The board shall have full, complete, and exclusive jurisdiction over the program and shall allocate funds from its treasury for the fulfillment and accomplishment of its duties and responsibilities in a manner as may be necessary and appropriate to carry out the purposes of this chapter. The board shall have the general powers and authority granted under the laws of this state for health insurers, and in addition thereto, the specific authority to do all of the following:
(a) Subject to compliance with Section 11-91A-8 where applicable, execute a contract or contracts to provide for the administration of the program in accordance with this chapter. The contract or contracts may be executed with one or more agencies or corporations licensed to transact or administer group health care business in this state with similar plans of the state for the joint performance of common administrative functions.
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Terms Used In Alabama Code 11-91A-7
- Contract: A legal written agreement that becomes binding when signed.
- following: means next after. See Alabama Code 1-1-1
- Jurisdiction: (1) The legal authority of a court to hear and decide a case. Concurrent jurisdiction exists when two courts have simultaneous responsibility for the same case. (2) The geographic area over which the court has authority to decide cases.
- Lease: A contract transferring the use of property or occupancy of land, space, structures, or equipment in consideration of a payment (e.g., rent). Source: OCC
- property: includes both real and personal property. See Alabama Code 1-1-1
- state: when applied to the different parts of the United States, includes the District of Columbia and the several territories of the United States. See Alabama Code 1-1-1
(b) Establish, and modify from time to time as appropriate, rates, rate schedules, rate adjustments, expense allowances, claim reserve formulas, and any other actuarial function necessary and appropriate for the operation of the program. Rates and rate schedules may be adjusted for appropriate factors such as age, family size, smokers and users of tobacco products, preventive care and wellness care participation, and any such other categories of risk that the board shall approve.
(c) Appoint appropriate legal, actuarial, and other committees as necessary to provide technical or program assistance to the board.
(d) Establish and maintain at a lawful depository or depositories in the State of Alabama as it shall select a Local Government Health Insurance Fund, composed of the money or moneys which may come into its hands from premiums, fees, assessments, grants, loans, or other sources, either public or private. The funds shall be used by the board to pay the administrative expenses of the board, pay medical claims costs of the program, and maintain a reserve fund. No moneys received or held by the board shall be co-mingled with any other funds of the state or any governmental entity.
(e) Borrow money to effect the purposes of this chapter as determined appropriate by the board.
(f) Take legal action as necessary, including, but not limited to, bringing action to do any of the following:
(1) Recover premiums, fees, assessments, and penalties due the board.
(2) Avoid the payment of improper claims against the board or the coverage provided by or through the board.
(3) Recover any amounts erroneously or improperly paid by the board.
(4) Recover any amounts paid by the board as a result of mistake of fact or law.
(5) Recover other amounts due the board.
(g) Promulgate rules concerning the selection of benefits offered and any other matters which in the opinion of the board may be required for the effective administration of this chapter.
(h) Subject to subsection (a) of Section property; assignment of contracts” class=”unlinked-ref” datatype=”S” sessionyear=”2021″ statecd=”AL” title=”11″>11-91A-6, employ or otherwise appoint a chief executive officer to serve as manager of the program under the direction and supervision of the board and as required under this chapter. The board may appoint the chief executive officer of the SEIB to continue as chief executive officer after the initial 18 months of service as provided in subsection (a) of Section 11-91A-6 upon mutual consent of the board and the SEIB.
(i) Employ and fix the compensation of employees, consultants, actuaries, and other personnel as may be necessary for carrying out the purposes and provisions of this chapter. All compensation shall be paid from the funds of the board. Employees of the board shall not be subject to the state Merit System Act; provided, however, the board shall offer its employees benefits equivalent to those offered to employees of the State of Alabama, including retirement, medical and dental care, and workers’ compensation plans. The employees of the board are eligible and may elect to participate in the state health care plan under Chapter 29 of Title 36, and in the State Employees’ Retirement System under Chapter 27 of Title 36.
(j) Acquire property by purchase or lease.
(k) Provide for reinsurance of risks incurred by the program.
(l)
(1) Provide additional types of optional health care coverages or services including, but not limited to, providing for the administration of the payment of health care services on behalf of employer participants whose eligible employees or officials suffer on-the-job injury, under such terms and conditions as the board shall determine.
(2) Participation in any service established for the administration of the payment of health care services on behalf of an employer participant relating to on-the-job injury shall be at the sole option of the employer participant. Refusal to participate by an employer participant shall not affect eligibility for the program or factor into the establishment of rates as authorized in subsection (b).
(m) Adopt bylaws, policies, and procedures as may be necessary or convenient for the implementation of this chapter and the operations of the program.