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36-29-6
Section 36-29-6 Authorization and execution of contracts; documentation of benefits. (a) The
board is hereby authorized to execute a contract or contracts to provide the plan determined
in accordance with the provisions of this chapter. Such contract or contracts may be executed
with one or more agencies or corporations licensed to transact or administer group health
insurance business in this state. All of the benefits to be provided under this chapter may
be included in one or more similar contracts issued by the same or different companies. (b)
Before entering into any contract or contracts authorized by subsection (a) of this section,
the board shall invite competitive bids from all qualified entities who may wish to administer
or offer plans for the health insurance coverage desired. The board shall award such contract
or contracts on a competitive basis as determined by the benefits afforded, administrative
costs, the costs to be incurred by employee, retiree, and employer, the...
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16-25A-7
Section 16-25A-7 Authorization and execution of contracts; evidence of coverage; denial of
claims. (a) The board is hereby authorized to execute a contract or contracts to provide for
the benefits or the administration of the plan determined in accordance with the provisions
of this article. Such contract or contracts may be executed with one or more agencies or corporations
licensed to transact or administer group health insurance business in this state. All of the
benefits to be provided under this article may be included in one or more similar contracts
issued by the same or different companies. The board is further authorized to develop a plan
whereby it may become self-insured upon its finding that such arrangement would be financially
advantageous to the state and plan participants. (b) Before entering into any contract or
contracts authorized by subsection (a), the board shall invite competitive bids from all qualified
entities who may wish to administer or offer plans for the...
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11-91A-7
care plan under Chapter 29 of Title 36, and in the State Employees' Retirement System under
Chapter 27 of Title 36. (j) Acquire property by purchase or lease. (k) Provide for reinsurance
of risks incurred by the program. (l)(1) Provide additional types of optional health care
coverages or services including, but not limited to, providing for the administration of the
payment of health care services on behalf of employer participants whose eligible employees
or officials suffer on-the-job injury, under such terms and conditions as the board
shall determine. (2) Participation in any service established for the administration of the
payment of health care services on behalf of an employer participant relating to on-the-job
injury shall be at the sole option of the employer participant. Refusal to participate
by an employer participant shall not affect eligibility for the program or factor into the
establishment of rates as authorized in subsection (b). (m) Adopt bylaws, policies, and...
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16-44A-14
Section 16-44A-14 Powers of board of directors. In furtherance of the purposes of the compact,
the board of directors may do the following: (1) Accept donations of funds or land, bequests,
grants, appropriations, loans, membership fees, or other forms of financial assistance for
educational and other purposes in furtherance of this article, from any federal entity, from
the state, its agencies and subdivisions, or any local public entity which are hereby authorized
to grant any of the foregoing forms of assistance, or from any private person, or other agency,
and to comply with rules and regulations concerning grants by the federal government or other
grantors, which are not in contravention of the constitution and laws of this state or the
United States. (2) Enjoy and exercise any powers and duties, not inconsistent with this chapter,
which are authorized to non-profit organizations under Title 10. (3) Engage the services,
by employment or otherwise, of a full-time or part-time...
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36-30-50
or chemotherapy has been determined to be medically necessary. 2. There are malignant tumors
which are treated by endoscopic procedures alone. 3. There are malignant melanomas. 4. There
is a tumor of the prostate, provided that it is treated with radical prostatectomy or external
beam therapy. c. The combined total of all benefits received under this subdivision by a firefighter
during his or her lifetime may not exceed fifty thousand dollars ($50,000). (2) Payable as
a result of a specific injury or illness, to begin six months after the disability
and submission to the insurance carrier or other payor of acceptable proof of disability precluding
service as a firefighter, and continuing for up to 36 consecutive monthly payments, one of
the following: a. For a career firefighter, a monthly benefit of three thousand dollars ($3,000).
b. For a certified volunteer firefighter, a monthly benefit of three thousand dollars ($3,000).
c. For a non-certified volunteer firefighter, a monthly...
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25-4-10
situations); (v) In a position which, under or pursuant to the laws of this state or of an
Indian tribe, is designated as a major nontenured policymaking or advisory position or a policymaking
or advisory position the performance of the duties of which ordinarily does not require more
than 8 hours per week; or d. In a facility conducted for the purpose of carrying out a program
of rehabilitation for individuals whose earning capacity is impaired by age or physical or
mental deficiency or injury or providing remunerative work for individuals who because
of their impaired physical or mental capacity cannot be readily absorbed in the competitive
labor market by an individual receiving such rehabilitation or remunerative work; provided
however, if an individual's employment is otherwise characterized as employment under subsection
(a) and the individual is performing work under the Javits Wagner O'Day Act or a similar set-aside
program under the laws of the United States, the...
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11-91A-8
Section 11-91A-8 Awarding of contracts. (a) Before entering into any contract or contracts
for a carrier or third party administrator, the board shall solicit competitive proposals
from companies or agencies qualified to administer or offer plans for group health care coverage.
The board shall carefully evaluate all proposals received and award the contract or contracts
to the most qualified company or agency taking into consideration all relevant factors, including,
but not limited to, the following: The benefits offered; the proposed administrative costs
and the costs to be incurred by the employer participant and its employees, retirees, and
dependents; and the experience of the companies or agencies submitting proposals. In evaluating
these factors, the board may employ the services of impartial professional insurance analysts
or actuaries. The contract or contracts executed by the board with the selected carrier or
third party administrator shall be a contract to offer coverage to...
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25-5-8
foregoing, the insurance association, organization, or corporation shall have first had its
contract and plan of business approved in writing by the Commissioner of the Department of
Insurance of Alabama and have been authorized by the Department of Insurance to transact the
business of workers' compensation insurance in this state and under the plan. Notwithstanding
any other provision of the law to the contrary, the obligations of employers under law for
workers' compensation benefits for injury of employees may be insured by any combination
of life, disability, accident, health, or other insurance provided that the coverages insure
without limitation or exclusion the workers' compensation benefits of this state. (b) Option
to operate as self-insurer. An employer subject to this chapter who elects not to insure his
or her liability thereunder shall furnish satisfactory proof to the secretary of his or her
financial ability to pay directly compensation in the amount and manner and...
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25-5-290
Section 25-5-290 Ombudsman program, creation; purpose; members; notification of service; benefit
review conferences. (a) The Department of Industrial Relations shall establish an Ombudsman
Program to assist injured or disabled employees, persons claiming death benefits, employers,
and other persons in protecting their rights and obtaining information available under the
Workers' Compensation Law. (b) Providing that the employer and the employee agree to participate
in the benefit review conference, the ombudsmen shall meet with or otherwise provide information
to injured or disabled employees, investigate complaints, and communicate with employers,
insurance carriers, and health care providers on behalf of injured or disabled employees.
(c) Ombudsmen shall be Merit System employees and demonstrate familiarity with the Workers'
Compensation Law. An ombudsman shall not be an advocate for any person who shall assist a
claimant, employer, or other person in any proceeding beyond the...
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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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