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27-21A-7
Section 27-21A-7 Evidence of coverage and charges for health care services. (a)(1) Every enrollee
residing in this state is entitled to an evidence of coverage. If the enrollee obtains such
coverage through an insurance policy or a contract issued by a health care service plan, the
insurer or the health care service plan shall issue the evidence of coverage. Otherwise, the
health maintenance organization shall issue the evidence of coverage. (2) No evidence of coverage,
or amendment thereto, shall be issued or delivered to any person in this state until a copy
of the basic form of the evidence of coverage, or amendment thereto, has been filed with the
commissioner and the State Health Officer, and approved by the commissioner. (3) An evidence
of coverage shall contain: a. No provisions or statements which encourage misrepresentation,
or which are untrue, misleading, or deceptive as defined in subsection (a) of Section 27-21A-13;
and b. A clear and concise statement, if a contract, or a...
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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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27-21A-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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27-7-1
Section 27-7-1 Definitions. For the purposes of this chapter, the following terms shall have
the meanings respectively ascribed to them by this section: (1) BUSINESS ENTITY. A corporation,
association, partnership, limited liability company, limited liability partnership, or other
legal entity. (2) COMMISSIONER. The Alabama Commissioner of Insurance. (3) HOME STATE. The
District of Columbia and any state or territory of the United States in which an insurance
producer maintains his or her principal place of residence or principal place of business
and is licensed to act as an insurance producer. (4) INSURANCE. As defined in Section 27-1-2.
(5) INSURANCE PRODUCER or PRODUCER. A person required to be licensed under the laws of this
state to sell, solicit, or negotiate insurance. (6) INSURER. As defined in Section 27-1-2.
For the purposes of this chapter, insurer shall also mean an insurance company licensed pursuant
to Chapter 3, commencing with Section 27-3-1 of this title; a health...
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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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13A-12-20
Section 13A-12-20 Definitions. The following definitions apply to this article: (1) ADVANCE
GAMBLING ACTIVITY. A person "advances gambling activity" if he engages in conduct
that materially aids any form of gambling activity. Conduct of this nature includes but is
not limited to conduct directed toward the creation or establishment of the particular game,
contest, scheme, device or activity involved, toward the acquisition or maintenance of premises,
paraphernalia, equipment or apparatus therefor, toward the solicitation or inducement of persons
to participate therein, toward the actual conduct of the playing phases thereof, toward the
arrangement of any of its financial or recording phases or toward any other phase of its operation.
A person advances gambling activity if, having substantial proprietary control or other authoritative
control over premises being used with his knowledge for purposes of gambling activity, he
permits that activity to occur or continue or makes no effort to...
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27-15-52
Section 27-15-52 Definitions. The following terms shall have the following meanings: (1) COMMERCIALLY
REASONABLE EFFORT. The plans, processes, or procedures necessary to confirm the death of the
insured, contract owner or annuitant, or retained asset account holder against other available
records and information and, as applicable, to locate the beneficiary or beneficiaries or
other person entitled to payment pursuant to the terms of the policy or contract which have
been developed by each insurer and submitted to and approved by the department. (2) CONTRACT.
An annuity contract. The term contract shall not include an annuity used to fund an employment-based
retirement plan or program where the insurer is not committed by terms of the annuity contract
to pay death benefits to the beneficiaries of specific plan participants. (3) DEATH MASTER
FILE. The United States Social Security Administration's Death Master File or any other database
or service that is at least as comprehensive as...
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27-36-1
Section 27-36-1 Liabilities generally. In any determination of the financial condition of an
insurer, capital stock and liabilities to be charged against its assets shall include: (1)
The amount of its capital stock outstanding, if any; (2) The amount, estimated consistent
with the provisions of this title, necessary to pay all of its unpaid losses and claims incurred
on or prior to the date of statement, whether reported or unreported, together with the expenses
of adjustment or settlement thereof; (3) With reference to life and disability insurance and
annuity contracts: a. The amount of reserves on life insurance policies and annuity contracts
in force, valued according to the tables of mortality, rates of interest, and methods adopted
pursuant to this title which are applicable thereto; b. Reserves for disability benefits,
for both active and disabled lives; c. Reserves for accidental death benefits; and d. Any
additional reserves which may be required by the commissioner...
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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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45-37A-51.03
Section 45-37A-51.03 Board of managers. (a)(1) In order to assure representation of all participants
of this system, there shall be a board of managers of five members for the administration,
management, and control of the supplemental pension system, including administration, management,
control, acquisition, and disbursement of the fund. The board shall consist of the president
of the governing body of the city, who shall be chair of the board, and four associate members,
designated respectively as Member No. 1, Member No. 2, Member No. 3, and Member No. 4. (2)
Member No. 1 shall be appointed by the Jefferson County Personnel Board and shall be a person
who at the time of appointment has had five or more consecutive years immediately preceding
his or her appointment and has been an officer of, or the occupant of an executive position
in insurance, actuarial, investment, banking, or as a certified public accountant and shall
serve for a term of four years. Should the appointed Member...
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