reglab/housing_qa huggingface dataset:
AL Code § 36-29-4 (2021)
2021 Code of Alabama|Title 36 - Public Officers and Employees.|Chapter 29 - State Employees' Health Insurance Plan.|Article 1 - General Provisions.|Section 36-29-4 - Establishment and Provisions of Health Insurance Plan; Rules and Regulations.

Section 36-29-4Establishment 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.)
AL Code § 36-29-5 (2021)
2021 Code of Alabama|Title 36 - Public Officers and Employees.|Chapter 29 - State Employees' Health Insurance Plan.|Article 1 - General Provisions.|Section 36-29-5 - Expenses, Treatment, etc., Not to Be Included Under Plan.

Section 36-29-5Expenses, treatment, etc., not to be included under plan. (a) Such health insurance shall not include any of the following: (1) Expenses incurred by or on account of an individual prior to the effective date of the plan. (2) Cosmetic surgery or treatment, except to the extent necessary for correction of damages caused by accidental injury while covered by the plan or as a direct result of disease covered by the plan. (3) Services received in a hospital owned or operated by the United States government for which no charge is made. (4) 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. (5) Expenses for which the individual is not required to make payment. (6) Expenses to the extent of benefits provided under any employer group plan other than the plan in which the state participates in the cost thereof. (7) Such other expenses as may be excluded by regulations of the board. (b) This section shall not mandate the coverage of hearing assistance devices except that the State Employees' Health Insurance Board may determine by a majority vote of the board to cover such expenses in part or in whole on or after April 11, 2000.  (Acts 1965, No. 833, p. 1564, §4; Act 1982, No. 82-519, p. 866, §1; Act 2000-218, p. 326, §1.)
AL Code § 36-29-8 (2021)
2021 Code of Alabama|Title 36 - Public Officers and Employees.|Chapter 29 - State Employees' Health Insurance Plan.|Article 1 - General Provisions.|Section 36-29-8 - Optional Inclusion by Persons Eligible for Coverage; Submission of False or Misleading Information.

Section 36-29-8Optional inclusion by persons eligible for coverage; submission of false or misleading information. (a) All persons in the employment of the State of Alabama who are eligible for coverage under the provisions of this chapter and the rules and regulations of the board adopted pursuant thereto shall have the option to be included in such coverage and shall have an option as to whether they will subscribe to such coverage for their dependents, such option to be exercised in the manner and within the time limitation prescribed by the board. (b) All persons who become employees of the State of Alabama, as defined by the terms of this chapter and the rules and regulations promulgated by the board pursuant thereto, shall have the option to become members of the plan hereby provided and shall have an option as to whether they will subscribe to such coverage for their dependents; provided, that the exercise of such option shall be contingent upon acceptance by the board subject to proper documentation of eligibility and such coverage may be deferred during any reasonable waiting period provided in the contract or contracts. (c) Any employee or retiree knowingly and willfully submitting materially false information to the board or engaging in fraudulent activity that causes financial harm to the plan, may, upon a determination by the board, (1) repay all claims and other expenses, including an interest charge based on the applicable interest rate paid by the state under Section 40-1-44, incurred by the plan related to the intentional submission of false or misleading information or fraudulent activity and (2) may be subject to disqualification from coverage under the plan. (Acts 1965, No. 833, p. 1564, §12; Act 2004-647, 1st Sp. Sess., p. 17, §1; Act 2011-698, p. 2141, §1.)
AL Code § 36-29-9 (2021)
2021 Code of Alabama|Title 36 - Public Officers and Employees.|Chapter 29 - State Employees' Health Insurance Plan.|Article 1 - General Provisions.|Section 36-29-9 - Contracts to Provide for Health Insurance for Retiring State Employees, Spouses and Dependents; Adoption of Rules and Regulations for Election by Retiring Employees or Surviving Spouses and Dependents as to Participation, etc., in Plan.

Section 36-29-9Contracts to provide for health insurance for retiring state employees, spouses and dependents; adoption of rules and regulations for election by retiring employees or surviving spouses and dependents as to participation, etc., in plan. The contract or contracts shall provide for health insurance for retiring state employees and their spouses and dependents as defined by rules and regulations of the board on such terms as the board may deem appropriate. The board shall adopt rules and regulations prescribing the conditions under which retiring employees, and in the event of the death of a retired employee their spouses and dependents, may elect to participate in or withdraw from the plan. (Acts 1965, No. 833, p. 1564, §7; Acts 1982, No. 82-519, p. 866, §1.)
AL Code § 36-29-10 (2021)
2021 Code of Alabama|Title 36 - Public Officers and Employees.|Chapter 29 - State Employees' Health Insurance Plan.|Article 1 - General Provisions.|Section 36-29-10 - Election by Retired Employees to Continue Coverage; Payment of Premiums.

Section 36-29-10Election by retired employees to continue coverage; payment of premiums. (a) Employees covered under the plan who retire from active service before January 1, 2012, and begin receiving monthly benefits from the Employees' Retirement System of Alabama, Judicial Retirement System of Alabama, or from the Teachers' Retirement System of Alabama may elect to continue coverage under the plan by consenting to have the employee contribution deducted from their monthly benefit payment for coverage of such retired employees. (b) Employees covered under the plan who retire from active service after December 31, 2011, with at least 10 years of creditable coverage and begin receiving monthly benefits from the Employees' Retirement System of Alabama, Judicial Retirement System of Alabama, or the Teachers' Retirement System of Alabama may elect to continue coverage under the plan by consenting to have the employee contribution deducted from their monthly benefit payment for coverage of such retired employees. (c) The premiums so deducted shall be transmitted monthly to the board. Notwithstanding the foregoing provisions no person otherwise eligible for coverage under the plan shall be denied participation therein, for the reason that such person is precluded from having the cost of his or her coverage deducted from a monthly benefit payment. (d) The board shall adopt such rules and regulations as they deem appropriate and necessary for carrying out the provisions of this section. (Acts 1965, No. 833, p. 1564, §10; Acts 1982, No. 82-519, p. 866, §1; Acts 1985, No. 85-649, p. 1008, §1; Act 2004-647, 1st Sp. Sess., p. 17, §1; Act 2011-698, p. 2141, §1.)
AL Code § 36-29-11 (2021)
2021 Code of Alabama|Title 36 - Public Officers and Employees.|Chapter 29 - State Employees' Health Insurance Plan.|Article 1 - General Provisions.|Section 36-29-11 - Payment of Benefits Under Plan.

Section 36-29-11Payment of benefits under plan. Any benefits payable under the plan adopted may be paid either directly to the attending physician, hospital, medical group or other furnishing the service upon which the claim is based or to the insured employee upon presentation of valid bills for such services, subject to such provisions designed to facilitate payment as may be made by the board. (Acts 1965, No. 833, p. 1564, §8.)
AL Code § 36-29-12 (2021)
2021 Code of Alabama|Title 36 - Public Officers and Employees.|Chapter 29 - State Employees' Health Insurance Plan.|Article 1 - General Provisions.|Section 36-29-12 - Rules and Regulations; Notice of Denial of Claim; Review.

Section 36-29-12Rules and regulations; notice of denial of claim; review. The board shall promulgate such rules and regulations as may be required for the effective administration of the provisions of this chapter. The board shall have discretion and authority to interpret the terms and conditions of the plan. The plan shall require adequate notice in writing to any participant whose claim for benefits under the plan has been denied, setting forth the specific reasons for such denial and shall afford a reasonable opportunity to any participant whose claim for benefits has been denied for a full and fair review by the claims administrator upon the written request of the participant, within 60 days of the date of denial, setting forth the specific reasons for review. The claims administrator shall provide in writing a final determination of the claim. Review of a final decision by the claims administrator shall be by the Circuit Court of Montgomery County. (Acts 1965, No. 833, p. 1564, §13; Act 2004-647, 1st Sp. Sess., p. 17, §1.)
AL Code § 36-29-13 (2021)
2021 Code of Alabama|Title 36 - Public Officers and Employees.|Chapter 29 - State Employees' Health Insurance Plan.|Article 1 - General Provisions.|Section 36-29-13 - Appropriations to Board; Recognition of Medicaid Premiums Paid by Retiree.

Section 36-29-13Appropriations to board; recognition of Medicaid premiums paid by retiree.  (a) There is hereby provided from the funds of the State Employees' Health Insurance Plan $1,592,605.00 (estimated) for the fiscal year beginning October 1, 1985. The State Employees' Insurance Board is hereby authorized to expend $22.35 per month per eligible retired employee towards coverage for said retired employee for the fiscal year beginning October 1, 1985. (b) It is the intent of the Legislature that subsequent appropriations to the State Employees' Insurance Board pursuant to this section shall be included in the appropriations made for active employees from employer funds pursuant to subsection (d) of Section 36-29-7 beginning with the fiscal year 1986-87 and each year thereafter and shall be increased to fully fund the employer's portion of the benefits provided for in Section 36-29-10. (c) The board shall recognize any Medicare premium paid by a retiree in determining any increases in retiree contributions in existing and newly imposed premiums proscribed on state employees and retirees. (Acts 1985, No. 85-649, p. 1008, §2; Act 2004-647, 1st Sp. Sess., p. 17, §1.)
AL Code § 36-29-14.1 (2021)
2021 Code of Alabama|Title 36 - Public Officers and Employees.|Chapter 29 - State Employees' Health Insurance Plan.|Article 1 - General Provisions.|Section 36-29-14.1 - Election by Soil and Water Conservation Districts to Receive Coverage for Officers and Employees.

Section 36-29-14.1Election by soil and water conservation districts to receive coverage for officers and employees. (a) The governing body of any county soil and water conservation district may, by resolution legally adopted to conform to rules prescribed by the State Employees' Insurance Board, elect to have its officers and employees who are full-time employees working at least a 40-hour work week and its retiring employees who worked full time at least a 40-hour work week during their active employment become eligible to participate in the State Employees' Health Insurance Plan. The term "officers" and "employees" as used in this section shall include those persons appointed or employed by the individual officers and performing their duties in public offices, but shall not include members of soil and water conservation district boards, known as district supervisors who are expressly prohibited from participating in said health insurance plan. (b) Each employee who is covered by the State Employees' Health Insurance Plan pursuant to this section shall be entitled to the coverage and benefits as though he were a state employee. (c) The cost of the insurance coverage for the employee shall be paid by the employer; however, each employee who chooses to have dependent coverage shall agree to pay the cost of coverage for his dependents. The chief fiscal officer of each employer shall pay to the State Employees' Insurance Board to the credit of the State Employees' Insurance Fund the amount of premiums paid by the employer and the employees. (d) The agreement of any employer to have its officers and employees and its retiring employees to be covered under the State Employees' Health Insurance Plan shall be irrevocable except it can be terminated by the employer, by resolution of the governing body, signifying its intention and desire to withdraw from such plan in writing and delivering a copy of such resolution to the State Employees' Insurance Board; provided, however, any officer or employee who becomes covered under such plan shall be entitled to a minimum of five consecutive years of coverage. (e) The State Employees' Insurance Board shall promulgate such rules and regulations as may be required for the effective administration of the provisions of this article. (Acts 1991, No. 91-565, p. 1045, §§ 1-5.)
AL Code § 36-29-15 (2021)
2021 Code of Alabama|Title 36 - Public Officers and Employees.|Chapter 29 - State Employees' Health Insurance Plan.|Article 1 - General Provisions.|Section 36-29-15 - Coverage of Members of Legislature, Lieutenant Governor and Dependents; Limitation of Benefits; Payment of Premiums; Rules and Regulations.

Section 36-29-15Coverage of members of Legislature, Lieutenant Governor and dependents; limitation of benefits; payment of premiums; rules and regulations. (a) Any member of the Legislature and the Lieutenant Governor, during their term of office, and their dependents, shall be eligible for coverage under the State Employees' Health Insurance Plan and upon expiration of their term of office may continue such coverage for a maximum of 36 months. (b) Preexisting conditions shall not be covered until the insured has been covered under the plan for a period of 12 months, provided, however, that any legislator enrolling within 30 days of April 23, 1990 or within 30 days of the beginning of any calendar year thereafter shall not be subject to this limitation of benefits. A preexisting condition is any condition for which the insured or their covered dependent received medical treatment, advice or consultation or received any prescribed medication within 12 months of the effective date of the insured's coverage under the plan. (c) The premiums for the insurance coverage for a legislator, the Lieutenant Governor and their dependents shall be paid by the individual legislator and the Lieutenant Governor. (d) The State Employees' Insurance Board shall promulgate such rules and regulations as may be required for the effective administration of the provisions of this section. (Acts 1990, No. 90-649, p. 1244, §§1-4.)
AL Code § 36-29-16 (2021)
2021 Code of Alabama|Title 36 - Public Officers and Employees.|Chapter 29 - State Employees' Health Insurance Plan.|Article 1 - General Provisions.|Section 36-29-16 - Group Insurance for Retired Judges of Probate and Legislators; Payment of Cost.

Section 36-29-16Group insurance for retired judges of probate and legislators; payment of cost. Any judge of probate who qualifies to retire from active service with a benefit from the Judicial Retirement Fund or any legislator shall be entitled to participate in the State Employees' Health Insurance Plan. The entire cost for the group health insurance during retirement for a judge of probate or for a legislator shall be paid by such retired judge or legislator under such terms and conditions as the group insurer may, from time to time, prescribe for such group health insurance. (Acts 1994, No. 94-608, p. 1123, §1.)
AL Code § 36-29-17 (2021)
2021 Code of Alabama|Title 36 - Public Officers and Employees.|Chapter 29 - State Employees' Health Insurance Plan.|Article 1 - General Provisions.|Section 36-29-17 - Election by Employees and Officers of Alabama Sports Hall of Fame Board to Receive Coverage.

Section 36-29-17Election by employees and officers of Alabama Sports Hall of Fame Board to receive coverage. (a) Notwithstanding the provisions of Section 36-29-1, an employee or executive officer of the Alabama Sports Hall of Fame Board and his or her dependents shall be eligible for coverage under the State Employees' Health Insurance Plan and upon the expiration of the employment may continue the coverage for a maximum of 36 months. (b) Preexisting conditions shall not be covered until the insured has been covered under the plan for a period of 12 months. An employee enrolling within 30 days of August 7, 1995 or within 30 days of the beginning of a calendar year thereafter shall not be subject to this limitation of benefits. A preexisting condition is a condition for which the insured or their covered dependent received medical treatment, advice, or consultation, or received a prescribed medication within 12 months of the effective date of the insured's coverage under the plan. (c) The premiums for the insurance coverage for employees, executive officers, and their dependents shall be paid pursuant to Section 36-29-7. For those purposes, the Alabama Sports Hall of Fame shall be the employer. (d) The State Employees' Insurance Board shall promulgate rules and regulations required for the effective administration of this section. (Acts 1995, No. 95-728, p. 1697, §1.)
AL Code § 36-29-18 (2021)
2021 Code of Alabama|Title 36 - Public Officers and Employees.|Chapter 29 - State Employees' Health Insurance Plan.|Article 1 - General Provisions.|Section 36-29-18 - Generic Equivalent Medications.

Section 36-29-18Generic equivalent medications. As a condition of participation in an insurance policy of the State Employees Insurance Board (SEIB) a pharmacist shall dispense a generic equivalent medication to fill a prescription for a patient covered by SEIB when one is available unless the physician indicates in longhand writing on the prescription "medically Necessary" or "dispense as written" or "do not substitute". The generic equivalent drug product dispensed shall be pharmaceutically and therapeutically equivalent and contain the same active ingredient, or ingredients, and shall be of the same dosage, form, and strength. (Act 2002-266, p. 549, §1.)
AL Code § 36-29-19.1 (2021)
2021 Code of Alabama|Title 36 - Public Officers and Employees.|Chapter 29 - State Employees' Health Insurance Plan.|Article 1 - General Provisions.|Section 36-29-19.1 - The State Employees' Insurance Board Shall Maintain Detailed Records.

Section 36-29-19.1The State Employees' Insurance Board shall maintain detailed records. The board shall maintain records in sufficient detail to accurately determine the total health insurance costs and the contributions toward health insurance premiums by employees and retirees separately, and in composite form. Not later than 90 days after the end of each fiscal year the board shall prepare a written report that contains a calculation of the total cost of health insurance premiums for such fiscal year and the amount of contributions by employees and retirees to the cost of such health insurance premiums and the cost of such coverage that shall be paid by the employer for the next fiscal year and the total savings to the state realized by the enactment of Act 2004-646, Act 2004-647, Act 2004-648, Act 2004-649, and Act 2004-650. Such report shall contain sufficient detail to determine the total cost of health insurance premiums for each class of employees or retirees and the amount of contributions by each class of employees or retirees. Such report shall be prepared or verified by an independent firm employed by the board with skill and experience in reporting for such matters. (Act 2004-647, 1st Sp. Sess., p. 17, §2.)
AL Code § 36-29-19.2 (2021)
2021 Code of Alabama|Title 36 - Public Officers and Employees.|Chapter 29 - State Employees' Health Insurance Plan.|Article 1 - General Provisions.|Section 36-29-19.2 - The State Employees' Insurance Board May Offer Supplemental Coverage.

Section 36-29-19.2The State Employees' Insurance Board may offer supplemental coverage.  The board may no later than January 1, 2006, offer employees a supplemental coverage to other employer group health insurance coverage. (1) For employees who have spouses with other employer group health insurance coverage available to them through their employer, or previous employer, the board may provide such employees with a supplemental coverage to the other employer group health insurance coverage in lieu of coverage in the basic medical plan of the State Employees' Health Insurance Plan. (2) An employer that provides its employees and their spouses with other employer group health insurance coverage may not exclude an employee, as defined under Section 36-29-1, or his or her spouse from coverage by application of a provision which does not also apply on the same terms and conditions to other employees or their spouses. No provision of this section requires an employer to amend its plan to provide additional benefits.  (Act 2004-647, 1st Sp. Sess., p. 17, §2.)
AL Code § 36-29-19.3 (2021)
2021 Code of Alabama|Title 36 - Public Officers and Employees.|Chapter 29 - State Employees' Health Insurance Plan.|Article 1 - General Provisions.|Section 36-29-19.3 - Surcharge on Smokers; Changes in Contributions.

Section 36-29-19.3Surcharge on smokers; changes in contributions. A surcharge on smokers and users of tobacco products shall be added to the employee and retiree contribution by the board to be effective October 1, 2005. (Act 2004-647, 1st Sp. Sess., p. 17, §2.)