reglab/statecodes huggingface dataset:
2023 Code of Alabama › Title 16 - Education. › Chapter 25 - Teachers' Retirement System. › Article 6 - Cost of Living Increase for Retirement Date Prior to October 1, 1996. › Section 16-25-112 - Funding for Benefits.

Section 16-25-112
Funding for benefits.
The cost-of-living increase granted to certain retired persons under the Teachers' Retirement System by this article may be financed, if possible, from existing funds of the Teachers' Retirement System subject to the following provisions and conditions:
(1) If the actuary for the Teachers' Retirement System finds that the cost-of-living increase can be paid for the 1996-97 fiscal year without appropriation of additional funds to the system without having an adverse actuarial impact on the system, beginning October 1, 1996, the Board of Control of the system may provide the cost-of-living increase authorized by this section. It is the intent of this section as pertains to funding similar increases in the future, that the funding thereof shall be in accordance with the requirements of Section 16-25-21. If the actuarial certification of the cost involved in funding the cost-of-living increase provided by this article, as required by Section 16-25-28, is not received by October 1, 1996, but satisfies the above condition when it is received during the 1996-97 fiscal year, then the cost-of-living increase shall be paid retroactively to October 1, 1996.
(2) If the conditions in subdivision (1) are not met, the cost-of-living increase shall be paid beginning October 1, 1997, and the cost of this benefit shall be included in the amount certified by the Board of Control to be contributed by the state under Section 16-25-21 or any other applicable law. The provisions of this subdivision shall govern and override any seeming or actual conflicts with other provisions of this section.
(Acts 1996, No. 96-572, p. 874, §3.)
2023 Code of Alabama › Title 16 - Education. › Chapter 25 - Teachers' Retirement System. › Article 6 - Cost of Living Increase for Retirement Date Prior to October 1, 1996. › Section 16-25-113 - Recipients of Medicaid Benefits.

Section 16-25-113
Recipients of Medicaid benefits.
Any person who receives benefits under the Medicaid program and whose eligibility for the benefits would be impaired by the cost-of-living increase provided by this article shall not be entitled to receive the increase. Any person who shall subsequently apply for benefits under the Medicaid program and who would have his or her eligibility to receive benefits impaired by the cost-of-living increase provided by this article, shall not be entitled to receive the increase after the date that the member files application for benefits under the Medicaid program.
(Acts 1996, No. 96-572, p. 874, §4.)
2023 Code of Alabama › Title 16 - Education. › Chapter 25 - Teachers' Retirement System. › Article 7 - Cost of Living for Retirement Date Prior to October 1, 1998 › Section 16-25-120 - Cost-of-Living Increase in Pension Benefits to Members and Beneficiaries of Teachers' Retirement System.

Section 16-25-120
Cost-of-living increase in pension benefits to members and beneficiaries of Teachers' Retirement System.
Commencing October 1, 1998, there is provided to each person currently receiving benefits whose effective date of retirement was prior to October 1, 1998, for purposes of receiving benefits, and to certain beneficiaries of deceased members and deceased retirees currently receiving survivor benefits, if the effective date of retirement or death for the deceased retiree or deceased member was prior to October 1, 1998, for purposes of receiving benefits from the Teachers' Retirement System, a cost-of-living increase of not less than thirty dollars ($30) per month and the increase shall be more if determined as follows:
(1) Four percent of the current gross benefit paid to the retiree and to certain beneficiaries of deceased members and deceased retirees.
(2) Two dollars ($2) per month for each year of service attained by the retiree for each retiree selecting the maximum retirement allowance or option one.
(3) Two dollars ($2) per month for each year of service attained by the retiree reduced by the retiree's option election factor for each retiree selecting option two, three, or four unless the beneficiary under the option selected is deceased on July 1, 1998, in which case the increase shall not be reduced.
(4) Two dollars ($2) per month for each year of service attained by the deceased member or deceased retiree reduced by the survivor's option factor for each beneficiary receiving monthly benefits from the Teachers' Retirement System.
(Act 98-355, p. 623, §1.)
2023 Code of Alabama › Title 16 - Education. › Chapter 25 - Teachers' Retirement System. › Article 7 - Cost of Living for Retirement Date Prior to October 1, 1998 › Section 16-25-121 - Cost-of-Living Increase to Members and Beneficiaries of Employees' Retirement System.

Section 16-25-121
Cost-of-living increase to members and beneficiaries of Employees' Retirement System.
(a) Commencing October 1, 1998, there is provided to certain persons identified in subsection (b) who are currently receiving benefits, whose effective date of retirement was prior to October 1, 1998, for purposes of receiving benefits from the Employees' Retirement System, and to certain beneficiaries of deceased members and deceased retirees who are currently receiving survivor benefits if the effective date of retirement or death for the deceased member or retiree was prior to October 1, 1998, for purposes of receiving benefits from the Employees' Retirement System shall receive a cost-of-living increase of not less than thirty dollars ($30) per month and the increase shall be more if determined as follows:
(1) Four percent of the current gross benefit paid to the retirees and to certain beneficiaries of deceased members and deceased retirees.
(2) Two dollars ($2) per month for each year of service attained by the retiree for each retiree selecting the maximum retirement allowance or option one.
(3) Two dollars ($2) per month for each year of service attained by the retiree reduced by the retiree's option election factor for each retiree selecting option two, three, or four unless the beneficiary under the option selected is deceased on July 1, 1998, in which case the increase shall not be reduced.
(4) Two dollars ($2) per month for each year of service attained by the deceased member or deceased retiree reduced by the survivor's option factor for each beneficiary receiving monthly benefits from the Employees' Retirement System.
(b) The benefits provided in this section are limited to those retirees whose participation in the Employees' Retirement System was based on Section 36-27-6, and whose employer at the time of retirement was a local board of education or a state supported institution of higher education. The benefits granted in this section shall not apply to any other participants in the Employees' Retirement System.
(Act 98-355, p. 623, §2.)
2023 Code of Alabama › Title 16 - Education. › Chapter 25 - Teachers' Retirement System. › Article 7 - Cost of Living for Retirement Date Prior to October 1, 1998 › Section 16-25-122 - Adjustment of Survivor Allowance.

Section 16-25-122
Adjustment of survivor allowance.
The survivor allowance shall be adjusted as provided in Sections 16-25-120 and 16-25-121 for those eligible retirees who have selected a monthly survivor allowance payable to a designated beneficiary upon the death of the retiree.
(Act 98-355, p. 623, §3.)
2023 Code of Alabama › Title 16 - Education. › Chapter 25 - Teachers' Retirement System. › Article 7 - Cost of Living for Retirement Date Prior to October 1, 1998 › Section 16-25-123 - Recipients of Medicaid Benefits.

Section 16-25-123
Recipients of Medicaid benefits.
Any person who receives benefits under the Medicaid Program and whose eligibility for the benefits would be impaired by the cost-of-living increase provided by this article shall not be entitled to receive the increase. Any person who shall subsequently apply for benefits under the Medicaid program and who would have his or her eligibility to receive benefits impaired by the cost-of-living increase provided by this article, shall not be entitled to receive the increase after the date that the member files application for benefits under the Medicaid program.
(Act 98-355, p. 623, §4.)
2023 Code of Alabama › Title 16 - Education. › Chapter 25 - Teachers' Retirement System. › Article 9 - Deferred Retirement Option Plan for Education Employees. › Section 16-25-152 - Relation to Federal Law.

Section 16-25-152
Relation to federal law.
At no time shall any provision or implementation of such provision pertaining to DROP be contrary to the rules and regulations of the federal law governing governmental plans. DROP is intended to operate in accordance with Section 415 and other applicable sections of the United States Internal Revenue Code. Any provision herein found in conflict with an applicable provision of the Internal Revenue Code shall be null and void. The Teachers' Board of Control is hereby authorized to interpret this article so as to achieve compliance with any applicable provisions of the United States Internal Revenue Code.
(Act 2002-23, p. 31, §1.)
2023 Code of Alabama › Title 16 - Education. › Chapter 25 - Teachers' Retirement System. › Article 9 - Deferred Retirement Option Plan for Education Employees. › Section 16-25-153 - Incentives for Participation in Plan.

Section 16-25-153
Incentives for participation in plan.
Notwithstanding the foregoing provisions of this article or any other laws to the contrary, no employer whose employees are covered under the Teachers' Retirement System shall offer any incentives of value including, but not limited to, monetary payments, prepayment of health insurance, or extraordinary payments for accrued leave, contingent on the member applying for or electing to participate in DROP. This provision shall not apply to regular payments for leave or contributions toward health insurance, but shall serve to prevent any extraordinary benefits or incentives offered during a limited time period solely for the purpose of enticing employees to elect to participate in DROP.
(Act 2002-23, p. 31, §3.)
2023 Code of Alabama › Title 16 - Education. › Chapter 25 - Teachers' Retirement System. › Article 9 - Deferred Retirement Option Plan for Education Employees. › Section 16-25-154 - Restoration to Active Service.

Section 16-25-154
Restoration to active service.
Any member of the Teachers' Retirement System who has participated in DROP and withdraws from service under Section 16-25-151 is not eligible to be restored to active service pursuant to subsection (i) of Section 16-25-14 or subsection (f) of Section 36-27-12. Rather, the employee shall be restored to active service pursuant to subdivision (3) of subsection (c) and subdivision (3) of subsection (d) of Section 16-25-151.
(Act 2002-23, p. 31, §5.)
2023 Code of Alabama › Title 16 - Education. › Chapter 25 - Teachers' Retirement System. › Article 11 - Cost-of-Living Increase Where Effective Date of Retirement Prior to October 1, 2004. › Section 16-25-190 - Increase in Benefits to Members and Beneficiaries.

Section 16-25-190
Increase in benefits to members and beneficiaries.
(a) Commencing October 1, 2005, there is provided an increase in benefits to each person currently receiving benefits whose effective date of retirement was prior to October 1, 2004, for purposes of receiving benefits, and to certain beneficiaries of deceased members and deceased retirees currently receiving survivor benefits, if the effective date of retirement or death for the deceased retiree or deceased member was prior to October 1, 2004, for purposes of receiving benefits from the Teachers' Retirement System, a cost-of-living adjustment (COLA) of four percent of the current gross benefit, but not less than fifteen dollars ($15) per month.
(b) Any future survivor allowance shall be adjusted as provided in the members' original option selection for those eligible retirees who have selected a monthly survivor allowance payable to a designated beneficiary upon the death of the retiree, or otherwise provided by law in the case of a qualifying member who dies prior to May 16, 2005.
(c) Any person who receives benefits under the Medicaid program and whose eligibility for the benefits would be impaired by the cost-of-living increase provided by this article shall not be entitled to receive the increase. Any person who shall subsequently apply for benefits under the Medicaid program and who would have his or her eligibility to receive benefits impaired by the cost-of-living increase provided by this article, shall not be entitled to receive the increase after the date that the member files application for benefits under the Medicaid program.
(d) The Board of Control of the Teachers' Retirement System shall determine annually the amount required to pay the cost of the increased allowance provided under this article, and shall notify the chief financial officer of each employer of the per centum rates of earnable compensation of the members required to be paid to the retirement system. Each employer of members of the Teachers' Retirement System shall pay on account of the increases provided in this article in the same manner and from the same sources of funds as provided in Section 16-25-21, it being the intent of the Legislature that the cost of providing the increase in this article shall be distributed from all funds in proportion to the salaries paid therefrom for active members.
(Act 2005-174, p. 351, §2.)
2023 Code of Alabama › Title 16 - Education. › Chapter 25 - Teachers' Retirement System. › Article 12 - Cost-of-Lving Adjustment Where Effective Date of Retirement Prior to October 1, 2006. › Section 16-25-200 - Increase in Benefits to Members and Beneficiaries.

Section 16-25-200
Increase in benefits to members and beneficiaries.
(a) Commencing October 1, 2006, there is provided a cost-of-living adjustment (COLA) in the amount of seven percent of the current gross benefit, but not less than twenty-five dollars ($25) per month to each person currently receiving benefits whose effective date of retirement was prior to October 1, 2005, for purposes of receiving benefits, and to certain beneficiaries of deceased members and deceased retirees currently receiving survivor benefits, if the effective date of retirement or death for the deceased retiree or deceased member was prior to October 1, 2005, for purposes of receiving benefits from the Teachers' Retirement System.
(b) Any future survivor allowance shall be adjusted as provided in the members' original option selection for those eligible retirees who have selected a monthly survivor allowance payable to a designated beneficiary upon the death of the retiree, or otherwise provided by law in the case of a qualifying member who dies prior to April 5, 2006.
(c) Any person who receives benefits under the Medicaid program and whose eligibility for the benefits would be impaired by the cost-of-living increase provided by this section shall not be entitled to receive the increase. Any person who shall subsequently apply for benefits under the Medicaid program and who would have his or her eligibility to receive benefits impaired by the cost-of-living increase provided by this section, shall not be entitled to receive the increase after the date that the member files application for benefits under the Medicaid program.
(d) The Board of Control of the Teachers' Retirement System shall determine annually the amount required to pay the cost of the increased allowance provided under this section, and shall notify the chief financial officer of each employer of the per centum rates of earnable compensation of the members required to be paid to the retirement system. Each employer of members of the Teachers' Retirement System shall pay on account of the increases provided in this section in the same manner and from the same sources of funds as provided in Section 16-25-21, it being the intent of the Legislature that the cost of providing the increase in this section shall be distributed from all funds in proportion to the salaries paid therefrom for active members.
(Act 2006-310, p. 653, §2.)
2023 Code of Alabama › Title 16 - Education. › Chapter 25A - Public Education Employees' Health Insurance. › Article 1 - General Provisions. › Section 16-25A-2 - Public Education Employees' Health Insurance Board; Membership, Compensation, Oath of Office, Officers, Staff, Etc.

Section 16-25A-2
Public Education Employees' Health Insurance Board; membership, compensation, oath of office, officers, staff, etc.
(a) The Public Education Employees' Health Insurance Board shall consist of the members of the Board of Control of the Teachers' Retirement System of Alabama;
(b) Board members shall serve without compensation for their services as board members, but shall be reimbursed from the fund established in subsection (f) of Section 16-25A-8 for all necessary expenses that they may incur through service on the board;
(c) Each board member shall, within 10 days after his appointment or election to the Board of Control of the Teachers' Retirement System, take an oath of office that, so far as it devolves on him, he will diligently and honestly administer the affairs of the board herein established, and that he will not knowingly violate, or willingly permit to be violated, any of the provisions of law applicable to the Public Employees' Health Insurance Plan. Such oath shall be subscribed to by the member making it, certified by the officer before whom it is taken, and immediately filed in the office of the Secretary of State;
(d) Each board member shall be entitled to one vote in matters concerning the board. Six votes shall be necessary for a decision at any meeting of said board. In case of a tie vote, the decision shall fail;
(e) The chairman and vice-chairman of the board shall be the chairman and vice-chairman of the Teachers' Retirement System Board of Control. The Secretary-Treasurer of the Teachers' Retirement System shall serve as chief executive officer of the Public Education Employees' Health Insurance Plan. In addition thereto, the board may engage such actuarial, administrative, legal, and other special services as shall be deemed necessary to transact the business of the insurance plan. The compensation and expenses for these special services shall be paid at such rates and in such amounts as the board shall approve. All other employees not in these categories of employment shall be employed under the provisions of the Merit System Act;
(f) The board shall keep in convenient form such data as shall be necessary for actuarial valuation of the funds of the insurance plan and for checking the experience of the plan.
(Acts 1983, No. 83-455, p. 640, §2.)
2023 Code of Alabama › Title 16 - Education. › Chapter 25A - Public Education Employees' Health Insurance. › Article 1 - General Provisions. › Section 16-25A-2.1 - Board as Body Corporate for Management of Plan.

Section 16-25A-2.1
Board as body corporate for management of plan.
The Public Education Employees' Health Insurance Board shall constitute a body corporate for the purposes of management of the health insurance plan. The board shall have all powers and may enforce all existing rights and claims, privileges of a corporation and hold its cash and securities and other property in trust for the purpose for which received; provided, however, that as instrumentalities of the state, funded by the state, the Public Education Employees' Health Insurance Board, their officers, and their employees shall be immune from suit to the same extent as the state, its agencies, officers, and employees.
(Act 2004-646, 1st Sp. Sess., p. 6, §4.)
2023 Code of Alabama › Title 16 - Education. › Chapter 25A - Public Education Employees' Health Insurance. › Article 1 - General Provisions. › Section 16-25A-3 - Board, Employees Not Liable for Good Faith Performance.

Section 16-25A-3
Board, employees not liable for good faith performance.
The members of the Public Employees' Health Insurance Board and their employees shall not be liable for punitive damages for acts arising out of the good faith performance of their duties in administering the health insurance plan.
(Acts 1983, No. 83-455, p. 640, §3.)
2023 Code of Alabama › Title 16 - Education. › Chapter 25A - Public Education Employees' Health Insurance. › Article 1 - General Provisions. › Section 16-25A-4 - Relationship Between Benefits and Expenses; Reasonable Controls on Utilization and for Stability.

Section 16-25A-4
Relationship between benefits and expenses; reasonable controls on utilization and for stability.
The health insurance plan provided for in this article shall be designed by the board to provide a reasonable relationship between the hospital, surgical, and medical benefits to be included and the expected hospital, surgical, and medical expenses to be incurred by the affected employee and retiree and dependents and to include reasonable controls, which may include, but are not limited to, deductible, copayment, coinsurance, and other cost containment measures to prevent unnecessary utilization of the various hospital, surgical, and medical services available and to provide reasonable assurance of stability in future years for the plan.
(Acts 1983, No. 83-455, p. 640, §4; Act 2004-646, 1st Sp. Sess., p. 6, §2.)
2023 Code of Alabama › Title 16 - Education. › Chapter 25A - Public Education Employees' Health Insurance. › Article 1 - General Provisions. › Section 16-25A-5 - Authorization for Health Insurance Plan; Election of Optional or Supplemental Coverage.

Section 16-25A-5
Authorization for health insurance plan; election of optional or supplemental coverage.
(a) The board is hereby empowered and authorized to establish a fully insured or self-insured health insurance plan for employees and, under certain conditions, retired employees and to adopt and promulgate rules and regulations for the administration of such plan subject to such limitations as may be contained in this article. Such plan may provide for group hospitalization, surgical, medical, cancer, cash indemnity, and dental 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 hospital/medical expenses indemnity benefits, including major medical benefits or such other coverage or benefits as may be deemed appropriate and desirable by the board, within the limits of such funds as may be available.
(b) Any member employee or, under certain conditions, retired employee may elect an optional or supplemental coverage provided by the board which shall include but is not limited to dental, cancer, or indemnity benefits. Such election shall be in accordance with the rules and regulations and at such times as the board shall prescribe. Election of an optional or supplemental coverage shall be in lieu of primary coverage under the basic medical plan, provided any individual covered under the basic medical plan may elect an optional coverage upon agreeing to pay the costs of such coverage. Any member employee or retired employee who does not elect an optional or supplemental coverage shall be deemed as a matter of law to have elected basic medical primary coverage.
(Acts 1983, No. 83-455, p. 640, §5; Act 2004-646, 1st Sp. Sess., p. 6, §2.)
2023 Code of Alabama › Title 16 - Education. › Chapter 25A - Public Education Employees' Health Insurance. › Article 1 - General Provisions. › Section 16-25A-5.1 - Supplemental Policy to Provide Secondary Coverage for Employees.

Section 16-25A-5.1
Supplemental policy to provide secondary coverage for employees.
The board may, no later than January 1, 2006, offer employees a supplemental policy that provides secondary coverage to other employer group 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 and retirees with a supplemental coverage policy to the other employer group health insurance coverage in lieu of full basic medical plan coverage through the 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 16-25A-1(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 2004-646, 1st Sp. Sess., p. 6, §4.)
2023 Code of Alabama › Title 16 - Education. › Chapter 25A - Public Education Employees' Health Insurance. › Article 1 - General Provisions. › Section 16-25A-5.2 - Supplemental Policy to Provide Secondary Coverage for Retirees.

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 employer group health insurance coverage in lieu of full basic medical plan coverage through the plan.
(3) An employer that provides its employees and their spouses with other employer group health insurance coverage may not exclude a retiree, as defined under Section 16-25A-1(13), 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 retirees or their spouses. No provision of this section requires an employer to amend its plan to provide additional benefits.
(Act 2004-649, 1st Sp. Sess., p. 30, §1.)
2023 Code of Alabama › Title 16 - Education. › Chapter 25A - Public Education Employees' Health Insurance. › Article 1 - General Provisions. › Section 16-25A-6 - Exclusions.

Section 16-25A-6
Exclusions.
Such health insurance shall not include the following:
(1) Expenses incurred by or on account of an individual prior to the effective date of the plan as to him;
(2) Hearing aids and examinations for the prescription or fitting thereof;
(3) Cosmetic surgery or treatment, except to the extent necessary for correction of damage caused by accidental injury while covered by the plan or as a direct result of disease covered by the plan;
(4) Services received in a hospital owned or operated by the United States government for which no charge is made;
(5) 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;
(6) Expenses for which the individual is not required to make payment;
(7) Expenses to the extent of benefits provided under any employer group plan other than this plan in which the state participates in the cost thereof;
(8) Such other expenses as may be excluded by regulations of the board; and
(9) Coordination of benefit of basic hospital/medical coverage provided herein and any supplemental hospital indemnity, cancer or dental coverage provided herein under the provisions of this article or as may privately be purchased by any employee.
(Acts 1983, No. 83-455, p. 640, §6.)
2023 Code of Alabama › Title 16 - Education. › Chapter 25A - Public Education Employees' Health Insurance. › Article 1 - General Provisions. › Section 16-25A-9 - Eligible Employees Covered.

Section 16-25A-9
Eligible employees covered.
(a) All employees and, under certain conditions, retired employees as defined in Section 16-25A-1 at the time of adoption and execution by the board of a contract or other arrangement providing for group health insurance plans and who are eligible for coverage under the provisions of this article and the rules and regulations of the board adopted pursuant thereto shall have the option to be included in such coverage of the plan 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, as defined by the terms of this article and the rules and regulations promulgated by the board pursuant thereto, shall become eligible for membership in the group health insurance plan offered by their employing board and shall have an option as to whether they will subscribe to such coverage for their dependents; provided, that such coverage may be deferred during any reasonable waiting period provided in the contract or contracts.
(Acts 1983, No. 83-455, p. 640, §9; Act 2004-646, 1st Sp. Sess., p. 6, §3.)
2023 Code of Alabama › Title 16 - Education. › Chapter 25A - Public Education Employees' Health Insurance. › Article 1 - General Provisions. › Section 16-25A-10 - Payment to Physician, Hospital, etc., Furnishing Service or to Insured.

Section 16-25A-10
Payment to physician, hospital, etc., furnishing service or to insured.
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 1983, No. 83-455, p. 640, §10.)
2023 Code of Alabama › Title 16 - Education. › Chapter 25A - Public Education Employees' Health Insurance. › Article 1 - General Provisions. › Section 16-25A-11 - Employees in Teachers' Retirement System May Vote to Be Covered by Article; Election Irrevocable; Contribution by Employer.

Section 16-25A-11
Employees in Teachers' Retirement System may vote to be covered by article; election irrevocable; contribution by employer.
Any board, agency, organization, or association which participates in the Teachers' Retirement System of Alabama, but whose employees are not included in the definition of employee in Section 16-25A-1 may, by resolution legally adopted to conform to rules prescribed by the board and upon a majority vote of its employees, elect to have its employees and under certain conditions its retired employees covered by the provisions of this article, provided such board, agency, organization, or association shall contract to pay the full cost of coverage for each such employee in the amounts set forth by the board and as defined in Section 16-25A-1 for a full-time employee; participation, once elected, is irrevocable. Each retired employee shall be given the option to participate under the provisions of Section 16-25A-8(c) provided any employer electing to have its employees covered by this section, shall contribute on account of each of its retired employees an amount equal to any amount appropriated by the state to fund benefits for retired employees. The board shall develop rules and regulations governing the operation of this section which shall contain but not be limited to entry and withdrawal from the plan.
(Acts 1983, No. 83-455, p. 640, §11.)
2023 Code of Alabama › Title 16 - Education. › Chapter 25A - Public Education Employees' Health Insurance. › Article 1 - General Provisions. › Section 16-25A-12 - Employees May Elect Not to Participate; Full State Funding; Subsequent Election to Participate.

Section 16-25A-12
Employees may elect not to participate; full state funding; subsequent election to participate.
(a) Any board of education, institution, or other employer with employees as defined by Section 16-25A-1, may, upon a majority vote of its employees, elect not to participate in the basic medical plan authorized by the provisions of this article; provided, however, that for any fiscal year ending September 30 the Legislature appropriates the full amount certified pursuant to Section 16-25A-8(b), the board shall declare the plan of insurance coverage to be fully state-funded whereupon all employees of any board of education, institution, or other employer as defined hereinabove shall for that fiscal year and all subsequent fiscal years be declared members of the Public Education Employees' Health Insurance Plan.
(b) Any employer electing not to participate in the basic medical plan shall certify to the board the names of their employees otherwise electing hospital/medical coverage. The board shall disburse monthly to each employer so electing, the amount appropriated per individual by the Legislature so certified in accordance with such rules and regulations as the board shall adopt; such amount shall be used to purchase plan(s) as approved by election of the majority of the participating employees; provided, however, any funds not so used in the fiscal year shall revert to the fund.
(c) Once an employer has elected not to participate in the basic medical plan authorized by this article, such employer may subsequently elect, under such rules and regulations and at such times as the board shall prescribe, to participate in the basic medical plan authorized by this article; participation, once elected, is irrevocable.
(Acts 1983, No. 83-455, p. 640, §12.)
2023 Code of Alabama › Title 16 - Education. › Chapter 25A - Public Education Employees' Health Insurance. › Article 1 - General Provisions. › Section 16-25A-13 - Advisory Committee.

Section 16-25A-13
Advisory committee.
REPEALED IN THE 2018 REGULAR SESSION BY ACT 2018-152 EFFECTIVE JUNE 1, 2018. THIS IS NOT IN THE CURRENT CODE SUPPLEMENT.
(Acts 1983, No. 83-455, p. 640, §13.)
2023 Code of Alabama › Title 16 - Education. › Chapter 25A - Public Education Employees' Health Insurance. › Article 1 - General Provisions. › Section 16-25A-14 - Companies Presently Providing Supplemental Coverage to Have Access to Payroll Deduction.

Section 16-25A-14
Companies presently providing supplemental coverage to have access to payroll deduction.
All insurance companies presently providing hospital indemnity coverage, cancer insurance and dental coverage as supplemental coverage for the employees of any board of education, institution, or other employer as defined in Section 16-25A-1 at July 14, 1983, shall have access to payroll deduction.
(Acts 1983, No. 83-455, p. 640, §14.)
2023 Code of Alabama › Title 16 - Education. › Chapter 25A - Public Education Employees' Health Insurance. › Article 1 - General Provisions. › Section 16-25A-15 - Rules and Regulations.

Section 16-25A-15
Rules and regulations.
The Public Education Employees' Health Insurance Board shall promulgate such rules and regulations as may be required for the effective administration of the provisions of this article.
(Acts 1983, No. 83-455, p. 640, §15.)
2023 Code of Alabama › Title 16 - Education. › Chapter 25A - Public Education Employees' Health Insurance. › Article 1 - General Provisions. › Section 16-25A-16

Section 16-25A-16
Coordination with State Employees' Health Insurance Board.
Once the Legislature has fully funded the Public Education Employees' Health Insurance Program, the Public Education Employees' Health Insurance Board and the State Employees' Health Insurance Board shall coordinate and equalize benefits so that both groups shall be insured and funded equally.
(Acts 1983, No. 83-455, p. 640, §16.)
2023 Code of Alabama › Title 16 - Education. › Chapter 25A - Public Education Employees' Health Insurance. › Article 1 - General Provisions. › Section 16-25A-17 - Partial Funding of Health Insurance Coverage for Retired Employees; Method of Determining Amount; Provisions Supplemental.

Section 16-25A-17
Partial funding of health insurance coverage for retired employees; method of determining amount; provisions supplemental.
(a)(1) Any premiums paid to the Public Education Employees' Health Insurance Board for active employees shall include an amount to partially fund the cost of coverage for retired employees. Notwithstanding the foregoing, if the plan becomes fully funded pursuant to this article, this section shall not apply.
(2) The amount authorized by subdivision (1) of this subsection shall not be less than an amount determined by multiplying the number of retired employees by an individual retired employee rate. The individual retired employee rate shall be determined by multiplying the full cost of coverage for a retired employee eligible to receive benefits under the federal Medicare program times the fractional amount derived by dividing the current individual premium for an employee not eligible for benefits under the federal Medicare program by the full cost of coverage for an employee not eligible to receive benefits under the federal Medicare program. The Public Education Employees' Health Insurance Board may provide additional premium payments for retirees in addition to the minimum amount guaranteed herein to the extent that it does not exceed the amount of their premium as established by the board. Any additional funding for premium amounts which may be provided to retirees with individual coverage who are not eligible for benefits under the federal Medicare program by the Public Education Employees' Health Insurance Board shall not have the effect of reducing the out-of-pocket cost below the total out-of-pocket cost paid by retirees with individual coverage who are eligible for benefits under the federal Medicare program. The total out-of-pocket cost for the retirees with individual coverage who are eligible for benefits under the federal Medicare program shall be determined by the combined cost of part B of the federal Medicare program and the Medicare supplement program provided by the Public Education Employees' Health Insurance Program.
(3) Any premium payments made pursuant to this section shall be deposited in the same fund and handled pursuant to the same manner as if made under this article.
(b) This section is supplemental and shall be construed in pari materia with other statutes relating to health insurance coverage for educational personnel.
(Acts 1984, No. 84-284, p. 491, §2; Acts 1995, No. 95-538, p. 1100, §13; Acts 1996, No. 96-373, p. 457, §1.)
2023 Code of Alabama › Title 16 - Education. › Chapter 25A - Public Education Employees' Health Insurance. › Article 1 - General Provisions. › Section 16-25A-17.1 - Assistance to Low Income Employees and Retirees.

Section 16-25A-17.1
Assistance to low income employees and retirees.
The board shall provide assistance to low income employees and retirees who meet the federal poverty levels defined in this section, effective October 1, 2005, and for each fiscal year thereafter.
(1) For employees and retirees who contribute to the cost of their health insurance premium and with annual income (determined as provided below on an aggregate basis for an employee or retiree and spouse) equal to or below 300 percent of the federal poverty level, the employee or retiree contribution shall be reduced as follows:
a. For employees or retirees with annual income equal to or less than 100 percent of the federal poverty level, the employee contribution will be calculated using 50 percent of the applicable premium.
b. For employees or retirees with annual income equal to or less than 150 percent of the federal poverty level, but more than 100 percent of the federal poverty level, the employee contribution will be calculated using 60 percent of the applicable premium.
c. For employees or retirees with annual income equal to or less than 200 percent of the federal poverty level, but more than 150 percent of the federal poverty level, the employee contribution will be calculated using 70 percent of the applicable premium.
d. For employees or retirees with annual income equal to or less than 250 percent of the federal poverty level, but more than 200 percent of the federal poverty level, the employee contribution will be calculated using 80 percent of the applicable premium.
e. For employees or retirees with annual income equal to or less than 300 percent of the federal poverty level, but more than 250 percent of the federal poverty level, the employee contribution will be calculated using 90 percent of the applicable premium.
(2) An application procedure shall be devised and implemented by the board through which employees and retirees may apply for the federal poverty level assistance described in this section. For purposes of applying for federal poverty level assistance, the annual income of an employee or retiree shall be aggregated with the annual income of the spouse of such employee or retiree and shall include all sources of income including, but not limited to, wages, pension benefits, and Social Security benefits, that may be included in gross income for purposes of federal income taxation. Applicants must submit with their application a copy of their federal tax return and, if the applicant did not file a joint return with his or her spouse, a copy of the spouse's federal tax return. Any reduction in an employee's or retiree's contribution pursuant to this section shall not be considered income of the employee or retiree for purposes of determining Medicaid eligibility for such employee or retiree.
(Act 2004-646, 1st Sp. Sess., p. 6, §4; Act 2011-704, p. 2178, §1.)
2023 Code of Alabama › Title 16 - Education. › Chapter 25A - Public Education Employees' Health Insurance. › Article 1 - General Provisions. › Section 16-25A-18 - Generic Equivalent Medications.

Section 16-25A-18
Generic equivalent medications.
As a condition of participation in the Public Education Employees Health Insurance Programs (PEEHIP), a pharmacist shall dispense a generic equivalent medication to fill a prescription for a patient covered by PEEHIP when one is available unless the physician indicates in longhand writing on the prescription, indicates by mark or signature in the appropriate place on the prescription, or indicates in an electronic prescription, the following: "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; Act 2016-304, §1.)
2023 Code of Alabama › Title 16 - Education. › Chapter 25A - Public Education Employees' Health Insurance. › Article 1 - General Provisions. › Section 16-25A-19 - Maintenance of Records; Annual Report.

Section 16-25A-19
Maintenance of records; annual report.
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 in the First Special Session of 2004. 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 2004-646, 1st Sp. Sess., p. 6, §4.)
2023 Code of Alabama › Title 16 - Education. › Chapter 25A - Public Education Employees' Health Insurance. › Article 1 - General Provisions. › Section 16-25A-20 - Submitting False Information.

Section 16-25A-20
Submitting false information.
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 health insurance plan related to the intentional failure to comply with the rules and procedures of the board or the intentional submission of false or misleading information or fraudulent activity, and (2) may be subject to being disqualified from coverage under the plan.
(Act 2004-646, 1st Sp. Sess., p. 6, §4; Act 2011-704, p. 2178, §1.)
2023 Code of Alabama › Title 16 - Education. › Chapter 25A - Public Education Employees' Health Insurance. › Article 1 - General Provisions. › Section 16-25A-21 - Flexible Employees' Benefits Programs.

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.)
2023 Code of Alabama › Title 16 - Education. › Chapter 25A - Public Education Employees' Health Insurance. › Article 2 - Public Education Flexible Emplpyees' Benefits Program. › Section 16-25A-40 - Legislative Findings.

Section 16-25A-40
Legislative findings.
The Legislature finds that private employers have provided their employees with flexible employee benefit plans which provide a savings both to the employer and the employee, and that the State of Alabama, its departments and agencies, may provide the same tax-effective benefits to its public education employees. It is, therefore, the intent of the Legislature to provide for the establishment of one statewide, universal "cafeteria plan" or flexible employee benefit plan to be made available to all employees in public education in compliance with the Internal Revenue Code of 1986, and to implement the plan in accordance with the rules and regulations established by the Public Education Flexible Employees' Benefit Board created by this article.
(Act 2004-650, 1st Sp. Sess., p. 31, §1.)