Coordinating Multiple Health Care Benefits

If you or a dependent have any other health insurance or health care plan coverage, benefits will be coordinated so that no more than 100% of covered charges will be paid or reimbursed.

The breakdown

  1. Your spouse’s coverage will be primary on him or her. In the case of a dependent child, the parent whose birthday falls earliest in the calendar year will be considered primary. In the case of children with divorced parents, in the absence of court-determined responsibility, the parent with custody will be primary. Any coordination of benefits issue which is not addressed herein or within the Plan’s other provisions will be settled using the NAIC guidelines adopted by the State of Illinois.
  2. If you have other health care plan coverage as the subscriber or as a survivor, it will be primary.
  3. Notwithstanding any other provisions herein, this Plan will be secondary to any coverage, including individual medical policies not purchased through payroll deduction with the Plan sponsor, which does not have coordination of benefits provision.
  4. This Plan is secondary, excess and supplemental to any student insurance coverage which may be in effect. Any coverage a dependent child has through other than a parent or step-parent will be primary over this Plan.