Code of Alabama

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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...
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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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27-14-19
Section 27-14-19 Delivery of policies. (a) Subject to the insurer's requirements as to payment
of premium, every policy shall be mailed or delivered to the insured or to the person entitled
thereto within a reasonable period of time after its issuance, except where a condition required
by the insurer has not been met by the insured. (b) In event the original policy is delivered,
or is so required to be delivered, to or for deposit with any vendor, mortgagee, or pledgee
of any motor vehicle, and in which policy any interest of the vendee, mortgagor, or pledgor
in or with reference to such vehicle is insured, a duplicate of such policy, setting forth
the name and address of the insurer, insurance classification of vehicle, type of coverage,
limits of liability, premiums for the respective coverages, and duration of the policy, or
memorandum thereof containing the same such information, shall be delivered by the vendor,
mortgagee, or pledgee to each such vendee, mortgagor, or pledgor...
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27-21A-1
Section 27-21A-1 Definitions. As used in this chapter, the following terms shall have the following
meanings, respectively: (1) AGENT. A person who is appointed or employed by a health maintenance
organization and who engages in solicitation of membership in such organization. This definition
does not include a person enrolling members on behalf of an employer, union, or other organization.
(2) BASIC HEALTH CARE SERVICES. Emergency care, inpatient hospital and physician care, and
outpatient medical services. (3) COMMISSIONER. The Commissioner of Insurance. (4) ENROLLEE.
An individual who is enrolled in a health maintenance organization. (5) EVIDENCE OF COVERAGE.
Any certificate, agreement, or contract issued to an enrollee setting out the coverage to
which he is entitled. (6) HEALTH CARE SERVICES. Any services included in the furnishing to
any individual of medical or dental care, or hospitalization or incident to the furnishing
of such care or hospitalization, as well as the...
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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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36-29-23
Section 36-29-23 Authorization to establish flexible employee benefit plan; provisions of plan.
The board, with the approval of the Governor, is authorized to establish a flexible employee
benefit plan for state employees in compliance with Section 125 and any other applicable sections
of the Internal Revenue Code. The flexible employee benefit plan may provide for payments
or salary reductions for qualified benefits in accordance with Section 125 of the Internal
Revenue Code, which presently include health insurance premiums, group life insurance, disability
insurance, supplemental health and accident insurance, dependent care expenses, and such other
types of employee benefits permitted under Section 125 and any other applicable sections of
the Internal Revenue Code. Futhermore, the board may establish a long-term care plan for employees.
(Acts 1989, No. 89-644, p. 1272, §4; Act 98-639, p. 1410, §1.)...
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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...
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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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25-5-290
Section 25-5-290 Ombudsman program, creation; purpose; members; notification of service; benefit
review conferences. (a) The Department of Industrial Relations shall establish an Ombudsman
Program to assist injured or disabled employees, persons claiming death benefits, employers,
and other persons in protecting their rights and obtaining information available under the
Workers' Compensation Law. (b) Providing that the employer and the employee agree to participate
in the benefit review conference, the ombudsmen shall meet with or otherwise provide information
to injured or disabled employees, investigate complaints, and communicate with employers,
insurance carriers, and health care providers on behalf of injured or disabled employees.
(c) Ombudsmen shall be Merit System employees and demonstrate familiarity with the Workers'
Compensation Law. An ombudsman shall not be an advocate for any person who shall assist a
claimant, employer, or other person in any proceeding beyond the...
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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...
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