Common use of Effect on the Benefits of this Plan Clause in Contracts

Effect on the Benefits of this Plan. 1. When this plan is secondary, it may reduce its benefits so that the total benefits paid or provided by all plans during a plan year are not more than the total allowable expenses. In determining the amount to be paid for any claim, the secondary plan will calculate the benefits it would have paid in the absence of other health care coverage and apply that calculated amount to any allowable expense under its plan that is unpaid by the Primary plan. The secondary plan may then reduce its payment by the amount so that, when combined with the amount paid by the primary plan, the total benefits paid or provided by all plans for the claim do not exceed the total allowable expense for that claim. In addition, the secondary plan shall credit to its plan Deductible any amount it would have credited to its Deductible in the absence of other health care coverage.

Effect on the Benefits of this Plan. 1. A. When this plan This Plan is secondary, it may reduce its benefits so that the total benefits paid or provided by all plans during a plan year Plans are not more than the total allowable expensesAllowable Expenses. In determining the amount to be paid for any claim, the secondary plan Secondary Plan will calculate the benefits it would have paid in the absence of other health care coverage and apply that calculated amount to any allowable expense Allowable Expense under its plan Plan that is unpaid by the Primary planPlan. The secondary plan Secondary Plan may then reduce its payment by the amount so that, when combined with the amount paid by the primary planPrimary Plan, the total benefits paid or provided by all plans Plans for the claim do not exceed the total allowable expense Allowable Expense for that claim. In addition, the secondary plan Secondary Plan shall credit to its plan Deductible deductible any amount amounts it would have credited to its Deductible deductible in the absence of other health care coverage.

Effect on the Benefits of this Plan. (1. ) When this plan is secondary, it may reduce its benefits so that the total benefits paid or provided by all plans during a plan year are not more than the total allowable expenses. In determining the amount to be paid for any claim, the secondary plan will calculate the benefits it would have paid in the absence of other health care coverage and apply that calculated amount to any allowable expense under its plan that is unpaid u npaid by the Primary plan. The secondary plan may then reduce its payment by the amount so that, when combined with the amount paid by the primary plan, the total benefits paid or provided by all plans for the claim do not exceed the total allowable expense expen se for that claim. In addition, the secondary plan shall credit to its plan Deductible deductible any amount amounts it would have credited to its Deductible deductible in the absence of other health care or dental coverage.

Effect on the Benefits of this Plan. 1. A. When this This plan is secondary, it may reduce its benefits so that the total benefits paid or provided by all plans Plans during a plan year are not more than the total allowable Allowable expenses. In determining the amount to be paid for any claim, the secondary plan Secondary Plan will calculate the benefits it would have paid in the absence of other health care coverage and apply that calculated amount to any allowable Allowable expense under its plan Plan that is unpaid by the Primary planPlan. The secondary plan Secondary Plan may then reduce its payment by the amount so that, when combined with the amount paid by the primary planPrimary Plan, the total benefits paid or provided by all plans Plans for the claim do not exceed the total allowable Allowable expense for that claim. In addition, the secondary plan Secondary Plan shall credit to its plan Deductible deductible any amount amounts it would have credited to its Deductible deductible in the absence of other health care coverage.