Co-ordination of Benefits. Where the spouse and/or family of an active full-time employee are provided with insurance coverage’s by virtue of such spouse’s and/or family’s employment, then the co-ordination of benefit coverage will occur. Where such other coverage’s are provided, the amount of benefit provided in the employee’s health and welfare plan shall be equal to the amount otherwise payable by the Company less the full amount which would be provided by virtue of the spouse’s employment in the absence of any benefits provided by the Company.
Co-ordination of Benefits. The parties agree to be bound by the carrier’s rules with respect to coordination of benefits. Within two (2) months of ratification all employees shall complete the necessary forms to enable the carrier to implement this process. Failure to complete the necessary forms shall result in postponement of payment of any benefit claims submitted until such times as the forms are satisfactorily completed.
Co-ordination of Benefits. This Plan will pay either its regular benefits in full, or a reduced amount which, when added to the benefits available under the other plan, or plans, will equal 100% of covered expenses. 'Plan' means any plan under which medical or dental benefits or services are provided by:
Co-ordination of Benefits. When payment provided under this Agreement is available to a person under any other prepaid health service contract, insurance policy or plan, benefits shall be co-ordinated and the most payable under this agreement shall be pro-rated and limited to the extent that the total amount available under all coverage does not exceed 100% of the allowable expenses. Benefits will be co-ordinated according to the current industry standard.
Co-ordination of Benefits. If you or your dependents are covered by more than one plan providing similar benefits, benefits under this plan will be coordinated so that claims can be made under both plans but in no event could you receive benefits in excess of expenses incurred.
Co-ordination of Benefits. If, at the time of loss, you have insurance from another source, or if any other party is responsible, for benefits also provided under this policy, the Insurer will pay eligible expenses only in excess of those covered by that other insurer or other responsible party, including credit cards, private or provincial auto plans or any other insurance, whether collectable or not. If, however, that other insurance is also “excess only”, the Insurer will co-ordinate payment of all eligible claims with that other insurer. All co-ordination follows guidelines set by the Canadian life and Health Insurance Association. In no case will the Insurer seek to recover against employment related plans if the lifetime maximum for all in-country and out-of-country benefits is $100,000 CAD or less. If your lifetime maximum is greater than $100,000 CAD, the Insurer will coordinate benefits only above this amount The entire coverage under this policy shall be voidable if the Insurer determines, whether before or after loss, you have concealed, misrepresented or failed to disclose any material fact or circumstance concerning this policy or your interest therein, or if you refuse to disclose information or permit the use of such information, pertaining to any of the Insured persons under this contract of insurance.
Co-ordination of Benefits. The Plan shall not be liable to provide Benefits in any matter to the extent that the Participant has a right to substantially identical benefits under the terms of an insurance contract, or any other legally-enforceable arrangement. Where multiple coverage results under this Plan by reason of the relation of two (2) (or more) Participants, the Plan shall co-ordinate Benefits. If any insurance contract or any other legally enforceable arrangement exists, the services under this Plan shall be secondary to such other coverage.
Co-ordination of Benefits. For Extended Health and Dental Benefits, where an employee and their dependents are insured under another plan, co-ordination of benefits is mandatory and total reimbursement cannot exceed the total amount charged for the allowable expenses incurred.
Co-ordination of Benefits. If a person, who is covered for benefits under this plan is also covered simultaneously under any other plan which provides similar benefits, the amount of benefits payable under this plan for allowable expenses incurred during any benefit year shall be co-ordinated and/or reduced, so that the benefits payable from all plans shall not exceed 100% of the actual allowable expenses. If a person is covered as an employee, and a spouse is also an employee, under the basic Dental Plan only, both employees will be allowed to be eligible for benefits. The amount of benefits payable under this particular plan shall be co-ordinated and/or reduced so that the benefits shall not exceed 100% of the allowable expenses.
Co-ordination of Benefits. In the event that a person who is covered for health and dental benefits under this plan is also entitled to health and dental benefits under any other group health and dental plan, the co-ordination of benefits provision operates only to reduce benefits if the insured person is eligible for more than 100% of the eligible expenses. It will be established by the Insurance Companies involved which company pays its normal benefits and which company can pay either its normal benefits of 100% of the total eligible expenses paid by the company that paid first.
