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27-21A-15
Section 27-21A-15 Powers of insurers and health care service plans. (a) An insurance company
licensed in this state, or a health care service plan authorized to do business in this state,
may either directly or through a subsidiary or affiliate organize and operate a health maintenance
organization under the provisions of this chapter. Notwithstanding any other law which may
be inconsistent herewith, any two or more such insurance companies, health care service plans,
or subsidiaries or affiliates thereof, may jointly organize and operate a health maintenance
organization. The business of insurance is deemed to include the providing of health care
by a health maintenance organization owned or operated by an insurer or a subsidiary thereof.
(b) Notwithstanding any provision of insurance and health care service plan laws, Title 10,
Chapter 4, Article 6 and Title 27, an insurer or a health care service plan may contract with
a health maintenance organization to provide insurance or...
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27-21A-21
Section 27-21A-21 Fees. (a) Every health maintenance organization subject to this chapter shall
pay to the commissioner the following fees: (1) For filing an application for certificate
of authority or amendment thereto, $50.00; (2) For filing an amendment to the organization
documents that requires approval, $10.00; (3) For filing each annual report, $20.00; (4) For
renewal of annual certificates of authority, $200.00. (b) Fees charged under this section
shall be deposited to the credit of the General Fund. (Acts 1986, No. 86-471, p. 854, ยง21.)...
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11-91A-2
Section 11-91A-2 Local Government Health Insurance Board; governance and administration of
program. (a) The Local Government Health Insurance Board shall govern and administer the Local
Government Health Insurance Program currently governed and administered by the State Employees'
Insurance Board (SEIB) pursuant to Chapter 29 of Title 36. The transfer of the governance
and administration to the board shall take effect at 12:01 a.m. on January 1, 2015, and thereafter
the board shall take all control and responsibility for the program under procedures and authority
set out in this chapter. (b) The program governed and administered by the board shall provide
a reasonable relationship between the health care benefits to be included and the expected
health care expenses to be incurred by affected employees, retirees, and their dependents.
The board may establish a fully insured or self-insured health care plan for employees and
retirees as defined in this chapter and may adopt rules for the...
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45-37A-51.242
Section 45-37A-51.242 Cost of living increases; future benefits (a) Upon approval of the governing
body of the municipality primarily served by the system and upon approval of the board of
managers, an increase in the amount of benefits, including improvements in the terms of benefits:
(1) for future retirees, benefits or improvements such as earlier vesting, decreased retirement
age, increase in multiplier used in calculating monthly benefit, or other like improvements
may be granted; and (2) for current retirees cost of living increases may be granted, subject
to the requirements of the United States Internal Revenue Code and regulations therewith.
Such increases shall apply to participants or retirees of the board of health. (b) Prior to
approving an increase in the above described benefits, the board shall obtain the actuarial
evaluation of the fund. Such evaluation shall project the actuarial cost of benefits for the
succeeding plan year and shall combine therewith the applicable...
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27-19A-12
Section 27-19A-12 Dental services - Coverages; fees; exceptions. (a) As used in this section,
the following terms shall have the following meanings: (1) COVERED PERSON. Any individual,
family, or family member on whose behalf third-party payment or prepayment of health or medical
expenses is provided under an insurance policy, plan, or contract providing for third-party
payment or prepayment of health care or medical expenses. (2) COVERED SERVICES. Dental care
services for which a reimbursement is available under an enrollee's plan contract, or for
which a reimbursement would be available but for the application of contractual limitations
such as deductibles, copayments, coinsurance, waiting periods, annual or lifetime maximums,
frequency limitations, alternative benefit payments, or any other limitation. (3) DENTAL CARE
PROVIDER. A licensed dentist. (4) DENTAL PLAN. Includes any policy of insurance which is issued
by a health care service contractor which provides for coverage of...
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27-19A-7
Section 27-19A-7 Contracting directly with patient; distribution of information about policy
or plan; payment and reimbursement procedures. The provisions of this chapter do not prohibit
the following conduct and shall be construed to provide that: (1) A dentist may contract directly
with a patient for the furnishing of dental care services to said patient as may be otherwise
authorized by law; (2) Any person providing a health insurance policy or employee benefit
plan, or an employer, or an employee organization may: a. Make available to its insureds,
beneficiaries, participants, employees, or members information relating to dental care services
by the distribution of factually accurate information regarding dental care services, rates,
fees, location, and hours of service, provided such distribution is made upon the request
of any dentist licensed by this state; or b. Establish an administrative mechanism which facilitates
payment for dental care services by insureds, beneficiaries,...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-19A-7.htm - 1K - Match Info - Similar pages
27-2B-3
Section 27-2B-3 Preparation and submission of RBC report; formulas; desirability of excess
capital; adjustment of inaccurate RBC report. (a) Every domestic insurer shall, on or prior
to each March 1 (the "filing date"), prepare and submit to the commissioner a report
of its RBC levels as of the end of the calendar year just ended, in a form and containing
information as is required by the RBC instructions. In addition, every domestic insurer shall
file its RBC report with: (1) The NAIC according to the RBC instructions. (2) The insurance
commissioner in any state in which the insurer is authorized to do business, if the insurance
commissioner has notified the insurer of its request in writing, in which case the insurer
shall file its RBC report not later than the later of either of the following: a. Fifteen
days from the receipt of notice to file its RBC report with that state. b. The filing date.
(b) A life and health insurer's and a fraternal benefit society's RBC shall be determined...
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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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34-23-184
Section 34-23-184 Audit procedures; report. (a) The entity conducting an audit shall follow
these procedures: (1) The pharmacy contract shall identify and describe in detail the audit
procedures. (2) The entity conducting the on-site audit shall give the pharmacy written notice
at least two weeks before conducting the initial on-site audit for each audit cycle. If the
pharmacy benefit manager does not include their auditing guidelines within their provider
manual, then the notice must include a documented checklist of all items being audited and
the manual, including the name, date, and edition or volume, applicable to the audit and auditing
guidelines. For on-site audits a pharmacy benefit manager shall also provide a list of material
that is copied or removed during the course of an audit to the pharmacy. The pharmacy benefit
manager may document this material on either a checklist or on an audit acknowledgement form.
The pharmacy shall produce any items during the course of the...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/34-23-184.htm - 9K - Match Info - Similar pages
38-9B-2
Section 38-9B-2 Definitions. THIS SECTION WAS AMENDED BY ACT 2018-422 IN THE 2018 REGULAR SESSION,
EFFECTIVE JANUARY 31, 2018. THIS IS NOT IN THE CURRENT CODE SUPPLEMENT. As used in this chapter,
the following words shall have the following meanings: (1) ALABAMA FAMILY CHARITABLE TRUST
(AFT CHARITABLE TRUST). The trust established by the board of trustees that qualifies as a
tax exempt charitable entity under the United States Internal Revenue Code, to provide benefits
for any individual who does not have a sufficient amount in his or her AFT Trust to meet the
individual's needs. (2) ALABAMA FAMILY TRUST (AFT TRUST). The Alabama Family Trust established
pursuant to this chapter. (3) ALABAMA FAMILY TRUST CORPORATION (AFT CORPORATION). An Alabama
not-for-profit corporation established by the board of trustees pursuant to this chapter that
qualifies as a tax exempt charitable organization under the United States Internal Revenue
Code. (4) BOARD OF TRUSTEES. The Alabama Family Trust Board...
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