Reduction in This Plan's Benefits. The benefits of This Plan will be reduced when the sum of: (1) the benefits that would be payable for the Allowable Expense under This Plan in the absence of this COB provision; and (2) the benefits that would be payable for the Allowable Expenses under the other plans, in the absence of provisions with a purpose like that of this COB provision, whether or not claim is made; exceeds those Allowable Expenses in a Claim Determination Period. In that case, the benefits of This Plan will be reduced so that they and the benefits payable under the other plans do not total more than those Allowable Expenses. When the benefits of This Plan are reduced as described above, each benefit is reduced in proportion. It is then charged against any applicable benefit limit of This Plan.
Appears in 6 contracts
Samples: Membership Contract, Membership Contract, Membership Contract
Reduction in This Plan's Benefits. The benefits of This Plan will be reduced when the sum of:
(1) the benefits that would be payable for the Allowable Expense under This Plan in the absence of this COB provision; and
(2) the benefits that would be payable for the Allowable Expenses under the other plans, in the absence of provisions with a purpose like that of this COB provision, whether or not claim is made; , exceeds those Allowable Expenses in a Claim Determination Period. In that case, the benefits of This The Plan will be reduced so that they and the benefits payable under the other plans do not total more than those Allowable Expenses. When the benefits of This The Plan are reduced as described above, each benefit is reduced in proportion. It is then charged against any applicable benefit limit of This Plan.
Appears in 3 contracts
Samples: Dental Benefit Plan, Dental Benefit Plan, Dental Benefit Plan
Reduction in This Plan's Benefits. The benefits Benefits of This Plan will be reduced when the sum of:
(1) the benefits a. The Benefits that would be payable for the Allowable Expense under This Plan in the absence of this COB provision; and
(2) the benefits b. The Benefits that would be payable for the Allowable Expenses under the other plansPlans, in the absence of provisions with a purpose like that of this COB provision, whether or not claim is made; exceeds those Allowable Expenses in a Claim Determination Period. In that case, the benefits Benefits of This Plan will be reduced so that they and the benefits payable under the other plans Plans do not total more than those Allowable Expenses. When the benefits Benefits of This Plan are reduced as described above, each benefit is reduced in proportion. It is then charged against any applicable benefit limit of This Plan.
Appears in 1 contract
Samples: Dental Insurance Policy