News & Updates

← Back to News & Updates

HCR Update: Impact of OAD 26 on Coordination of Benefits

Feb 09, 2011

Health Care Reform Update

February 4, 2011

Impact of dependent coverage provision on coordination of benefits   

The health care reform provision that extends dependent coverage to age 26 (regardless of student status, employment status or marital status) presents a new scenario for dual coverage: A member could be a dependent child on one policy and a spouse on another. 

In this situation, the same coordination of benefits rules that existed before health care reform continue to apply. The member's benefit contract language provides the plan's coordination of benefits rules. Most self-insured plans follow National Association of Insurance Commissioners (NAIC) model COB rules. For fully insured plans, the COB provisions in our certificates are based on state COB rules (which are generally based on the NAIC model rules, but the requirements and language vary slightly by state).  

For more details and talking points, refer to this fact sheet

Now you have a single, reliable resource for health care reform information.


This content is provided solely for informational purposes: it is not intended as and does not constitute legal advice. The information contained herein should not be relied upon or used as a substitute for consultation with legal, accounting, tax and/or other professional advisers.

Privacy Policy