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.
Structure Code of Alabama
Title 36 - Public Officers and Employees.
Chapter 29 - State Employees' Health Insurance Plan.
Article 1 - General Provisions.
Section 36-29-1 - Definitions.
Section 36-29-3 - Factors to Be Considered by Board in Design of Health Insurance Plan.
Section 36-29-4 - Establishment and Provisions of Health Insurance Plan; Rules and Regulations.
Section 36-29-5 - Expenses, Treatment, etc., Not to Be Included Under Plan.
Section 36-29-6 - Authorization and Execution of Contracts; Documentation of Benefits.
Section 36-29-10 - Election by Retired Employees to Continue Coverage; Payment of Premiums.
Section 36-29-11 - Payment of Benefits Under Plan.
Section 36-29-12 - Rules and Regulations; Notice of Denial of Claim; Review.
Section 36-29-13 - Appropriations to Board; Recognition of Medicaid Premiums Paid by Retiree.
Section 36-29-16 - Group Insurance for Retired Judges of Probate and Legislators; Payment of Cost.
Section 36-29-18 - Generic Equivalent Medications.
Section 36-29-19.1 - The State Employees' Insurance Board Shall Maintain Detailed Records.
Section 36-29-19.2 - The State Employees' Insurance Board May Offer Supplemental Coverage.
Section 36-29-19.3 - Surcharge on Smokers; Changes in Contributions.
Section 36-29-19.4 - Assistance to Low Income Employees and Retirees.
Section 36-29-19.5 - Premium Deductions Shall Be Pretax; Transfer of Funds.
Section 36-29-19.6 - The State Employees' Insurance Board Shall Constitute a Body Corporate.
Section 36-29-19.7 - Retiree Contribution Based on Years of Service.
Section 36-29-19.8 - Supplemental Coverage for Certain Retirees.