Common use of Coordination of Benefits Clause in Contracts

Coordination of Benefits. If a Contractor’s QHP provides coverage for the Pediatric Dental Essential Health Benefit, Contractor shall include a Coordination of Benefits (COB) provision in its Evidence of Coverage or Policy Form that (i) is consistent with Health and Safety Code § 1374.19 or Insurance Code § 10120.2, and (ii) provides that the QHP is the primary dental benefit plan or policy under that COB provision. This provision shall apply to Contractor’s QHPs offered both inside and outside of Covered California for the Individual Market, except where 28 CCR § 1300.67.13 or 10 CCR § 2232.56 provides for a different order of determination for COB in the small group market.

Appears in 12 contracts

Samples: Covered California Qualified Health Plan Issuer Contract, Covered California Qualified Health Plan Issuer Contract, Covered California Qualified Health Plan Issuer Contract

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Coordination of Benefits. If a Contractor’s QHP provides coverage for the Pediatric Dental Essential Health Benefit, Contractor shall include a Coordination of Benefits (COB) provision in its Evidence of Coverage or Policy Form that (i) is consistent with Health and Safety Code § 1374.19 or Insurance Code § 10120.2, 10120.2 and (ii) provides that the QHP is the primary dental benefit plan or policy under that COB provision. This provision shall apply to Contractor’s QHPs offered both inside and outside of Covered California for the Individual MarketSmall Business, except where 28 CCR § 1300.67.13 or 10 CCR § 2232.56 provides for a different order of determination for COB in the small group market.

Appears in 6 contracts

Samples: Qualified Health Plan Issuer Contract, Qualified Health Plan Issuer Contract, Qualified Health Plan Issuer Contract

Coordination of Benefits. If a Contractor’s QHP provides coverage for the Pediatric Dental Essential Health Benefitpediatric dental essential health benefit, Contractor shall include a Coordination of Benefits (COB) provision in its Evidence of Coverage (EOC) and Disclosure Forms or Policy Form policy form that (i) is consistent with Health and Safety Code § 1374.19 or Insurance Code § 10120.2, and (ii) provides that the QHP is the primary dental benefit plan or policy under that COB provision. This provision shall apply to Contractor’s QHPs offered both inside and outside of Covered California for the Individual Market, except where 28 CCR § 1300.67.13 or 10 CCR § 2232.56 provides for a different order of determination for COB in the small group market.

Appears in 3 contracts

Samples: Qualified Health Plan Issuer Contract, Qualified Health Plan Issuer Contract, Qualified Health Plan Issuer Contract

Coordination of Benefits. If a Contractor’s QHP provides coverage for the Pediatric Dental Essential Health Benefit, Contractor shall include a Coordination of Benefits (COB) provision in its Evidence of Coverage or Policy Form that (i) is consistent with Health and Safety Code § 1374.19 or Insurance Code § 10120.2, 10120.2 and (ii) provides that the QHP is the primary dental benefit plan or policy under that COB provision. This provision shall apply to Contractor’s QHPs offered both inside and outside of the Covered California for the Individual MarketSmall Business Exchange, except where 28 CCR § 1300.67.13 or 10 CCR § 2232.56 provides for a different order of determination for COB in the small group market.

Appears in 1 contract

Samples: Qualified Health Plan Issuer Contract

Coordination of Benefits. If a Contractor’s QHP provides coverage for the Pediatric Dental Essential Health Benefitpediatric dental essential health benefit, Contractor shall include a Coordination of Benefits (COB) provision in its Evidence of Coverage (EOC) and Disclosure Form or Policy Form policy form that (i) is consistent with Health and Safety Code § 1374.19 or Insurance Code § 10120.2, and (ii) provides that the QHP is the primary dental benefit plan or policy under that COB provision. This provision shall apply to Contractor’s QHPs offered both inside and outside of Covered California for the Individual MarketSmall Business, except where 28 CCR § 1300.67.13 or 10 CCR § 2232.56 provides for a different order of determination for COB in the small group market.

Appears in 1 contract

Samples: Qualified Health Plan Issuer Contract

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Coordination of Benefits. If a Contractor’s QHP provides coverage for the Pediatric Dental Essential Health Benefit, Contractor shall include a Coordination of Benefits (COB) provision in its Evidence of Coverage or Policy Form that (i) is consistent with Health and Safety Code § 1374.19 or Insurance Code § 10120.2, and (ii) provides that the QHP is the primary dental benefit plan or policy under that COB provision. This provision shall apply to Contractor’s QHPs offered both inside and outside of Covered California for the Individual MarketSmall Business, except where 28 CCR § 1300.67.13 or 10 CCR § 2232.56 provides for a different order of determination for COB in the small group market.

Appears in 1 contract

Samples: Qualified Health Plan Issuer Contract

Coordination of Benefits. If a Contractor’s QHP provides coverage for the Pediatric Dental Essential Health Benefit, Contractor shall include a Coordination of Benefits (COB) provision in its Evidence of Coverage or Policy Form that (i) is consistent with Health and Safety Code § 1374.19 or Insurance Code § 10120.2, and (ii) provides that the QHP is the primary dental benefit plan or policy under that COB provision. . This provision shall apply to Contractor’s QHPs offered both inside and outside of Covered California for the Individual Market, except where 28 CCR § 1300.67.13 or 10 CCR § 2232.56 provides for a different order of determination for COB in the small group market.

Appears in 1 contract

Samples: Qualified Health Plan Issuer Contract

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