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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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27-1-10.1
Section 27-1-10.1 Insurance coverage for drugs to treat life-threatening illnesses. (a) The
Legislature finds and declares the following: (1) The citizens of this state rely upon health
insurance to cover the cost of obtaining health care and it is essential that the citizens'
expectation that their health care costs will be paid by their insurance policies is not disappointed
and that they obtain the coverage necessary and appropriate for their care within the terms
of their insurance policies. (2) Some insurers deny payment for drugs that have been approved
by the Federal Food and Drug Administration, hereafter referred to as FDA, when the drugs
are used for indications other than those stated in the labelling approved by the FDA, off-label
use, while other insurers with similar coverage terms do pay for off-label use. (3) Denial
of payment for off-label use can interrupt or effectively deny access to necessary and appropriate
treatment for a person being treated for a...
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27-56-10
Section 27-56-10 Vision care providers - Contract requirements; rates; reimbursements; discounts.
(a) As used in this section, the following words shall have the following meanings: (1) CONTRACTUAL
DISCOUNT. A percentage reduction from a provider's usual and customary rate for covered services
and materials required under a participating provider agreement. (2) COVERED MATERIALS. Materials
for which reimbursement from the insurer or vision care plan is provided to a vision care
provider by an enrollee's plan contract, or for which a reimbursement would be available but
for the application of the enrollee's contractual limitations of deductibles, copayments,
or coinsurance. (3) COVERED SERVICES. Services for which reimbursement from the insurer or
vision care plan is provided to a vision care provider by an enrollee's plan contract, or
for which a reimbursement would be available but for the application of the enrollee's contractual
plan limitations of deductibles, copayments, or...
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16-22-17
Section 16-22-17 Payroll deductions for participation in statewide programs. (a) When used
in this section, the following terms shall have the following meanings, respectively: (1)
EMPLOYEE. Any person employed full-time as provided by law by those employers enumerated in
this section and adult bus drivers. (2) EMPLOYER. All public city and county boards of education;
the Board of Trustees of the Alabama Institute for Deaf and Blind; the Alabama Youth Services
Department District Board in its capacity as the Board of Education for the Youth Services
Department District; the Board of Directors of the Alabama School of Fine Arts; the Board
of Trustees of the Alabama High School of Mathematics and Science; the State Board of Education
as applied to the payroll office of two-year postsecondary education institutions; and the
Board of Trustees of Alabama A and M University. (3) PROFESSIONAL ORGANIZATION or ORGANIZATION.
The employees' local professional organization representing the...
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27-20-1
Section 27-20-1 Group disability insurance - Eligible groups. Group disability insurance is
hereby declared to be that form of disability insurance covering groups of persons as defined
in this section, with or without one or more members of their families or one or more of their
dependents, or covering one or more members of the families or one or more dependents of such
groups of persons, and issued upon the following basis: (1) Under a policy issued to an employer
or trustees of a fund established by an employer, who shall be deemed the policyholder, insuring
employees of such employer for the benefit of persons other than the employer. The term "employees"
as used in this subdivision shall be deemed to include the officers, managers, and employees
of the employer, the individual proprietor or partner if the employer is an individual proprietor
or partnership, the officers, managers, and employees of subsidiary or affiliated corporations
and the individual proprietors, partners, and...
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11-104-2
Section 11-104-2 Definitions. As used in this chapter, the following terms shall have the following
meanings: (1) DEPENDENTS. The spouse, children, or other dependents of the retired employee,
as defined by and covered under the documents governing the governmental entities' benefit
plans that provide post-employment benefits. (2) EMPLOYEE. Any person who is an employee of
any governmental entity located in the state who may become eligible for post-employment benefits
from the governmental entity. (3) EMPLOYER. Any governmental entity that sponsors, in whole
or in part, post-employment benefits. (4) FISCAL YEAR. The annual period at the end of which
a governmental entity determines its financial condition. (5) GASB. The Governmental Accounting
Standards Board. (6) GOVERNMENTAL ENTITY. Any political subdivision of the state, any department,
agency, board, commission, or authority of any such political subdivision, or any public corporation,
authority, agency, instrumentality, board,...
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27-29-1
Section 27-29-1 Definitions. For purposes of this chapter, unless otherwise stated, the following
terms shall have the meanings respectively ascribed to them by this section: (1) AFFILIATE.
The term shall include an affiliate of, or person affiliated with, a specific person, and
shall mean a person that directly, or indirectly through one or more intermediaries, controls,
or is controlled by, or is under common control with, the person specified. (2) COMMISSIONER.
The Commissioner of Insurance, his or her deputies, or the Insurance Department as appropriate.
(3) CONTROL. The term shall include controlling, controlled by, or under common control with
and shall mean the possession, direct or indirect, of the power to direct or cause the direction
of the management and policies of a person, whether through the ownership of voting securities,
by contract other than a commercial contract for goods or nonmanagement services, or otherwise,
unless the power is the result of an official...
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27-7-4.2
Section 27-7-4.2 Licenses - Applicability to insurance producer. (a) Nothing in this chapter
shall be construed to require an insurer to obtain an insurance producer license. In this
section, the term "insurer" does not include an insurer's officers, directors, employees,
subsidiaries, or affiliates. (b) A license as an insurance producer shall not be required
of any of the following: (1) An officer, director, or employee of an insurer or of an insurance
producer, provided that the officer, director, or employee does not receive any commission
on policies written or sold to insure risks residing, located, or to be performed in this
state and any of the following: a. The officer, director, or employee's activities are executive,
administrative, managerial, clerical, or a combination of these, and are only indirectly related
to the sale, solicitation, or negotiation of insurance. b. The officer, director, or employee's
function relates to underwriting, loss control, inspection, or the...
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35-12-71
Section 35-12-71 Definitions. As used in this article, unless the context otherwise requires,
the following terms shall have the meanings respectively ascribed to them by this section:
(1) APPARENT OWNER. A person whose name appears on the records of a holder as the person entitled
to property held, issued, or owing by the holder. (2) BUSINESS ASSOCIATION. A corporation,
joint stock company, investment company, partnership, unincorporated association, joint venture,
limited liability company, business trust, trust company, safe deposit company, financial
organization, insurance company, mutual fund, utility, or other business entity consisting
of one or more persons, whether or not for profit. (3) DOMICILE. The state of incorporation
of a corporation and the state of the principal place of business of a holder other than a
corporation. (4) FINANCIAL ORGANIZATION. A savings and loan association, building and loan
association, industrial loan organization, credit union, cooperative bank,...
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22-21-260
Section 22-21-260 Definitions. As used in this article, the following words and terms, and
the plurals thereof, shall have the meanings ascribed to them in this section, unless otherwise
required by their respective context: (1) ACQUISITION. Obtaining the legal equitable title
to a freehold or leasehold estate or otherwise obtaining the substantial benefit of such titles
or estates, whether by purchase, lease, loan or suffrage, gift, devise, legacy, settlement
of a trust or means whatever, and shall include any act of acquisition. The term "acquisition"
shall not mean or include any conveyance, or creation of any lien or security interest by
mortgage, deed of trust, security agreement, or similar financing instrument, nor shall it
mean or include any transfer of title or rights as a result of the foreclosure, or conveyance
or transfer in lieu of the foreclosure, of any such mortgage, deed of trust, security agreement,
or similar financing instrument, nor shall it mean or include any...
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