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Coordination Of Benefits : When You Are Covered Under Two Or More Health Plans

How To Determine Which Plan Is Primary: One Plan Is An Individual Health Insurance Plan; The Other Plan Is Group Health Coverage.

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Because individual plans do not have the Coordination of Benefits provision attached, there is no coordination between the two plans.

If you're covered under a group plan and an individual health insurance plan, each plan will pay their full benefits without regard to what the other plan pays. This means someone covered under a group plan and an individual plan could actually make a profit.

For example, if the bill is $4,000, the group plan pays $3,000 and the individual plan pays $2,500, you would be entitled to keep the $1,500 left over after paying the bill.


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