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27-50-3
Section 27-50-3 Health benefit plan. As used in this chapter, the term "health benefit
plan" has the following meaning: A health insurance policy, including a self-insured
health plan, that covers hospital, medical, or surgical expenses, 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 beneficiaries
in this state. The term does not include accident-only, specified disease, individual hospital
indemnity, credit, dental-only, Medicare-supplement, long-term care, or disability income
insurance; coverage issued as a supplement to liability insurance, workers' compensation or
similar insurance; or automobile medical-payment insurance. For the purpose of this chapter,
a health benefit plan located or domiciled outside of the State of...
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34-23-181
Section 34-23-181 Definitions. The following words shall have the following meanings as used
in this article: (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 article if it receives, processes, adjudicates,
pays, or denies claims for health care services submitted by or...
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27-45-2
Section 27-45-2 Definitions. As used in this article, the following terms shall have the respective
meanings herein set forth, unless the context shall otherwise require: (1) ALABAMA INSURANCE
CODE. Title 27 of the Code of Alabama 1975. (2) INSURER. Such term shall have the meaning
ascribed in Section 27-1-2. (3) PERSON. Such term shall have the meaning ascribed in Section
27-1-2. (4) COMMISSIONER and DEPARTMENT. Such terms, respectively, shall have the meanings
ascribed in Section 27-1-2. (5) CONTRACTUAL OBLIGATION. Any obligation under covered policies
or employee benefit plans. (6) COVERED POLICY OR PLAN. Any policy, employee benefit plan,
or contract within the scope of this article. (7) HEALTH INSURANCE POLICY. Any individual,
group, blanket, or franchise insurance policy, insurance agreement, or group hospital service
contract providing for pharmaceutical services, including without limitation, prescription
drugs, incurred as a result of accident or sickness, or to prevent same....
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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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27-55-8
Section 27-55-8 Construction. This chapter does not and shall not be construed as creating
a private cause of action and does not and shall not require insurers, including any health
benefit plan, to extend coverage to any providers or type of providers for which coverage
is not specifically provided within the policy or certificate of insurance or health benefit
plan, or to add additional providers to existing networks, or to add any health care benefits.
(Act 2000-595, p. 1185, §8.)...
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32-7-22
Section 32-7-22 Motor vehicle liability policy defined; policy provisions. (a) A motor vehicle
liability policy, as the term is used in this chapter, means an owner's or an operator's policy
of liability insurance, certified as provided in Section 32-7-20 or Section 32-7-21 as proof
of financial responsibility, and issued, except as otherwise provided in Section 32-7-21,
by an insurance carrier duly authorized to transact business in this state, to or for the
benefit of the person named in the policy as insured. (b) The owner's policy of liability
insurance: (1) Shall designate by explicit description or by appropriate reference all motor
vehicles to be insured; and (2) Shall insure the person named in the policy and any other
person, as insured, using any motor vehicle or motor vehicles designated in the policy with
the express or implied permission of the named insured, against loss from the liability imposed
by law for damages arising out of the ownership, maintenance, or use of...
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36-26-121
Section 36-26-121 Annual itemized statement of employee and retirement benefits, and total
employer contributions to retirement systems and health insurance plans. (a) As used in this
article, the following words have the following meanings: (1) EMPLOYEE BENEFIT. Any benefit
a public employee received or accrued from his or her employer, including, but not limited
to, salary or wages; insurance; allowance for days off such as vacation, holidays, sick leave,
or personal days; and contributions toward retirement or pension benefits. (2) HEALTH INSURANCE
PLAN. Either of the following health insurance plans as it applies to an individual public
employee or retiree: a. The State Employees' Health Insurance Plan. b. The Public Education
Employees' Health Insurance Plan. (3) RETIREE. A retiree or a beneficiary of a deceased retiree
who receives an employee benefit or pension benefit from a retirement system, as defined in
this section. (4) RETIREMENT SYSTEM. One of the following as it applies...
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27-12-10
Section 27-12-10 Financial inducements to purchase insurance. (a) No person shall issue or
deliver, or permit its agents, officers, or employees to issue or deliver, agency company
stock or other capital stock, or benefit certificates or shares in any common-law corporation,
or securities, or any special or advisory board contract or other contract of any kind promising
returns and profits as an inducement to insurance. The commissioner shall refuse to issue
a certificate of authority or license to any insurer or other person that is in violation
of this section and shall revoke the certificate of authority or license of any such violating
insurer or person if such authority or license is already outstanding. (b) No person shall
issue or deliver, or permit its agents, officers, or employees to issue or deliver, in this
state, any life insurance policy or contract of annuity in which are used such words as "investment
plan," "expansion plan," "profit-sharing," "charter plan,"
"founders'...
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27-12A-1
Section 27-12A-1 Definitions. As used in this chapter, the following terms shall have the following
meanings: (1) COMMISSIONER. The Alabama Commissioner of Insurance or his or her designee.
(2) DEPARTMENT. The Alabama Department of Insurance. (3) INSURANCE. As defined in Section
27-1-2, and specifically including any contract, arrangement, or agreement, in which one undertakes
to do any one of the following: a. Pay or indemnify another as to loss from certain contingencies
called risks. b. Pay or grant a specified amount or determinable benefit to another in connection
with ascertainable risk contingencies. c. Pay an annuity to another. d. Act as surety. For
the purposes of this chapter, insurance also includes any health benefit plan as defined in
Section 27-53-1. (4) INSURANCE PRODUCER or PRODUCER. As defined in Section 27-7-1. (5) INSURER.
A person entering into agreements, contracts of insurance, arrangements, or reinsurance, or
a health benefit plan, or a group health plan as...
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27-59-3
Section 27-59-3 Implementation of coverage. (a) The benefits provided in this chapter shall
be subject to the same annual deductible or co-insurance established for all covered benefits
within a given policy. Private third party payors may not reduce or eliminate coverage due
to the requirements of this chapter. (b) A health benefit plan subject to this chapter may
not terminate services, reduce capitation payment, or otherwise penalize an attending physician
or health care provider who orders medical care consistent with this chapter. (c) Nothing
in this chapter is intended to expand the list of designations of covered providers as specified
in any health benefit plan. (Act 2008-502, p. 1106, §3.)...
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