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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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27-52-2
Section 27-52-2 Authority. The plan shall have the general powers and authority granted under
the laws of this state to health insurers and in addition thereto, the specific authority
to do all of the following: (1) Enter into contracts as are necessary or proper to carry out
the provisions and purposes of this article, including the authority, with the approval of
the commissioner, to enter into contracts with similar plans of other states for the joint
performance of common administrative functions, or with persons or other organizations for
the performance of administrative functions. (2) Sue or be sued, including taking any legal
actions necessary or proper to recover or collect assessments due the plan. (3) Take legal
action as necessary to do any of the following: a. To avoid the payment of improper claims
against the plan or the coverage provided by or through the plan. b. To recover any amounts
erroneously or improperly paid by the plan. c. To recover any amounts paid by the...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-52-2.htm - 3K - Match Info - Similar pages
35-8A-313
Section 35-8A-313 Insurance. (a) Commencing not later than the time of the first conveyance
of a unit to a person other than a declarant, the association shall maintain, to the extent
reasonably available: (1) Property insurance on the common elements insuring against all risks
of direct physical loss commonly insured against or, in the case of a conversion building,
against fire and extended coverage perils. The total amount of insurance after application
of any deductibles shall be not less than the greater of 80 percent of the actual cash value
of the insured property at the time the insurance is purchased or such greater percentage
of such actual cash value as may be necessary to prevent the applicability of any co-insurance
provision and at each renewal date, exclusive of land, excavations, foundations, and other
items normally excluded from property policies; and (2) Liability insurance, including medical
payments insurance, in an amount determined by the board but not less than...
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27-15-78
Section 27-15-78 Calculations of adjusted premiums by the nonforfeiture net level premium method.
(a) This section shall apply to all policies issued on or after the operative date of this
section as defined herein. Except as provided in subsection (g), the adjusted premiums for
any policy shall be calculated on an annual basis and shall be such uniform percentage of
the respective premiums specified in the policy for each policy year, excluding extra premiums
on a substandard policy and also excluding any uniform annual contract charge or policy fee
specified in the policy in a statement of the method to be used in calculating the cash surrender
values and paid-up nonforfeiture benefits, that the present value, at the date of issue of
the policy, of all adjusted premiums shall be equal to the sum of: (1) The then present value
of the future guaranteed benefits provided for by the policy. (2) One percent of either the
amount of insurance, if the insurance be uniform in amount, or the...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-15-78.htm - 12K - Match Info - Similar pages
35-8A-409
Section 35-8A-409 Resales of units. (a) Except in the case of a sale where delivery of an offering
statement is required, or unless exempt under Section 35-8A-401(b), a unit owner upon written
request by a purchaser of a unit previously disposed of, which written request must be made
within 14 days of the date the purchaser signs the contract with a purchaser, shall furnish
to a purchaser before the conveyance and in any event within 15 days of receipt of the written
request, a copy of the declaration, the bylaws, the rules, and the regulations of the association,
and a certificate containing: (1) A statement setting forth the amount of the periodic common
expense assessment; (2) A statement setting forth the amount of any unpaid common expense
or special assessments against the unit either past due or then due owing; (3) A statement
of any other assessments or fees assessed against the unit or the unit owner either past due
or then due and owing; (4) The most recent regularly prepared...
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27-15-8.1
Section 27-15-8.1 Life insurance policy provisions - Maximum rates of interest on policy loans.
(a) For purposes of this section the "published monthly average" means: (1) The
Monthly Average of the Composite Yield on Seasoned Corporate Bonds as published by Moody's
Investors Service, Inc., or any successor thereto; or (2) In the event that the Monthly Average
of the Composite Yield on Seasoned Corporate Bonds is no longer published, a substantially
similar average, established by regulation issued by the commissioner. (b)(1) Policies issued
on or after May 15, 1981, shall provide for policy loan interest rates as follows: a. A provision
permitting a maximum interest rate of not more than eight percent per annum; or b. A provision
permitting an adjustable maximum interest rate established from time to time by the life insurer
as permitted by law. (2) The rate of interest charged on a policy loan made under subdivision
(1) of this subsection shall not exceed the higher of the following:...
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38-15-4
Section 38-15-4 Registration of certain youth residential institutions or organizations; staff
training plans; rights of children; licensing and inspection of food preparation areas; access
by law enforcement agencies. (a) Commencing on January 1, 2018, the department shall register
any religious, faith-based, or church nonprofit, other nonprofit, or for profit affiliated
youth residential facility, youth social rehabilitation facility, community treatment facility
for youths, youth transitional care facility, long term youth residential facility, private
alternative boarding school, private alternative outdoor program, and any organization entrusted
with the residential care of children in any organizational form or combination defined by
this section, whenever children are housed at the facility or location of the program for
a period of more than 24 hours. At a minimum, registered youth residential institution or
organization under this section shall do all of the following: (1) Be...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/38-15-4.htm - 13K - Match Info - Similar pages
22-6-153
Section 22-6-153 Contract to provide medical care to Medicaid beneficiaries; enrollment; grievance
procedures; duties of Medicaid Agency. (a) Subject to approval of the federal Centers for
Medicare and Medicaid Services, the Medicaid Agency shall enter into a contract in each Medicaid
region for at least one fully certified regional care organization to provide, pursuant to
a risk contract under which the Medicaid Agency makes a capitated payment, medical care to
Medicaid beneficiaries. However, the Medicaid Agency may enter into a contract pursuant to
this section only if, in the judgment of the Medicaid Agency, care of Medicaid beneficiaries
would be better, more efficient, and less costly than under the then existing care delivery
system. The Medicaid Agency may contract with more than one regional care organization in
a Medicaid region. Pursuant to the contract, the Medicaid Agency shall set capitation payments
for the regional care organization. (b) The Medicaid Agency shall...
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27-54-2
Section 27-54-2 Definitions. For purposes of this chapter, the following terms have the following
meanings: (1) DAY TREATMENT SERVICES. Includes, but is not limited to: Physiological, psychological,
and psychosocial concepts, techniques, and processes necessary to maintain or develop functional
skills of clients, provided to individuals and groups for periods of more than two hours but
less than 24 hours a day. (2) HEALTH BENEFIT PLAN. A health care service plan governed by
the provisions of Article 6, Chapter 4, Title 10, and a group health insurance policy, including
an employee welfare health benefit plan, that covers hospital, medical, or surgical expenses,
issued by insurers, 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...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-54-2.htm - 3K - Match Info - Similar pages
36-29-1
Section 36-29-1 Definitions. When used in this chapter, the following terms shall have the
following meanings, respectively, unless the context clearly indicates otherwise: (1) BOARD.
The State Employees' Insurance Board. (2) CLASS. An employee or retiree shall be included
in one of the following classes: (i) active employee single, (ii) active employee family,
(iii) non-Medicare retiree single, (iv) non-Medicare retiree family, (v) Medicare retiree
single, (vi) Medicare retiree family, (vii) non-Medicare retiree with Medicare eligible dependent(s),
or (viii) Medicare retiree with non-Medicare dependent(s). (3) EMPLOYEE. A person who works
full time for the State of Alabama or for a county health department and who receives his
or her full compensation on a monthly basis through means of a state warrant drawn upon the
State Treasury or by check drawn by the Treasurer of the Alabama State Port Authority or by
check drawn by the treasurer of the Alabama state agency for surplus property...
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