Code of Alabama
Article 1 - General Provisions.
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.

Structure Code of Alabama

Code of Alabama

Title 16 - Education.

Chapter 25A - Public Education Employees' Health Insurance.

Article 1 - General Provisions.

Section 16-25A-1 - Definitions.

Section 16-25A-2 - Public Education Employees' Health Insurance Board; Membership, Compensation, Oath of Office, Officers, Staff, Etc.

Section 16-25A-2.1 - Board as Body Corporate for Management of Plan.

Section 16-25A-3 - Board, Employees Not Liable for Good Faith Performance.

Section 16-25A-4 - Relationship Between Benefits and Expenses; Reasonable Controls on Utilization and for Stability.

Section 16-25A-5 - Authorization for Health Insurance Plan; Election of Optional or Supplemental Coverage.

Section 16-25A-5.1 - Supplemental Policy to Provide Secondary Coverage for Employees.

Section 16-25A-5.2 - Supplemental Policy to Provide Secondary Coverage for Retirees.

Section 16-25A-6 - Exclusions.

Section 16-25A-7 - Authorization and Execution of Contracts; Evidence of Coverage; Denial of Claims.

Section 16-25A-8 - Funding of Health Insurance Plan; Participation; Public Education Employees' Health Insurance Fund.

Section 16-25A-8.1 - Retiree Contribution Based on Years of Service.

Section 16-25A-9 - Eligible Employees Covered.

Section 16-25A-10 - Payment to Physician, Hospital, etc., Furnishing Service or to Insured.

Section 16-25A-11 - Employees in Teachers' Retirement System May Vote to Be Covered by Article; Election Irrevocable; Contribution by Employer.

Section 16-25A-12 - Employees May Elect Not to Participate; Full State Funding; Subsequent Election to Participate.

Section 16-25A-13 - Advisory Committee.

Section 16-25A-14 - Companies Presently Providing Supplemental Coverage to Have Access to Payroll Deduction.

Section 16-25A-15 - Rules and Regulations.

Section 16-25A-16

Section 16-25A-17 - Partial Funding of Health Insurance Coverage for Retired Employees; Method of Determining Amount; Provisions Supplemental.

Section 16-25A-17.1 - Assistance to Low Income Employees and Retirees.

Section 16-25A-18 - Generic Equivalent Medications.

Section 16-25A-19 - Maintenance of Records; Annual Report.

Section 16-25A-20 - Submitting False Information.

Section 16-25A-21 - Flexible Employees' Benefits Programs.