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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,...
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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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27-56-10
Section 27-56-10 Vision care providers - Contract requirements; rates; reimbursements; discounts.
(a) As used in this section, the following words shall have the following meanings: (1) CONTRACTUAL
DISCOUNT. A percentage reduction from a provider's usual and customary rate for covered services
and materials required under a participating provider agreement. (2) COVERED MATERIALS. Materials
for which reimbursement from the insurer or vision care plan is provided to a vision care
provider by an enrollee's plan contract, or for which a reimbursement would be available but
for the application of the enrollee's contractual limitations of deductibles, copayments,
or coinsurance. (3) COVERED SERVICES. Services for which reimbursement from the insurer or
vision care plan is provided to a vision care provider by an enrollee's plan contract, or
for which a reimbursement would be available but for the application of the enrollee's contractual
plan limitations of deductibles, copayments, or...
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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...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-1-22.htm - 3K - Match Info - Similar pages
27-44-5
Section 27-44-5 Definitions. As used in this chapter, the following terms shall have the following
meanings, respectively, unless the context clearly indicates otherwise: (1) ACCOUNT. Either
of the three accounts created under Section 27-44-6. (2) ASSOCIATION. The Alabama Life and
Disability Insurance Guaranty Association created under Section 27-44-6. (3) AUTHORIZED ASSESSMENT
or the term AUTHORIZED when used in the context of assessments. A resolution by the board
of directors has been passed whereby an assessment will be called immediately or in the future
from member insurers for a specified amount. An assessment is authorized when the resolution
is passed. (4) BENEFIT PLAN. A specific employee, union, or association of natural persons
benefit plan. (5) CALLED ASSESSMENT or the term CALLED when used in the context of assessments.
A notice that has been issued by the association to member insurers requiring that an authorized
assessment be paid within the time frame set forth within...
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35-12-71
of, or deliver to, or pay to, the owner or apparent owner as applicable, property that is subject
to this article. (6) INSURANCE COMPANY. An association, corporation, or fraternal or mutual
benefit organization, whether or not for profit, engaged in the business of providing life
endowments, annuities, or insurance, including, but not limited to, accidental, burial, casualty,
credit life, contract performance, dental, disability, fidelity, fire, health, hospitalization,
illness, life, malpractice, marine, mortgage, surety, wage protection, and workers'
compensation insurance. (7) MINERAL. Gas; oil; coal; other gaseous, liquid, and solid hydrocarbons;
oil shale; cement material; sand and gravel; road material; building stone; chemical raw material;
gemstone; fissionable and nonfissionable ores; colloidal and other clay; steam and other geothermal
resource; or any other substance defined as a mineral by the law of this state. (8) MINERAL
PROCEEDS. Amounts payable for the extraction,...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/35-12-71.htm - 6K - Match Info - Similar pages
34-24-125
Section 34-24-125 Chiropractic agreements. (a) For the purposes of this section, the following
words shall have the following meanings: (1) CHIROPRACTOR. A person licensed to practice chiropractic
in this state. (2) CHIROPRACTIC AGREEMENT or AGREEMENT. A contract between a chiropractor
and a patient or his or her legal representative in which the chiropractor or the chiropractor's
chiropractic practice agrees to provide chiropractic services to the patient for an agreed
upon fee and period of time. (3) CHIROPRACTIC PRACTICE. A chiropractor or a chiropractic practice
of a chiropractor that charges a periodic fee for chiropractic services and which does not
bill a third party any additional fee for services for patients covered under a chiropractic
agreement. The per visit charge of the practice shall be less than the monthly equivalent
of the periodic fee. (b) A chiropractic agreement is not insurance, may not be deemed an insurance
arrangement, and is not subject to state insurance...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/34-24-125.htm - 4K - Match Info - Similar pages
27-7-4.2
Section 27-7-4.2 Licenses - Applicability to insurance producer. (a) Nothing in this chapter
shall be construed to require an insurer to obtain an insurance producer license. In this
section, the term "insurer" does not include an insurer's officers, directors, employees,
subsidiaries, or affiliates. (b) A license as an insurance producer shall not be required
of any of the following: (1) An officer, director, or employee of an insurer or of an insurance
producer, provided that the officer, director, or employee does not receive any commission
on policies written or sold to insure risks residing, located, or to be performed in this
state and any of the following: a. The officer, director, or employee's activities are executive,
administrative, managerial, clerical, or a combination of these, and are only indirectly related
to the sale, solicitation, or negotiation of insurance. b. The officer, director, or employee's
function relates to underwriting, loss control, inspection, or the...
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38-15-4
Section 38-15-4 Registration of certain youth residential institutions or organizations; staff
training plans; rights of children; licensing and inspection of food preparation areas; access
by law enforcement agencies. (a) Commencing on January 1, 2018, the department shall register
any religious, faith-based, or church nonprofit, other nonprofit, or for profit affiliated
youth residential facility, youth social rehabilitation facility, community treatment facility
for youths, youth transitional care facility, long term youth residential facility, private
alternative boarding school, private alternative outdoor program, and any organization entrusted
with the residential care of children in any organizational form or combination defined by
this section, whenever children are housed at the facility or location of the program for
a period of more than 24 hours. At a minimum, registered youth residential institution or
organization under this section shall do all of the following: (1) Be...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/38-15-4.htm - 13K - Match Info - Similar pages
25-14-9
Section 25-14-9 Written contract; rights and duties of clients; employees, and professional
employer organizations. (a) All professional employer organization arrangements shall have
a written contract between the client and the professional employer organization recognizing
the rights, responsibilities, and duties of each party. The contract shall disclose to the
client the services to be rendered by the professional employer organization, including the
total administrative fees charged for professional employer organization services, the respective
rights and obligations of the parties, and shall provide the following: (1) The professional
employer organization reserves a right of direction and control over contract employees and
exercises that right in the context of the need to do so according to the terms and conditions
of the professional employment agreement. The client, however, as an employer, may retain
sufficient direction and control over covered employees necessary to...
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