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.
Structure Code of Alabama
Chapter 25A - Public Education Employees' Health Insurance.
Article 1 - General Provisions.
Section 16-25A-1 - Definitions.
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-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-8.1 - 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-13 - Advisory Committee.
Section 16-25A-15 - Rules and Regulations.
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.