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27-19-53
Section 27-19-53 Standards for policy provisions; limitations of benefits. (a) The commissioner
shall issue reasonable regulations to establish specific standards for policy provisions of
Medicare supplement policies and certificates. The standards shall be in addition to and in
accordance with applicable laws of this state, including Article 1 and Chapter 20. No requirement
of this title relating to minimum required policy benefits, other than the minimum standards
contained in this article, shall apply to Medicare supplement policies and certificates. The
standards may cover but shall not be limited to the following: (1) Terms of renewability.
(2) Initial and subsequent conditions of eligibility. (3) Nonduplication of coverage. (4)
Probationary periods. (5) Benefit limitations, exceptions, and reductions. (6) Elimination
periods. (7) Requirements for replacement. (8) Recurrent conditions. (9) Definition of terms.
(b) The commissioner may issue reasonable regulations that specify...
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27-19-105
Section 27-19-105 Regulations for long-term care policies; outline of coverage, policy summary,
and monthly report. (a) The commissioner may adopt regulations that include standards for
full and fair disclosure setting forth the manner, content, and required disclosures for the
sale of long-term care insurance policies, terms of renewability, initial and subsequent conditions
of eligibility, nonduplication of coverage provisions, coverage of dependents, preexisting
conditions, termination of insurance, continuation or conversion, probationary periods, limitations,
exceptions, reductions, elimination periods, requirements for replacement, recurrent conditions,
and definitions of terms. Regulations under this subsection should recognize the developing
and unique nature of long-term care insurance and the distinction between group and individual
long-term insurance policies. (b) No long-term care insurance policy may do any of the following:
(1) Be cancelled, nonrenewed, or otherwise...
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27-1-22
Section 27-1-22 Uniform prescription drug information card or technology. (a) Every health
benefit plan that provides coverage for prescription drugs or devices, or administers a plan,
including, but not limited to, third party administrators for self-insured plans and state
administered plans, excluding the Alabama Medicaid Program, shall issue to its insureds a
card or other technology containing prescription drug information. The uniform prescription
drug information card or technology shall be in the format approved by the National Council
for Prescription Drug Programs (NCPDP) and shall include all of the required fields and conform
to the most recent pharmacy ID card or technology implementation guide produced by NCPDP or
conform to a national format acceptable to the Commissioner of Insurance. If a health care
plan includes a conditional or situational field, it shall conform to the most recent pharmacy
information card or technology implementation guide by the NCPDP or conform...
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31-10-21.1
Section 31-10-21.1 Qualifications for tuition reimbursement applicants; priority of state educational
benefits; tuition rates; applicability of section; repayment of benefits. THIS SECTION WAS
RENUMBERED BY ACT 2018-406, THE CODIFICATION ACT, IN THE 2018 REGULAR SESSION, EFFECTIVE MARCH
28, 2018. THIS IS NOT IN THE CURRENT CODE SUPPLEMENT. IT IS NOW SECTION 31-10-4.1. (a) Beginning
October 1, 2016, any member of the Alabama National Guard enrolled in a program leading to
a certificate, or an associate or bachelor's degree at an accredited public institution of
higher education, technical college, or community college within the State of Alabama may
apply for a tuition reimbursement benefit as provided for in this section if the applicant
under this chapter meets the following requirements: (1) The individual is 17 years of age
or over. (2) The individual is a member of the Alabama National Guard in good standing throughout
the period or semester for which that individual receives...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/31-10-21.1.htm - 4K - Match Info - Similar pages
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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27-19-103
Section 27-19-103 Definitions. Unless the context requires otherwise, the definitions in this
section apply throughout this article. (1) APPLICANT. In the case of: a. An individual long-term
care insurance policy, the person who seeks to contract for benefits. b. A group long-term
care insurance policy, the proposed certificate holder. (2) CERTIFICATE. Any certificate issued
under a group long-term care insurance policy, which policy has been delivered or issued for
delivery in this state. (3) COMMISSIONER. The Alabama Commissioner of Insurance. (4) GROUP
LONG-TERM CARE INSURANCE. A long-term care insurance policy which is delivered or issued for
delivery in this state and issued to any of the following: a. One or more employers or labor
organizations, or to a trust or to the trustees of a fund established by one or more employers
or labor organizations, or a combination thereof, for employees or former employees or a combination
thereof, or for members or former members or a...
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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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27-1-17
Section 27-1-17 Limitation periods for payment of claims; overdue claims; retroactive denials,
adjustments, etc.; penalties. (a) Each insurer, health service corporation, and health benefit
plan that issues or renews any policy of accident or health insurance providing benefits for
medical or hospital expenses for its insured persons shall pay for services rendered by Alabama
health care providers within 45 calendar days upon receipt of a clean written claim or 30
calendar days upon receipt of a clean electronic claim. If the insurer, health service corporation,
or health benefit plan is denying or pending the claim, the insurer, health service corporation,
or health benefit plan shall, within 45 calendar days for a written claim and 30 calendar
days for an electronic claim, notify the health care provider or certificate holder of the
reason for denying or pending the claim and what, if any, additional information is required
to process the claim. Any undisputed portion of the claim...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-1-17.htm - 17K - Match Info - Similar pages
31-10-4.1
Section 31-10-4.1 Qualifications for tuition reimbursement applicants; priority of state educational
benefits; tuition rates; applicability of section; repayment of benefits. (a) Beginning October
1, 2016, any member of the Alabama National Guard enrolled in a program leading to a certificate,
or an associate or bachelor's degree at an accredited public institution of higher education,
technical college, or community college within the State of Alabama may apply for a tuition
reimbursement benefit as provided for in this section if the applicant under this chapter
meets the following requirements: (1) The individual is 17 years of age or over. (2) The individual
is a member of the Alabama National Guard in good standing throughout the period or semester
for which that individual receives education benefits as indicated by continued satisfactory
participation in the Alabama National Guard as required by all applicable laws and regulations
of the Department of the Army, the Department of...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/31-10-4.1.htm - 4K - Match Info - Similar pages
27-55-3
Section 27-55-3 Prohibited practices; disclosure of information. (a) No insurer may: (1) Deny,
refuse to issue, renew, or reissue, cancel, or otherwise terminate, restrict, or exclude coverage
on an insurance policy or health benefit plan on the basis of an applicant's or insured's
abuse status, or on the basis of any association, relationship, or assistance to a subject
of abuse. (2) Exclude or limit coverage for a loss, deny benefits, or deny a claim on the
basis of the insured's abuse status, or on the basis of any association, relationship, or
assistance to a subject of abuse, except as otherwise permitted or required by the laws of
this state relating to acts of abuse committed by a life insurance beneficiary. Notwithstanding
anything to the contrary in this section, a liability insurer may include policy provisions
providing that a payment required by this subsection may be denied or, if paid, recovered
by the insurer from the insured, if the claim arose out of an act of abuse by...
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