Longer/Shorter Length of Coverage. If none of the above rules determine the order of benefits, the benefits of the plan which covered a member or subscriber longer are determined before those of the plan which covered that person for the shorter term. In general, if you use more benefits than you are covered for during a benefit period, the following formula is used to determine coverage: The insurer covering you first will cover you up to its allowance. Then, the other insurer will cover any allowable benefits you use over that amount. It will never be more than the total amount of coverage that would have been provided if benefits were not coordinated. Maximum benefits paid by primary insurer + Any remaining allowable expense to be paid by secondary insurer Total Benefits Payable
Appears in 18 contracts
Samples: Subscriber Agreement, Subscriber Agreement, Subscriber Agreement
Longer/Shorter Length of Coverage. If none of the above rules determine the order of benefits, the benefits of the plan which covered a member or subscriber longer are determined before those of the plan which covered that person for the shorter term. In general, if you use more benefits than you are covered for during a benefit period, the following formula is used to determine coverage: The insurer covering you first will cover you up to its allowance. Then, the other insurer will cover any allowable benefits you use over that amount. It will never be more than the total amount of coverage that would have been provided if benefits were not coordinated. Maximum benefits paid by primary first insurer + Any remaining allowable expense to be paid by secondary other insurer Total Benefits Payable
Appears in 10 contracts
Samples: Subscriber Agreement, Subscriber Agreement, Subscriber Agreement
Longer/Shorter Length of Coverage. If none of the above rules determine the order of benefits, the benefits of the plan which that covered a member or subscriber longer are determined before those of the plan which that covered that person for the shorter term. In general, if you use more benefits than you are covered for during a benefit period, the following formula is used to determine coverage: The insurer covering you first will cover you up to its allowance. Then, the other insurer will cover any allowable benefits you use over that amount. It will never be more than the total amount of coverage that would have been provided if benefits were not coordinated. Maximum benefits paid by primary insurer + Any remaining allowable expense to be paid by secondary insurer Total Benefits Payable
Appears in 1 contract
Samples: Subscriber Agreement
Longer/Shorter Length of Coverage. If none of the above rules determine the order of benefits, the benefits of the plan which covered a member or subscriber longer are determined before those of the plan which covered that person for the shorter term. In general, if you use more benefits than you are covered for during a benefit period, the following formula is used to determine coverage: The insurer covering you first will cover you up to its allowance. Then, allowance and then the other insurer will cover any allowable benefits you use over that amount. It will amount (never be more than the total amount of coverage that would have been provided if benefits were not coordinated). Maximum benefits paid by primary first insurer + Any remaining allowable expense to be paid by secondary other insurer Total Benefits Payable
Appears in 1 contract
Samples: Subscriber Agreement