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if a patient has coverage under two group insurance plans, the primary …

Question

if a patient has coverage under two group insurance plans, the primary plan is the one that

multiple choice

pays the largest benefit.

has the largest deductible.

has been in effect for the patient the longest.

is a government plan.

Explanation:

Define Coordination of Benefits

Using the Coordination of Benefits knowledge point
When a patient is covered under two group health insurance plans, coordination of benefits (COB) rules determine which plan pays first (primary) and which pays second (secondary).

Determine Primary Insurance Rule

Using the Primary Insurance knowledge point
Under standard coordination of benefits guidelines for individuals covered as an employee, subscriber, or member under two active group plans, the plan that has been in effect for the patient the longest is designated as the primary plan.

Answer:

  • pays the largest benefit.
  • has the largest deductible.
  • has been in effect for the patient the longest. (Correct answer)
  • is a government plan.