The purpose of a coordination-of-benefits provision in group health insurance plans is to
A)determine which plan pays first if more than one plan covers a loss.
B)determine which health care provider an insured may use for his or her care.
C)determine if the calendar-year deductible has been satisfied by the insured.
D)determine if the employee is eligible for coverage under the group health plan.

Question

Quizplus · Accepted Answer

The coordination-of-benefits provision is designed to determine which health insurance plan pays first in the event that more than one plan covers a particular loss. This provision helps to avoid overpayment and ensures that claims are paid fairly and accurately. It is a common feature of group health insurance plans.

The Purpose of a Coordination-Of-Benefits Provision in Group Health Insurance