Covered By Another Plan Sample Clauses
The "Covered By Another Plan" clause defines how benefits or coverage are coordinated when an individual is eligible for coverage under more than one insurance plan. Typically, this clause outlines the procedures for determining which plan is primary and which is secondary, and how payments are allocated between the plans to avoid duplication of benefits. Its core practical function is to prevent double payment for the same claim and to ensure that the insured receives the appropriate level of benefits without exceeding the total cost of the covered services.
Covered By Another Plan. The person receiving continuation coverage becomes covered under another group health plan with no pre-existing condition limitation or exclusion. For plan years beginning on or after June 30, 1997, however, a pre-existing exclusion or limitation in the other group health plan will not prevent COBRA continuation coverage from being terminated if the exclusion or limitation does not apply (or is otherwise satisfied) due to the applicable group health plan portability, access and renewability provisions of the Health Insurance Portability and Accessibility Act.