Question

Jill is covered under two Group Health policies, one through her employer and one through her husband's employer. If Jill suffers a loss, which policy provision dictates the primary coverage

Answer 1

Answer:

Coordination of benefits

Explanation:

When someone has 2 different health policies from 2 different insurance companies, both policies must work together and that is called Coordination of Benefits.

In case of a married couple, where the wife is insured by both her employer and her husband's health policy, the primary insurer is the wife's employer. The husband's health insurance will provide the secondary coverage.

The secondary insurer kicks in when medical are not fully paid by the primary insurer, and they must pay their share depending on their coverage.