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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
27-19-28
Section 27-19-28 Exclusion of hospitalization benefits for mental patients in tax-supported
institutions. (a) No policy of health, sickness, or accident insurance delivered, or issued
for delivery, in this state, including both individual and group policies, which provide coverage
for psychiatric treatment or mental illness shall exclude hospitalization benefits for mental
patients in tax-supported institutions of the State of Alabama, or any county or municipality
thereof. (b) The provisions of this section shall not apply to any policy of insurance in
effect prior to September 20, 1971, nor shall the provisions of this section apply to any
employee benefit plan providing hospital benefits for mental patients where such employee
benefit plan is established by the employer and contributions to the plan are provided by
the employer and the employee, or either of them, and such plan is not evidenced by individual,
or group or blanket policies of health, sickness, or accident insurance...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-19-28.htm - 1K - 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...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-21A-7.htm - 3K - Match Info - Similar pages
16-25A-8
Section 16-25A-8 Funding of health insurance plan; participation; Public Education Employees'
Health Insurance Fund. (a) The Public Education Employees' Health Insurance Board is hereby
authorized to provide under the contract or contracts entered into under the provisions of
this article an insurance benefit plan for each covered employee and, under certain conditions,
retired employees; the cost of such plan may be funded in part or in full through monthly
premiums per active employee from the same source of funds as those used for the payment of
salaries of active members and in part from other funds. (b) On or before January 1 next preceding
each regular meeting of the Legislature, the board shall certify to the Governor and to the
Legislature the amount or amounts necessary to fund coverage for benefits authorized by this
article for the following fiscal year for employees and for retired employees as a monthly
premium per active member per month. The Legislature shall set the...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/16-25A-8.htm - 6K - Match Info - Similar pages
36-29-15
Section 36-29-15 Coverage of members of Legislature, Lieutenant Governor and dependents; limitation
of benefits; payment of premiums; rules and regulations. (a) Any member of the Legislature
and the Lieutenant Governor, during their term of office, and their dependents, shall be eligible
for coverage under the State Employees' Health Insurance Plan and upon expiration of their
term of office may continue such coverage for a maximum of 36 months. (b) Preexisting conditions
shall not be covered until the insured has been covered under the plan for a period of 12
months, provided, however, that any legislator enrolling within 30 days of April 23, 1990
or within 30 days of the beginning of any calendar year thereafter shall not be subject to
this limitation of benefits. A preexisting condition is any condition for which the insured
or their covered dependent received medical treatment, advice or consultation or received
any prescribed medication within 12 months of the effective date of...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/36-29-15.htm - 1K - Match Info - Similar pages
22-6-150
Section 22-6-150 Definitions. For the purposes of this article, the following words shall have
the following meanings: (1) ALTERNATE CARE PROVIDER. A contractor, other than a regional care
organization, that agrees to provide a comprehensive package of Medicaid benefits to Medicaid
beneficiaries in a defined region of the state pursuant to a risk contract. (2) CAPITATION
PAYMENT. A payment the state Medicaid Agency makes periodically to a contractor on behalf
of each recipient enrolled under a contract for the provision of medical services. (3) CARE
DELIVERY SYSTEM. The manner in which the benefits and services set forth in the state Medicaid
plan are provided to Medicaid beneficiaries. (4) COLLABORATOR. A private health carrier, third
party purchaser, provider, health care center, health care facility, state and local governmental
entity, or other public payers, corporations, individuals, and consumers who are expecting
to collectively cooperate, negotiate, or contract with another...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-6-150.htm - 2K - Match Info - Similar pages
27-19-38
Section 27-19-38 Coverage of newly born children in health insurance policies. (a) All individual
and group health insurance policies providing coverage on an expense-incurred basis and individual
and group service or indemnity type contracts issued by a nonprofit service corporation which
provide coverage for a family member of the insured or subscriber shall, as to such family
members' coverage, also provide that the health insurance benefits applicable for children
shall be payable with respect to a newly born child of the insured or subscriber from the
moment of birth. (b) The coverage for newly born children shall consist of coverage of injury
or sickness including the necessary care and treatment of medically diagnosed congenital defects
and birth abnormalities, but need not include benefits for routine well-baby care. (c) The
requirements of this section shall apply to all insurance policies and subscriber contracts
renewed, delivered, or issued for delivery in this state, 60...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-19-38.htm - 1K - Match Info - Similar pages
36-29-16
Section 36-29-16 Group insurance for retired judges of probate and legislators; payment of
cost. Any judge of probate who qualifies to retire from active service with a benefit from
the Judicial Retirement Fund or any legislator shall be entitled to participate in the State
Employees' Health Insurance Plan. The entire cost for the group health insurance during retirement
for a judge of probate or for a legislator shall be paid by such retired judge or legislator
under such terms and conditions as the group insurer may, from time to time, prescribe for
such group health insurance. (Acts 1994, No. 94-608, p. 1123, §1.)...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/36-29-16.htm - 931 bytes - Match Info - Similar pages
36-29-4
Section 36-29-4 Establishment and provisions of health insurance plan; rules and regulations.
The board is hereby empowered and authorized to establish a fully insured or self-insured
health insurance plan for employees and retirees of the State of Alabama and to adopt and
promulgate rules and regulations for the administration of such plan, subject to such limitations
as may be contained in this chapter. Such plan may provide for group hospitalization, surgical,
and medical insurance against the financial costs of hospitalization, surgical, and medical
treatment and care and may also include, among other things, prescribed drugs, medicines,
prosthetic appliances, hospital inpatient and outpatient service benefits, and medical expenses
indemnity benefits, including major medical benefits or such other coverage or benefits as
may be deemed appropriate and desirable by the board. (Acts 1965, No. 833, p. 1564, §3; Act
2004-647, 1st Sp. Sess., p. 17, §1.)...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/36-29-4.htm - 1K - Match Info - Similar pages
16-25A-1
Section 16-25A-1 Definitions. When used in this article, the following terms shall have the
following meanings, respectively, unless the context clearly indicates otherwise: (1) EMPLOYEE.
Any person covered by the Public Education Employees' Health Insurance Plan pursuant to Section
16-25A-11 or person who is employed full-time in any public institution of education within
the State of Alabama which provides instruction at any combination of grades K through 14,
exclusively, under the auspices of the State Board of Education or the Alabama Institute for
Deaf and Blind; provided, any person employed part-time by any public institution of education
within the State of Alabama which provides instruction at any combination of grades K through
14, exclusively, under the auspices of the State Board of Education or the Alabama Institute
for Deaf and Blind, shall be included in the definition of employee if such person shall agree
to have deducted from his or her compensation a pro rata...
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