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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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27-52-3
Section 27-52-3 Additional powers; guidelines. (a) The commissioner shall, by regulation, establish
additional powers and duties of the plan and may adopt such rules as are necessary and proper
to implement this article. For the purpose of this section, the term "insurer" means
any entity covered by the Health Insurance Portability Act, including, but not limited to,
as the terms are defined in the Health Insurance Portability Act, a health insurance issuer,
a health maintenance organization and, notwithstanding Section 10-4-115, any health benefit
plan. In the case of a self-funded health benefit plan operating through a third party administrator,
the third party administrator shall be the insurer for the purpose of this section. The commissioner
may, by regulation, define health insurance premiums consistent with the purpose of this section.
(b) The regulations shall set forth coverage eligibility criteria consistent with the requirements
of Health Insurance Portability and...
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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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27-45-5
Section 27-45-5 Article does not mandate that pharmaceutical services be provided. The provisions
of this article do not mandate that any type of benefits for pharmaceutical services, including
without limitation, prescription drugs, be provided by a health insurance policy or an employee
benefit plan. (Acts 1988, No. 88-379, p. 565, §5.)...
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27-55-8
Section 27-55-8 Construction. This chapter does not and shall not be construed as creating
a private cause of action and does not and shall not require insurers, including any health
benefit plan, to extend coverage to any providers or type of providers for which coverage
is not specifically provided within the policy or certificate of insurance or health benefit
plan, or to add additional providers to existing networks, or to add any health care benefits.
(Act 2000-595, p. 1185, §8.)...
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36-36-3
Section 36-36-3 Definitions. As used in this chapter, the following words and phrases shall
have the following respective meanings: (1) ALABAMA RETIRED EDUCATION EMPLOYEES' HEALTH CARE
TRUST. The Alabama Retired Education Employees' Health Care Trust created by the state and
the Public Education Employees' Health Insurance Board pursuant to this chapter. (2) ALABAMA
RETIRED STATE EMPLOYEES' HEALTH CARE TRUST. The Alabama Retired State Employees' Health Care
Trust created by the state and the State Employees' Insurance Board pursuant to this chapter.
(3) BOARDS. The State Employees' Insurance Board and the Public Education Employees' Health
Insurance Board. (4) DEPENDENTS. The spouse and dependent children, as defined by the rules
and regulations of the respective boards, of a retired employee who are covered by either
the Public Education Employees' Health Insurance Plan pursuant to Chapter 25A of Title 16,
as amended from time to time, or the State Employees' Health Insurance Plan...
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36-29-19.8
Section 36-29-19.8 Supplemental coverage for certain retirees. The board may offer a retiree
a supplemental coverage to other employer group health insurance coverage and certain requirements
shall be maintained regarding retiree health coverage and cost sharing. (1) For employees
who retire after September 30, 2005, and who become employed by an employer that provides
employees at least 50 percent of the cost of single health insurance coverage and that qualify
to receive other employer group health insurance coverage through that employer shall be required
to use the employer's health benefit plan for primary coverage and the State Employees' Health
Insurance Plan may provide supplemental coverage. (2) For retirees who have spouses with other
employer group health insurance coverage available to them through their employer or previous
employer, the board may provide such retirees with a supplemental coverage to other employer
group health insurance coverage in lieu of coverage in the...
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16-25A-21
Section 16-25A-21 Flexible employees' benefits programs. Employee premium contributions shall
be deducted, by all employers, from payroll on a pretax basis as permitted under Section 125
of the Internal Revenue Code. The board is authorized to transfer the necessary funds from
the Public Education Employees' Health Insurance Plan to the fund established by the Public
Education Flexible Employees Benefit Board for the administration of the Public Education
Flexible Employees Benefits Program. All public education employees shall be offered flexible
spending accounts by employers for pretax deductions for medical and childcare expenses. (Act
2004-646, 1st Sp. Sess., p. 6, §4.)...
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16-25A-5.2
Section 16-25A-5.2 Supplemental policy to provide secondary coverage for retirees. The board
may offer retirees a supplemental policy that provides secondary coverage to other employer
group coverage and certain requirements shall be maintained regarding retiree health coverage
and cost sharing. (1) For employees who retire after September 30, 2005, and who become employed
by an employer that provides employees at least 50 percent of the cost of single health insurance
coverage and that qualify to receive other employer group health insurance coverage through
that employer shall be required to use the employer's health benefit plan for primary coverage
and the Public Education Employees' Health Insurance Plan may provide supplemental secondary
coverage. (2) For retirees who have spouses with other employer group health insurance coverage
available to them through their employer or previous employer, the board may provide such
retirees with a supplemental coverage policy to the other...
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27-55-4
Section 27-55-4 Statement of reasons for adverse action. An insurer that takes an action which
adversely affects a subject of abuse, or a related individual or entity, based on an abuse-related
medical condition, abuse-related claim, abuse status, or association or relationship with
a subject of abuse, pursuant to an individual or group insurance policy or health benefit
plan, shall advise the applicant or the insured of the specific reasons for the action in
writing. Reference to general underwriting practices or guidelines shall constitute a specific
reason. The specific reason for the actions of the insurer shall be stated in writing. The
actions of the health carrier or insurer, and any applicable policy provisions, shall be applied
equally to all applicants or insureds with similar medical conditions or similar claim or
claims history without regard to whether the condition or the claims are abuse related. (Act
2000-595, p. 1185, §4.)...
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