The group medical plan provision that applies when a claimant has coverage under more than one plan
A. coinsurance.
B. integration.
C. maximum benefits.
D. coordination of benefits.
Answer (2)
The provision that applies when a claimant has coverage under multiple plans is called coordination of benefits. This mechanism establishes the primary and secondary payment processes to ensure payments do not exceed the total costs of medical claims. Thus, the correct answer to the question is D: coordination of benefits.
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The provision that applies when a claimant has coverage under multiple plans is called coordination of benefits . This ensures that payments do not exceed the total cost of claims while establishing primary and secondary payers. It allows for efficient processing of medical expenses across different insurance policies. ;
