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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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22-8A-9
Section 22-8A-9 Withholding or withdrawal of treatment, etc., not suicide; execution of advance
directive not to affect sale, etc., of life or health insurance nor be condition for receipt
of treatment, etc.; provisions of chapter cumulative. (a) The withholding or withdrawal of
life-sustaining treatment or artificially provided nutrition and hydration from a patient
in accordance with the provisions of this chapter shall not, for any purpose, constitute a
suicide and shall not constitute assisting suicide. (b) The making of an advance directive
for health care pursuant to this chapter shall not affect in any manner the sale, procurement,
or issuance of any policy of life or health insurance, nor shall it be deemed to modify the
terms of an existing policy of life or health insurance. No policy of life or health insurance
shall be legally impaired or invalidated in any manner by the withholding or withdrawal of
life-sustaining treatment or artificially provided nutrition and hydration...
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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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27-14-11.1
Section 27-14-11.1 Contents of policies - Denial or reduction of benefits due to Medicaid eligibility
void. (a) For purposes of this section, "private insurer" is defined as any of the
following: (1) Any commercial insurance company offering health or casualty insurance to individuals
or groups, including both experience-rated contracts and indemnity contracts. (2) Any profit
or nonprofit prepaid plan offering either medical services or full or partial payment for
the diagnosis or treatment of an injury, disease, or disability. (3) Any organization administering
health or casualty insurance plans for professional associations, unions, fraternal groups,
employer-employee benefit plans, and any similar organization offering these payments or services,
including self-insured and self-funded plans. (4) Any health insurer, including group health
plans, as defined in Section 607(1) of the Employee Retirement Income Security Act of 1974,
self-insured plans, service benefit plans, managed care...
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36-27-1
Section 36-27-1 Definitions. When used in this article, the following terms shall have the
following meanings, respectively, unless the context clearly indicates otherwise: (1) RETIREMENT
SYSTEM. The Employees' Retirement System of Alabama as defined in Section 36-27-2. (2) EMPLOYEE.
Any regular employee of the State of Alabama whose salary is paid by state warrant by the
state, except a member of the Legislature of the state, a person who is covered or eligible
to be covered under the Teachers' Retirement System of Alabama or any other retirement system
to which contributions are made by the state, an elective official of the state government,
and a temporary employee or person engaged under retainer or special agreement. In all cases
of doubt the Board of Control shall determine who is an employee within the meaning of this
article. The term shall include any regular employee of the Alabama state hospitals and Partlow
State School and Hospital and the Alabama State Port Authority,...
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27-56-2
Section 27-56-2 Definitions. As used in this chapter, 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) EYE CARE PROVIDER. A licensed optometrist or a licensed ophthalmologist. (3)
INSURANCE POLICY, PLAN, OR CONTRACT PROVIDING FOR THIRD-PARTY PAYMENT OR PREPAYMENT OF HEALTH
OR MEDICAL EXPENSES. Includes an individual or group policy for accident or health insurance,
an individual or group hospital or health care service contract, an individual or group health
maintenance organization contract, an organized delivery system contract, or a preferred provider
organization contract, and any other similar policy, plan, or contract. This term shall not
include any employee welfare benefit plan, as defined...
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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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27-19-52
Section 27-19-52 Definitions. For purposes of this article, the following terms shall have
the meaning indicated herein: (1) APPLICANT. Includes either of the following: a. In the case
of an individual Medicare supplement policy or subscriber contract, the person who seeks to
contract for insurance benefits. b. In the case of a group Medicare supplement policy or subscriber
contract, the proposed certificate holder. (2) CERTIFICATE. Any certificate issued under a
group Medicare supplement policy, which policy has been delivered or issued for delivery in
this state. (3) CERTIFICATE FORM. The form on which the certificate is delivered or issued
for delivery by the issuer. (4) ISSUER. Insurance companies, fraternal benefit societies,
health care service plans, health maintenance organizations, and any other entity delivering
or issuing for delivery in this state Medicare supplement policies or certificates. (5) MEDICARE.
The "Health Insurance for the Aged Act," Title XVIII of the Social...
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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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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...
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