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27-52-20
Section 27-52-20 Alabama Small Employer Allocation Program created. There is hereby created
the Alabama Small Employer Allocation Program which shall promote the availability of health
insurance coverage to small employers regardless of their health status or claims experience,
to prevent abusive rating practices, to prevent segmentation of the health insurance market
based upon health risk, to spread health insurance risk more broadly, to require disclosure
of rating practices to purchasers, to establish rules regarding renewability of coverage,
to limit use of preexisting conditions exclusions, and to improve the overall fairness and
efficiency of the small group health insurance market. (Acts 1997, No. 97-713, p. 1476, §7.)...
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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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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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27-52-21
Section 27-52-21 Commissioner of Insurance; benefits offered to small employers; "small
employer" defined. (a) The Commissioner of Insurance shall, by regulation, establish
the conditions, restrictions, requirements, and plan of operation of the Alabama Small Employer
Allocation Program consistent with the requirements of the Health Insurance Portability and
Accountability Act of 1996 and any and all federal regulations adopted pursuant thereto, which
plan benefits shall be inclusive of the provisions of Sections 27-1-10 and 27-19-39. The program
shall be patterned after the Small Employer Health Insurance Availability models developed
by the National Association of Insurance Commissioners. (b) All insurers that offer health
benefit plans to small employers in this state on and after August 1, 1997, shall be required
to meet the requirements of the program as a condition of authority to transact business in
this state. (c) For the purposes of this article, a "small employer" means any...
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27-52-30
Section 27-52-30 Consultation with State Board of Health. The commissioner shall consult with
the State Board of Health on all aspects related to the provision of medical services under
the Alabama Health Insurance Plan and the Alabama Small Employer Allocation Program established
under this chapter. All regulations, bylaws, policies, guidelines, or directives issued by
the commissioner applicable to the Alabama Health Insurance Plan and the Alabama Small Employer
Allocation Program pertaining to the delivery of medical services, including, but not limited
to, those items specified in subdivisions (8), (13), (14), (15) of Section 27-52-2 and Section
27-52-4, shall be promulgated with the concurrence of the State Board of Health. (Acts 1997,
No. 97-713, p. 1476, §9.)...
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36-29-14
Section 36-29-14 Health insurance coverage under State Employees' Insurance Board; operation
of board. (a) Any agency of the state, or any governmental entity, body, or subdivision thereto,
any county, any municipality, any municipal foundation, any fire or water district, authority,
or cooperative, any regional planning and development commission established pursuant to Sections
11-85-50 through 11-85-73, that is not and was not for the 12 months immediately preceding
the date of application to participate in any plan created pursuant to the provisions of this
article a member of an existing government sponsored health insurance program, formed under
the provisions of Section 11-26-2, the Association of County Commissions of Alabama or the
Alabama League of Municipalities, the Alabama Retired State Employees' Association, the Alabama
State Employees Credit Union, Easter Seals Alabama, Alabama State University, the Alabama
Rural Water Association, Rainbow Omega, Incorporated, The Arc...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/36-29-14.htm - 5K - Match Info - Similar pages
12-5A-9
Section 12-5A-9 Participation of eligible employees in Employees' Retirement System; creditable
service; formal leave accounting system; inclusion in health insurance plan. (a) Class specifications
and rates of compensation for employees covered by this chapter, juvenile probation officers,
juvenile probation professional staff, and clerical staff, hereafter called "eligible
employees," and any future employees occupying those positions shall be established by
the Administrative Director of Courts. Notwithstanding the foregoing, the compensation of
any employee shall not be diminished as a result of his or her inclusion in the state court
system personnel system. (b) Eligible employees included in the state court system personnel
system pursuant to this chapter shall, on October 1 of the year their county transitions,
be covered by the Employees' Retirement System. An employee who on that date is participating
in a local retirement plan other than a unit administered by the Employees'...
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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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27-44-3
Section 27-44-3 Scope of chapter. (a) This chapter shall provide coverage for the policies
and contracts specified in subsection (b) as follows: (1) To persons who, regardless of where
they reside (except for non-resident certificate holders under group policies or contracts),
are the beneficiaries, assignees, or payees of the persons covered under subdivision (2).
(2) To persons who are owners of or certificate holders under the policies or contracts, other
than structured settlement annuities, and in each case who are either of the following: a.
Residents b. Not residents, but only under all of the following conditions: 1. The insurer
that issued the policies or contracts is domiciled in this state. 2. The states in which the
persons reside have associations similar to the association created by this chapter. 3. The
persons are not eligible for coverage by an association in any other state due to the fact
the insurer was not licensed in the state at the time specified in the state's...
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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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