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27-3A-5
Section 27-3A-5 Standards for utilization review agents. (a) Except as provided in subsection
(b), all utilization review agents shall meet the following minimum standards: (1) Notification
of a determination by the utilization review agent shall be mailed or otherwise communicated
to the provider of record or the enrollee or other appropriate individual within two business
days of the receipt of the request for determination and the receipt of all information necessary
to complete the review. (2) Any determination by a utilization review agent as to the necessity
or appropriateness of an admission, service, or procedure shall be reviewed by a physician
or determined in accordance with standards or guidelines approved by a physician. (3) Any
notification of determination not to certify an admission, service, or procedure shall include
the principal reason for the determination and the procedures to initiate an appeal of the
determination. (4) Utilization review agents shall maintain...
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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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25-14-9
Section 25-14-9 Written contract; rights and duties of clients; employees, and professional
employer organizations. (a) All professional employer organization arrangements shall have
a written contract between the client and the professional employer organization recognizing
the rights, responsibilities, and duties of each party. The contract shall disclose to the
client the services to be rendered by the professional employer organization, including the
total administrative fees charged for professional employer organization services, the respective
rights and obligations of the parties, and shall provide the following: (1) The professional
employer organization reserves a right of direction and control over contract employees and
exercises that right in the context of the need to do so according to the terms and conditions
of the professional employment agreement. The client, however, as an employer, may retain
sufficient direction and control over covered employees necessary to...
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27-55-2
Section 27-55-2 Definitions. As used in this chapter, these terms shall have the following
meanings: (1) ABUSE. The occurrence of one or more of the following acts by a family or household
member, as defined by subdivision (3) of subsection (b) of Section 15-10-3: a. Attempting
to cause or intentionally, knowingly, or recklessly causing another person, including a minor
child, bodily injury, severe emotional injury, or psychological trauma or conduct which constitutes
the crime of rape. b. Intentionally following another person, including a minor child, without
proper authority, under circumstances that place the person in reasonable fear of bodily injury
or physical harm. c. Subjecting another person, including a minor child, to false imprisonment
or kidnapping. d. Attempting to cause or intentionally, knowingly, or recklessly causing damage
to property to intimidate or attempt to control the behavior of another person, including
a minor child. e. Assault, child abuse, criminal...
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25-4-10
Section 25-4-10 Employment. (a) Subject to other provisions of this chapter, "employment"
means: (1) Any service performed prior to January 1, 1978, which was employment as defined
in this section prior to such date and, subject to the other provisions of this section, services
performed for remuneration after December 31, 1977, including service in interstate commerce,
by: a. Any officer of a corporation; or b. Any individual who, under the usual common law
rules applicable in determining the employer-employee relationship, has the status of an employee;
or c. Any individual other than an individual who is an employee under paragraphs a. or b.
of this subdivision (1) who performs services for remuneration for any person: 1. As an agent-driver
or commission-driver engaged in distributing meat products, bakery products, beverages (other
than milk) or laundry or dry cleaning services for a principal; 2. As a traveling or city
salesman engaged upon a full-time basis in the solicitation on...
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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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25-14-3
Section 25-14-3 Definitions. As used in this chapter, the following terms shall have the following
meanings: (1) ADMINISTRATIVE FEE. The fee charged to a client by a professional employer organization
for professional employer services. The term does not include any amount of a fee by the professional
employer organization that is for wages and salaries, benefits, workers' compensation, payroll
taxes, withholding, or other assessments paid by the professional employer organization to
or on behalf of covered employees under the professional employer agreement. (2) CLIENT. A
person or entity that enters into a professional employer agreement with a professional employer
organization, including a worksite employer. (3) CONTROLLING PERSON. Any of the following:
a. An officer or director of a corporation operating as a professional employer organization,
a shareholder holding 25 percent or more of the voting stock of a corporation operating as
a professional employer organization, or a...
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27-44-8
Section 27-44-8 Powers and duties of association. (a) If a member insurer is an impaired insurer,
the association may, in its discretion and subject to any conditions imposed by the association
that do not impair the contractual obligations of the impaired insurer, and that are approved
by the commissioner: (1) Guarantee or reinsure, or cause to be guaranteed, assumed, or reinsured,
any or all of the covered policies of the impaired insurers. (2) Provide such moneys, pledges,
notes, guarantees, or other means as are proper to effectuate subdivision (1), and assure
payment of the contractual obligations of the impaired insurer pending action under subdivision
(1). (b) If a member insurer is an insolvent insurer, the association shall, in its discretion
and subject to the approval of the commissioner, do either of the following: (1)a. Guarantee,
assume, or reinsure, or cause to be guaranteed, assumed, or reinsured, the covered policies
of the insolvent insurer. b. Assure payment of the...
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36-1A-5
Section 36-1A-5 Participation limited to voluntary, charitable, health and human care federations
and agencies with a substantial local presence. (a) Participation in the Alabama State Employee
Combined Charitable Campaign shall be limited to voluntary, charitable, health and human care
federations and agencies with a substantial local presence that provide or support direct
health and welfare services to individuals or their families and meet the criteria set forth
in this section. "Substantial local presence" is defined as a facility, staffed
by professionals or volunteers, available to provide its services and open at least 15 hours
a week. Such services must be available to state employees in the local campaign community,
unless they are rendered to needy persons overseas. Such services must directly benefit human
beings, whether children, youth, adults, the aged, the ill and infirm, or the mentally or
physically handicapped. Such services must consist of care, research, or...
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7-9A-102
Section 7-9A-102 Definitions and index of definitions. (a) Article 9A definitions. In this
article: (1) "Accession" means goods that are physically united with other goods
in such a manner that the identity of the original goods is not lost. (2) "Account,"
except as used in "account for," means a right to payment of a monetary obligation,
whether or not earned by performance, (i) for property that has been or is to be sold, leased,
licensed, assigned, or otherwise disposed of, (ii) for services rendered or to be rendered,
(iii) for a policy of insurance issued or to be issued, (iv) for a secondary obligation incurred
or to be incurred, (v) for energy provided or to be provided, (vi) for the use or hire of
a vessel under a charter or other contract, (vii) arising out of the use of a credit or charge
card or information contained on or for use with the card, or (viii) as winnings in a lottery
or other game of chance operated or sponsored by a State, governmental unit of a State, or...
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