is required to hold a...
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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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36-29-19.8
Section 36-29-19.8 Supplemental coverage for certain retirees. The board may offer a retiree
a supplemental coverage to other employer group health insurance coverage and certain requirements
shall be maintained regarding retiree health coverage and cost sharing. (1) For employees
who retire after September 30, 2005, and who become employed by an employer that provides
employees at least 50 percent of the cost of single health insurance coverage and that qualify
to receive other employer group health insurance coverage through that employer shall be required
to use the employer's health benefit plan for primary coverage and the State Employees' Health
Insurance Plan may provide supplemental coverage. (2) For retirees who have spouses with other
employer group health insurance coverage available to them through their employer or previous
employer, the board may provide such retirees with a supplemental coverage to other employer
group health insurance coverage in lieu of coverage in the...
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11-91A-2
Section 11-91A-2 Local Government Health Insurance Board; governance and administration of
program. (a) The Local Government Health Insurance Board shall govern and administer the Local
Government Health Insurance Program currently governed and administered by the State Employees'
Insurance Board (SEIB) pursuant to Chapter 29 of Title 36. The transfer of the governance
and administration to the board shall take effect at 12:01 a.m. on January 1, 2015, and thereafter
the board shall take all control and responsibility for the program under procedures and authority
set out in this chapter. (b) The program governed and administered by the board shall provide
a reasonable relationship between the health care benefits to be included and the expected
health care expenses to be incurred by affected employees, retirees, and their dependents.
The board may establish a fully insured or self-insured health care plan for employees and
retirees as defined in this chapter and may adopt rules for the...
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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...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-1-20.htm - 3K - Match Info - Similar pages
27-21A-7
Section 27-21A-7 Evidence of coverage and charges for health care services. (a)(1) Every enrollee
residing in this state is entitled to an evidence of coverage. If the enrollee obtains such
coverage through an insurance policy or a contract issued by a health care service plan, the
insurer or the health care service plan shall issue the evidence of coverage. Otherwise, the
health maintenance organization shall issue the evidence of coverage. (2) No evidence of coverage,
or amendment thereto, shall be issued or delivered to any person in this state until a copy
of the basic form of the evidence of coverage, or amendment thereto, has been filed with the
commissioner and the State Health Officer, and approved by the commissioner. (3) An evidence
of coverage shall contain: a. No provisions or statements which encourage misrepresentation,
or which are untrue, misleading, or deceptive as defined in subsection (a) of Section 27-21A-13;
and b. A clear and concise statement, if a contract, or a...
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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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27-19A-7
Section 27-19A-7 Contracting directly with patient; distribution of information about policy
or plan; payment and reimbursement procedures. The provisions of this chapter do not prohibit
the following conduct and shall be construed to provide that: (1) A dentist may contract directly
with a patient for the furnishing of dental care services to said patient as may be otherwise
authorized by law; (2) Any person providing a health insurance policy or employee benefit
plan, or an employer, or an employee organization may: a. Make available to its insureds,
beneficiaries, participants, employees, or members information relating to dental care services
by the distribution of factually accurate information regarding dental care services, rates,
fees, location, and hours of service, provided such distribution is made upon the request
of any dentist licensed by this state; or b. Establish an administrative mechanism which facilitates
payment for dental care services by insureds, beneficiaries,...
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