Common use of HOW WE COORDINATE YOUR BENEFITS WHEN YOU ARE COVERED BY MORE THAN ONE PLAN Clause in Contracts

HOW WE COORDINATE YOUR BENEFITS WHEN YOU ARE COVERED BY MORE THAN ONE PLAN. Introduction This Coordination of Benefits ("COB") provision applies when you or your covered dependents have dental care benefits under more than one plan. We follow the COB rules of payment issued by the National Association of Insurance Commissioners (NAIC). The COB rules have been adopted by the Rhode Island Office of the Health Insurance Commissioner (OHIC). From time to time these rules may change before we issue a revised subscriber agreement. We use the COB regulations in effect at the time of coordination to determine benefits available to you under this agreement. If this provision applies, the order of benefit determination rules as stated in this section will determine whether we pay benefits before or after the benefits of another plan. Note: All services must be dentally necessary to be covered (Orthodontic services must be medically necessary). It does not matter if this plan is the primary or secondary plan. Covered dental services paid by other plans will be taken into consideration when determining any duration or visit limits. When this plan is secondary, covered dental services that in total are more than the duration or visit limits on this plan, will not be covered unless dentally necessary.

HOW WE COORDINATE YOUR BENEFITS WHEN YOU ARE COVERED BY MORE THAN ONE PLAN. Introduction This Coordination of Benefits ("COB") provision applies when you or your covered dependents have dental care benefits under more than one plan. We follow the COB rules of payment issued by the National Association of Insurance Commissioners (NAIC). The COB rules have been adopted by the Rhode Island Office of the Health Insurance Commissioner (OHIC) in Regulation 48 and the National Association of Insurance Commissioners (NAIC). From time to time these rules may change before we issue a revised subscriber agreement. We use the COB regulations in effect at the time of coordination to determine benefits available to you under this agreement. If this provision applies, the order of benefit determination rules as stated in this section will determine whether we pay benefits before or after the benefits of another plan. Note: All services must be dentally necessary to be covered (Orthodontic services must be medically necessary). It does not matter if this plan is the primary or secondary plan. Covered dental services paid by other plans will be taken into consideration when determining any duration or visit limits. When this plan is secondary, covered dental services that in total are more than the duration or visit limits on this plan, will not be covered unless dentally necessary.