Common use of Continuation Coverage Clause in Contracts

Continuation Coverage. If a person whose coverage is provided under the right of continuation pursuant to federal, state or local law also is covered under another Plan, the following shall be the order of benefits determination: (1) First, the benefits of a Plan covering the person as an employee, retiree, member or subscriber (or as that person’s dependent); (2) Second, the benefits under the continuation coverage. If the other Plan does not have the rule described above, and if, as a result, the Plans do not agree on the order of benefits, this rule is ignored.

Appears in 26 contracts

Sources: Individual Enrollment Agreement for a Qualified Health Plan, Individual Enrollment Agreement for a Qualified Health Plan, Individual Enrollment Agreement for a Qualified Health Plan

Continuation Coverage. If a person whose coverage is provided under the a right of continuation pursuant to federal, provided by federal or state or local law also is covered under another Plan, the following shall be the order of benefits determination: (1) First, the benefits of a Plan covering the person as an employee, retiree, member Subscriber or subscriber retiree (or as that person’s dependent); (2) Secondis primary, the benefits under and the continuation coveragecoverage is secondary. If the other Plan does not have the rule described abovethis rule, and if, as a result, the Plans do not agree on the order of benefits, this rule is ignored.

Appears in 13 contracts

Sources: Group Agreement, Group Agreement, Group Agreement

Continuation Coverage. If a person whose coverage is provided under the right of continuation pursuant to federal, federal or state or local law also is covered under another Plan, the following shall be the order of benefits determination: (1) First, the benefits of a Plan covering the person as an employee, retiree, member or subscriber (or as that person’s 's dependent); (2) Second, the benefits under the continuation coverage. If the other Plan does not have the rule described above, and if, as a result, the Plans do not agree on the order of benefits, this rule is ignored.

Appears in 11 contracts

Sources: Individual Enrollment Agreement for a Qualified Health Plan, In Network Individual Enrollment Agreement, Individual Enrollment Agreement

Continuation Coverage. If a person whose coverage is provided under the a right of continuation pursuant to federal, provided by the federal or state or local law is also is covered under another Planplan, the following shall be the order of benefits determinationthen: (1) First, the benefits of a Plan a. The plan covering the person as an employee, retireemember, member subscriber, or subscriber retiree (or as that person’s dependent);a dependent of an employee, (2) Second, b. The continuation coverage is the benefits under the continuation coveragesecondary plan. If the other Plan plan does not have the this rule described above, in paragraph 6; and if, as a result, the Plans plans do not agree on the order of benefits, ; then this rule is ignored. This rule does not apply if the rule under paragraph 3 can determine the order of benefits.

Appears in 6 contracts

Sources: Health Insurance Contract, Health Insurance Contract, Health Insurance Contract

Continuation Coverage. (A) If a person whose has continuation coverage under federal or state law and is provided under the right of continuation pursuant to federal, state or local law also is covered under another Plan, the following shall be determine the order of benefits determinationbenefits: (1) . First, the benefits of a Plan covering the person as employee, member, or subscriber or dependent of an employee, retireemember, member or subscriber (or as that person’s dependent);subscriber. (2) . Second, the benefits under the continuation coverage. . (B) If the other Plan does not have the rule described abovein subparagraph (A), and if, if as a result, the Plans do not agree on the order of benefits, this rule paragraph (v) is ignored.

Appears in 3 contracts

Sources: Dental Care Benefits Contract, Master Group Ppo Contract, Master Group Contract

Continuation Coverage. If a person whose coverage is provided under the a right of continuation pursuant to federal, provided by federal or state or local law also is covered under another Plan, the following shall be the order of benefits determination: (1) First, the benefits of a Plan covering the person as an employee, retireeMember, member Subscriber or subscriber retiree (or as that person’s dependent); (2) Secondis primary, the benefits under and the continuation coveragecoverage is secondary. If the other Plan does not have the rule described abovethis rule, and if, as a result, the Plans do not agree on the order of benefits, this rule is ignored.

Appears in 2 contracts

Sources: Group Agreement, Group Agreement

Continuation Coverage. If a person whose coverage is provided under the a right of continuation pursuant to federal, provided by the federal or state or local law is also is covered under another Planplan, the following shall be the order of benefits determinationthen: (1) First, the benefits of a Plan a. The plan covering the person as an employee, retireemember, member subscriber, or subscriber retiree (or as that person’s dependent);a dependent of an employee, (2) Second, b. The continuation coverage is the benefits under the continuation coveragesecondary plan. If the other Plan plan does not have the rule described above, this rule; and if, as a result, the Plans plans do not agree on the order of benefits, ; then this rule is ignored. This rule does not apply if the rule under paragraph 1 can determine the order of benefits.

Appears in 2 contracts

Sources: Health Insurance Contract, Health Insurance Contract

Continuation Coverage. If a person whose coverage is provided under the a right of continuation pursuant to federal, federal or state or local law also is covered under another Planplan, the following shall will be the order of benefits benefit determination: (1) First, the benefits Benefits of a Plan plan covering the person as an employee, retiree, member or subscriber a Plan Participant (or as that person’s dependent's Dependent); (2) Second, the benefits Benefits under the continuation coverage. If the other Plan plan does not have the rule described above, and if, as a result, the Plans plans do not agree on the order of benefitsBenefits, this rule is ignored.

Appears in 2 contracts

Sources: Group Dental Care and Treatment Contract, Group Dental Care and Treatment Contract

Continuation Coverage. If a person whose coverage is provided under the right of continuation pursuant to federal, state Federal or local State law also is covered under another Plan, the following shall be the order of benefits determination: (1) First, the benefits of a Plan covering the person as an employee, retiree, member or subscriber (or as that person’s dependent); (2) Second, the benefits under the continuation coverage. If the other Plan does not have the rule described above, and if, as a result, the Plans do not agree on the order of benefits, this rule is ignored.

Appears in 2 contracts

Sources: Member Contract, Member Contract

Continuation Coverage. If a person whose coverage is provided under the a right of continuation pursuant to federalfederal law (i.e., COBRA) or state or local law also is covered under another Plan, the following shall be the order of benefits determination: (1) First, the benefits of a the Plan covering the person as an employee, retireemember, member or subscriber (or as that person’s dependent); (2) Second, shall be determined before the benefits under the continuation coverage. If the other Plan does not have the this rule described above, and if, as a result, the Plans do not agree on the order of benefits, this rule is subparagraph (C)(2)(e) shall be ignored.

Appears in 1 contract

Sources: Dental Insurance Policy

Continuation Coverage. If a person whose coverage is provided under the a right of continuation pursuant to federal, federal or state or local law also is covered under another Planplan, the following shall be the order of benefits benefit determination: (1) a. First, extended benefits payable under the continuation coverage b. Second, the benefits of a Plan covering the person as an employeeEmployee, retiree, member Member or subscriber Subscriber (or as that person’s dependent's Dependent); (2) Second, the benefits under the continuation coverage. If the other Plan does not have the rule described above, and if, as a result, the Plans do not agree on the order of benefits, this rule is ignored.

Appears in 1 contract

Sources: Master Group Contract

Continuation Coverage. If a person whose coverage is provided under the a right of continuation pursuant to federal, federal or state or local law also is covered under another Planplan, the following shall will be the order of benefits benefit determination: (1a) First, the benefits Benefits of a Plan plan covering the person as an employee, retiree, member Member or subscriber Subscriber (or as that person’s dependent's Dependent); (2b) Second, the benefits Benefits under the continuation coverage. If the other Plan plan does not have the rule described above, and if, as a result, the Plans plans do not agree on the order of benefitsBenefits, this rule is ignored.

Appears in 1 contract

Sources: Group Limited Vision Benefit Plan

Continuation Coverage. If a person whose coverage is provided under the right of continuation pursuant to federal, state Federal or local State law also is covered under another Plan, the following shall be the order of benefits determination: (1) i. First, the benefits of a Plan covering the person as an employee, retiree, member or subscriber Subscriber (or as that person’s dependent's Dependent); (2) ii. Second, the benefits under the continuation coverage. If the other Plan does not have the rule described above, and if, as a result, the Plans do not agree on the order of benefits, this rule is ignored.

Appears in 1 contract

Sources: Member Contract

Continuation Coverage. If a person whose coverage is provided under the right of continuation pursuant to federal, state Federal or local State law also is covered under another Plan, the following shall be the order of benefits determination: (1) First, the benefits of a Plan covering the person as an employee, retireemember, member subscriber or subscriber retiree (or as that person’s dependent); (2) Second, the benefits under the continuation coverage. If the other Plan does not have the rule described above, and if, as a result, the Plans do Plan does not agree on the order of benefits, this rule is ignored.

Appears in 1 contract

Sources: Individual Plan Agreement

Continuation Coverage. If a person whose coverage is provided under the right of continuation pursuant to federal, state Federal or local State law also is covered under another Plan, the following shall be the order of benefits determination: (1) : i First, the benefits of a Plan covering the person as an employee, retireemember, member subscriber or subscriber retiree (or as that person’s dependent); (2) ; ii Second, the benefits under the continuation coverage. If the other Plan does not have the rule described above, and if, as a result, the Plans do not agree on the order of benefits, this rule is ignored.

Appears in 1 contract

Sources: Individual Plan Agreement