Duplicative Coverage Sample Clauses
The Duplicative Coverage clause defines how situations are handled when multiple insurance policies or sources provide coverage for the same risk or loss. In practice, this clause typically outlines the order in which different policies will respond, may specify that one policy is primary while others are excess, or may require coordination between insurers to avoid overpayment. Its core function is to prevent double recovery by the insured and to clarify the responsibilities of each insurer, thereby ensuring fair allocation of liability and avoiding disputes over payment.
Duplicative Coverage. This subsection applies to married County employees and employees in domestic partnerships as defined in Appendix C, who are both employed by the County. The intent of this subsection is to limit married County employees and County employees in domestic partnerships from both covering each other within the same dental plan. Married County employees and employees in domestic partnerships both employed by the County, shall be entitled to one (1) choice from the following list of dental plan coverages:
a. Up to one (1) full family PPO/Indemnity plan together with up to one (1) full supplemental spousal plan.
b. Up to one (1) full family PPO/Indemnity plan together with up to one (1) full family pre-paid closed panel dental plan.
c. Up to one (1) full family pre-paid closed panel dental plan.
d. Up to one (1) full family PPO/Indemnity plan. This subsection also applies to County employees when a parent and their child under the age of 26 are both employed by the County. The child employee under the age of 26 cannot have duplicative coverage within the same plan as the parent employee.
Duplicative Coverage. This subsection applies to married County employees and domestic partnerships (as defined in Appendix B), who are both employed by the County. The intent of this subsection limits County employees who are married or in domestic partnerships from both covering each other within the same medical plan. Married County employees and employees in domestic partnerships, who are both employed by the County, may choose from the following list of Medical Plan coverages, if available during the Open Enrollment period:
a. Up to one (1) full family Indemnity/PPO membership.
b. Up to one (1) full family HMO membership. (County HMO plan or Operating Engineers HMO plan).
c. Up to one (1) full family HMO membership (County HMO plan or Operating Engineers HMO plan) with up to one (1) full family Indemnity/PPO membership.
d. Up to one (1) full family Operating Engineers Health and Welfare Trust.
e. Up to one (1) full family HMO membership with up to one (1) full family alternative HMO option membership. This Section also applies to County employees when a parent and their child, under the age of twenty-six (26), are both employed by the County. The child employee under the age of twenty-six (26) cannot have duplicative coverage within the same plan as the parent employee. If the parent employee has the child employee on a family HMO plan the child employee cannot select individual coverage on the same HMO plan as the parent employee.
Duplicative Coverage. This applies to married AHS employees and employees in domestic partnerships both employed by AHS. The intent of this section limits AHS employees who are married or in a domestic partnership from both covering each other within the same health plan. Married AHS employees and employees in domestic partnerships, both employed by AHS, shall be entitled to one (1) choice from plans offered through AHS.
Duplicative Coverage. This section applies to married County employees (and employees in domestic partnerships as defined in the Appendix B), both employed by the County. The intent of this Section limits County employees who are married or in a domestic partnership from both covering each other within the same medical plan. Married County employees and domestic partners, both employed by the County, shall be entitled to one choice from the following list of medical plan coverages:
a) Up to one full family PPO/Indemnity membership.
b) Up to one full family HMO membership.
c) Up to one full family HMO option membership with up to one full family PPO/Indemnity membership.
d) Up to one full family PPO/Indemnity membership with up to one full family PPO/Spousal membership.
e) Up to one full family HMO membership with up to one full family alternative HMO membership.
Duplicative Coverage. The intent of this section limits County employees who are married or in a Domestic Partnership from both covering each other within the same Dental plan. Married County employees and employees in Domestic Partnerships (as defined in Appendix C), both employed by the County, shall be entitled to one choice from the following list of Dental plan coverages:
a. Up to one full family PPO/indemnity plan together with up to one supplemental spousal plan.
b. Up to one full family PPO/indemnity plan together with up to one full family pre-paid closed panel dental plan.
c. Up to one full family pre-paid closed panel dental plan.
d. Up to one full family PPO/indemnity plan.
Duplicative Coverage. This subsection applies to married County employees and employees in domestic partnerships (as defined in Appendix B) who are both employed by the County. The intent of this subsection limits married County employees and County employees in domestic partnerships from both covering each other within the same Medical Plan. Married County employees or
a. Up to one (1) full family HMO membership,
b. Up to one (1) full family PPO/Indemnity membership,
c. Up to one (1) full family HMO membership with up to one (1) full family PPO/Indemnity membership,
d. Up to one (1) full family HMO membership with up to one (1) full family alternative HMO membership. This section also applies to County employees when a parent and their child under the age of 26 are both employed by the County. The child employee under the age of 26 cannot have duplicative coverage within the same plan as the parent employee. If the parent employee has the child employee on a family HMO plan, the child employee cannot select individual coverage on the same HMO plan as the parent employee.
Duplicative Coverage. The intent of this section limits married County employees (and County employees in domestic partnerships as defined in Appendix C) from both covering each other within the same medical plan. Married County employees and employees in domestic partnerships, both employed by the County may choose one option from the following list of medical plans:
a. Up to one full family HMO membership.
b. Up to one full family PPO/Indemnity membership.
c. Up to one full family HMO membership with up to one full family PPO/Indemnity membership.
d. Up to one full family HMO membership with up to one full family alternative HMO option membership.
Duplicative Coverage. This section applies to married County employees and employees in domestic partnerships (as defined in Appendix B), when both are employed by the County. The intent of this section limits married County employees and County employees in a domestic partnership from both covering each other within the same dental plan. Married County employees and employees in domestic partnerships, both employed by the County, shall be entitled to one (1) choice from the following list of dental plan coverages:
a. Up to one (1) full family PPO/Indemnity plan together with up to one (1) full supplemental spousal plan.
b. Up to one (1) full family PPO/Indemnity plan together with up to one (1) full pre-paid closed panel Dental Plan
c. Up to one (1) full pre-paid closed panel Dental Plan.
d. Up to one (1) full family PPO/Indemnity plan.
Duplicative Coverage. This applies to married County employees and employees in domestic partnerships who are both employed by the County. The intent of this Section limits County employees who are married or in a domestic partnership from both covering each other within the same health plan. Married County employees and employees in domestic partnerships who are both employed by the County, shall be entitled to one choice from the following list of health plan coverages:
a. Up to one full family Indemnity/PPO membership.
b. Up to one full family HMO membership.
c. Up to one full Family HMO membership with up to one full family Indemnity/PPO membership (excluding spousal).
d. Up to one full family HMO membership with up to one full family alternative HMO membership.
Duplicative Coverage. This section applies to married County employees or employees with domestic partners when both are employed by the County. The intent of this Section limits County employees who are married or in a domestic partnership from both covering each other within the same Medical Plan. Married County employees or employees with a domestic partner, (as defined in the appendices) both employed by the County, shall be entitled to one choice from the following list of health plan coverages:
a. Up to one full family PPO/Indemnity membership.
b. Up to one full family HMO membership.
c. Up to one full family HMO membership with up to one full family PPO/Indemnity membership.
d. Up to one full family PPO/Indemnity membership with up to one full family PPO/Spousal membership.
e. Up to one full family HMO membership with up to one full family alternative HMO membership.
f. Up to one full family Operating Engineers – Health and Welfare Trust Plan membership with up to one full family Operating Engineers Trust alternative plan.