Title 16 — Title 16

When used in this article, the following terms shall have the following meanings, respectively, unless the context clearly indicates otherwise: (1) EMPLOYEE. Any person covered by the Public Education Employees’ Health Insurance Plan pursuant to Section 16-25A-11 or person who is…

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…

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 leg…

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 articl…

REPEALED IN THE 2018 REGULAR SESSION BY ACT 2018-152 EFFECTIVE JUNE 1, 2018. THIS IS NOT IN THE CURRENT CODE SUPPLEMENT. History: (Acts 1983, No. 83-455, p. 640, §13.)

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 1…

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. History: (Acts 1983, No. 83-455, p. 640, §15.)

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 f…

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 t…

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…

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 longhan…

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 y…

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…

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 …

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 ch…

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 th…

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. History: (Acts 1983, No. 83-455, p. 640, §3.)

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 …

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 …

The following terms shall have the following meanings, unless the context clearly indicates otherwise: (1) BOARD. The Public Education Flexible Employees Benefit Board. (2) EMPLOYEE. Any person employed by a state or local board of education, postsecondary institution, or other e…

(a) There is hereby created the Public Education Flexible Employees Benefit Board, which shall consist of the chair and vice chair of the Public Education Employees’ Health Insurance Board and three members of the Public Education Employees’ Health Insurance Board, one of whom sh…

The board is authorized to establish a flexible employee benefit plan for employees in compliance with Section 125 and any other applicable sections of the Internal Revenue Code. The flexible employee benefit plan may provide for payments or salary reductions for qualified benefi…

In order to carry out the provisions of the flexible employee benefit plan or any long- term care plan, or both, the head of each department, agency, board of education, or other employer with employees as defined by Section 16-25A-1 shall provide, at no local administrative cost…

The board shall promulgate rules and regulations to implement the flexible benefits program, including, but not limited to, setting policies and requirements concerning the administration of employee payments, amounts deducted pursuant to salary reduction agreements, and advances…

The board and the head of each department, agency, board of education, or other employer with employees as defined by Sections 16-25A-1 and 16-25A-11 and their employees shall not incur any liability to any employee for errors or omissions in the performance of any agreement auth…

Employee premium contributions shall be deducted from payroll by all employers on a pretax basis as permitted under Section 125 of the Internal Revenue Code. All employers must offer a flexible benefit plan to all employees by October 1, 2005. Local school boards which are deemed…

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 su…

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 o…

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 bec…

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 t…

of Claims. (a) The board may execute a contract or contracts to provide for the benefits or the administration of the plan determined in accordance with this article. The contract or contracts may be executed with one or more agencies or corporations licensed to transact or admin…

Employees’ Health Insurance Fund. (a) The Public Education Employees’ Health Insurance Board is hereby authorized to provide under the contract or contracts entered into under the provisions of this article an insurance benefit plan for each covered employee and, under certain co…

(a) The board shall set forth the employer contribution to the health insurance premium for each retiree class. (b)(1) Except as provided in subdivision (2), for employees who retire after September 30, 2005, but before January 1, 2012, the employer contribution of the health ins…

(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 provision…