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27-19A-9
Section 27-19A-9 Nonconforming policies and plans not to be approved by commissioner. The Commissioner
of Insurance shall not approve for sale in this state any health insurance policy or employee
benefit plan providing for dental care services which does not conform to the provisions of
this chapter or to the provisions of Sections 27-14-8 and 27-14-9. (Acts 1984, No. 84-411,
p. 960, §8.)...
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22-21-361
Section 22-21-361 Definitions. The following terms shall have the meanings respectively ascribed
by this section unless the context clearly indicates otherwise: (1) COMMISSIONER. The commissioner
of insurance of this state. (2) DENTAL SERVICE PLAN or PLAN. Any plan or other arrangement
whereby dental services are provided in whole or in part through a dental service corporation
by dentists participating in the plan to provide dental services to those members of the public
who become subscribers to the plan under a contract with such corporation. The terms "dental
service plan" or "plan" do not include an insurer authorized by the insurance
department to transact insurance in this state or to a nonprofit health insurance plan organized
pursuant to Section 10-4-100, or to any policy of insurance or contract which includes dental
benefits issued by such insurer or nonprofit health insurance plan. (3) DEPARTMENT. The Department
of Insurance. (4) LICENSE. The certificate of authority issued...
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27-19A-6
Section 27-19A-6 Dental benefits not required. The provisions of this chapter do not mandate
that any type of benefits for dental care expenses be provided by a health insurance policy
or an employee benefit plan. (Acts 1984, No. 84-411, p. 960, §5.)...
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27-19A-2
Section 27-19A-2 Definitions. As used in this chapter, 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 chapter. (7) HEALTH INSURANCE POLICY. Any individual,
group, blanket, or franchise insurance policy, insurance agreement, or group hospital service
contract providing benefits for dental care expenses incurred as a result of an accident or
sickness. (8) EMPLOYEE BENEFIT PLAN. Any plan, fund, or program...
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27-54A-2
Section 27-54A-2 Treatment under certain policies and contracts. (a) As used in this section,
the following words have the following meanings: (1) APPLIED BEHAVIOR ANALYSIS. The design,
implementation, and evaluation of environmental modifications, using behavioral stimuli and
consequences, to produce socially significant improvement in human behavior, including the
use of direct observation, measurement, and functional analysis of the relationship between
environment and behavior. (2) AUTISM SPECTRUM DISORDER. Any of the pervasive developmental
disorders or autism spectrum disorders as defined by the most recent edition of the Diagnostic
and Statistical Manual of Mental Disorders (DSM) or the edition that was in effect at the
time of diagnosis. (3) BEHAVIORAL HEALTH TREATMENT. Counseling and treatment programs, including
applied behavior analysis that are both of the following: a. Necessary to develop, maintain,
or restore, to the maximum extent practicable, the functioning of an...
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27-55-3
Section 27-55-3 Prohibited practices; disclosure of information. (a) No insurer may: (1) Deny,
refuse to issue, renew, or reissue, cancel, or otherwise terminate, restrict, or exclude coverage
on an insurance policy or health benefit plan on the basis of an applicant's or insured's
abuse status, or on the basis of any association, relationship, or assistance to a subject
of abuse. (2) Exclude or limit coverage for a loss, deny benefits, or deny a claim on the
basis of the insured's abuse status, or on the basis of any association, relationship, or
assistance to a subject of abuse, except as otherwise permitted or required by the laws of
this state relating to acts of abuse committed by a life insurance beneficiary. Notwithstanding
anything to the contrary in this section, a liability insurer may include policy provisions
providing that a payment required by this subsection may be denied or, if paid, recovered
by the insurer from the insured, if the claim arose out of an act of abuse by...
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27-1-21
Section 27-1-21 Uniformity of limits applied to fulfillment of certain drug prescriptions.
(a) For the purposes of this section, the following words shall have the following meanings:
(1) ENROLLEE. A person enrolled in a health benefit plan. (2) HEALTH BENEFIT PLAN. Any individual
or group plan, policy, or contract for health care services issued, delivered, issued for
delivery, 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, purchases, or
furnishes health care services to patients, insureds, or beneficiaries in this state. The
term includes, but is not limited to, entities created pursuant to Article 6 of Chapter 4
of Title 10. The term shall not include any collective bargaining agreement...
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27-19-28
Section 27-19-28 Exclusion of hospitalization benefits for mental patients in tax-supported
institutions. (a) No policy of health, sickness, or accident insurance delivered, or issued
for delivery, in this state, including both individual and group policies, which provide coverage
for psychiatric treatment or mental illness shall exclude hospitalization benefits for mental
patients in tax-supported institutions of the State of Alabama, or any county or municipality
thereof. (b) The provisions of this section shall not apply to any policy of insurance in
effect prior to September 20, 1971, nor shall the provisions of this section apply to any
employee benefit plan providing hospital benefits for mental patients where such employee
benefit plan is established by the employer and contributions to the plan are provided by
the employer and the employee, or either of them, and such plan is not evidenced by individual,
or group or blanket policies of health, sickness, or accident insurance...
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45-37-123.01
Section 45-37-123.01 Definitions. For the purposes of this part, the following terms shall
have the following meanings: (1) ACT. The act adding this part, to be called the General Retirement
System for Employees of Jefferson County Act. (2) ACTIVE MEMBER. An individual who currently
is employed by the county or other entities set forth in subdivision (20) and is making employee
contributions to the system. (3) ACTUARIAL EQUIVALENT. Effective July 30, 1984, or such other
dates as set forth in Exhibit A, which is maintained in the office of the pension board, a
form of benefit differing in time, period, or manner of payment from a specific benefit provided
under the plan but having the same value when computed using the mortality tables, the interest
rate, and any other assumptions last adopted by the pension board, which assumptions shall
clearly preclude any discretion in the determination of the amount of a member's benefit.
(4) ACTUARIAL GAIN. As defined in Section...
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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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