27-19A-3
Section 27-19A-3 Prohibited provisions. No health insurance policy or employee benefit plan which is delivered, renewed, issued for delivery, or otherwise contracted for in this state shall: (1) Prevent any person who is a party to or beneficiary of any such health insurance policy or employee benefit plan from selecting the dentist of his choice to furnish the dental care services offered by said policy or plan or interfere with said selection provided the dentist is licensed to furnish such dental care services in this state; (2) Deny any dentist the right to participate as a contracting provider for such policy or plan provided the dentist is licensed to furnish the dental care services offered by said policy or plan; (3) Authorize any person to regulate, interfere, or intervene in any manner in the diagnosis or treatment rendered by a dentist to his patient for the purpose of preventing, alleviating, curing, or healing dental illness or injury provided said dentist practices within...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-19A-3.htm - 1K - Match Info - Similar pages
16-25A-5
Section 16-25A-5 Authorization for health insurance plan; election of optional or supplemental coverage. (a) The board is hereby empowered and authorized to establish a fully insured or self-insured health insurance plan for employees and, under certain conditions, retired employees and to adopt and promulgate rules and regulations for the administration of such plan subject to such limitations as may be contained in this article. Such plan may provide for group hospitalization, surgical, medical, cancer, cash indemnity, and dental insurance against the financial costs of hospitalization, surgical, and medical treatment and care and may also include, among other things, prescribed drugs, medicines, prosthetic appliances, hospital inpatient and outpatient service benefits, and hospital/medical expenses indemnity benefits, including major medical benefits or such other coverage or benefits as may be deemed appropriate and desirable by the board, within the limits of such funds as may be...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/16-25A-5.htm - 2K - Match Info - Similar pages
36-29-4
Section 36-29-4 Establishment and provisions of health insurance plan; rules and regulations. The board is hereby empowered and authorized to establish a fully insured or self-insured health insurance plan for employees and retirees of the State of Alabama and to adopt and promulgate rules and regulations for the administration of such plan, subject to such limitations as may be contained in this chapter. Such plan may provide for group hospitalization, surgical, and medical insurance against the financial costs of hospitalization, surgical, and medical treatment and care and may also include, among other things, prescribed drugs, medicines, prosthetic appliances, hospital inpatient and outpatient service benefits, and medical expenses indemnity benefits, including major medical benefits or such other coverage or benefits as may be deemed appropriate and desirable by the board. (Acts 1965, No. 833, p. 1564, §3; Act 2004-647, 1st Sp. Sess., p. 17, §1.)...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/36-29-4.htm - 1K - Match Info - Similar pages
16-25A-6
Section 16-25A-6 Exclusions. Such health insurance shall not include the following: (1) Expenses incurred by or on account of an individual prior to the effective date of the plan as to him; (2) Hearing aids and examinations for the prescription or fitting thereof; (3) Cosmetic surgery or treatment, except to the extent necessary for correction of damage caused by accidental injury while covered by the plan or as a direct result of disease covered by the plan; (4) Services received in a hospital owned or operated by the United States government for which no charge is made; (5) Services received for injury or sickness due to war or any act of war, whether declared or undeclared, which war or act of war shall have occurred after the effective date of this plan; (6) Expenses for which the individual is not required to make payment; (7) Expenses to the extent of benefits provided under any employer group plan other than this plan in which the state participates in the cost thereof; (8)...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/16-25A-6.htm - 1K - Match Info - Similar pages
27-19A-8
Section 27-19A-8 Plans not in conformance with chapter unlawful. It shall be unlawful for any insurer or any person to provide any health insurance policy or employee benefit plan providing for dental care services that does not conform to the provisions of this chapter. (Acts 1984, No. 84-411, p. 960, §7.)...
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27-45-6
Section 27-45-6 Compliance with article. It shall be unlawful for any insurer or any person to provide any health insurance policy or employee benefit plan providing for pharmaceutical services, including without limitation, prescription drugs, that does not conform to the provisions of this article. (Acts 1988, No. 88-379, p. 565, §6.)...
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34-19-21
Section 34-19-21 Coverage or reimbursement for services not required. Nothing contained in this chapter shall be construed to create a requirement that any health benefit plan, group insurance plan, policy, or contract for health care services that covers hospital, medical, or surgical expenses, health maintenance organizations, preferred provider organizations, medical service organizations, physician-hospital organizations, or any other person, firm, corporation, joint venture, or other similar business entity that pays for, purchases, or furnishes group health care services to patients, insureds, or beneficiaries in this state, including entities created pursuant to Article 6, commencing with Section 10A-20-6.01, of Chapter 20, Title 10A, provide coverage or reimbursement for the services described or authorized in this chapter. (Act 2017-383, §4.)...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/34-19-21.htm - 1K - Match Info - Similar pages
27-45-3
Section 27-45-3 Choice of pharmaceutical services; right to participate as contracting provider. No health insurance policy or employee benefit plan which is delivered, renewed, issued for delivery, or otherwise contracted for in this state shall: (1) Prevent any person who is a party to or beneficiary of any such health insurance policy or employee benefit plan from selecting the pharmacy or pharmacist of his choice to furnish the pharmaceutical services, including without limitation, prescription drugs, offered by said policy or plan or interfere with said selection provided the pharmacy or pharmacist is licensed to furnish such pharmaceutical services in this state; or (2) Deny any pharmacy or pharmacist the right to participate as a contracting provider for such policy or plan provided the pharmacist is licensed to furnish pharmaceutical services, including without limitation, prescription drugs offered by said policy or plan. (Acts 1988, No. 88-379, p. 565, §3.)...
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27-48-3
Section 27-48-3 Prohibition against plan termination of services, reduction of capitation payment, or other penalty for health care provider in compliance with chapter; prohibition against financial encouragement of early discharge from postpartum care. No health benefit plan subject to the provisions of this chapter shall terminate the services, reduce capitation payment, or otherwise penalize an attending physician, certified nurse midwife, or other health care provider who orders medical care consistent with this chapter. No health benefit plan shall provide, directly or indirectly, any financial incentive or disincentive or grant or deny any special favor or advantage of any kind or nature to any person to encourage or cause early discharge of a hospital patient from postpartum care, excluding capitation or global fee arrangements. Provided nothing contained in this chapter is intended to expand the list or designation of covered providers as specified in any health benefit plan or...
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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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