When You Are Covered by More Than One Insurer A healthcare coverage plan is considered the primary plan and its benefits will be paid first if: • the plan does not use similar COB rules to determine coverage; or • the plan does not have a COB provision; or • The plan has similar the COB rules and is determined to be primary under the order of benefit determination rules described below. Benefits under another plan include all benefits that would be paid if claims had been initially submitted under that plan. The following factors are used to determine which plan is primary and which plan is • if you are the main subscriber or a dependent; • if you are married, which spouse was born earlier in the year; • the length of time each spouse has been covered under the plan; • if a parental custody or divorce decree applies; or • if Medicare is your other coverage then Medicare guidelines will apply. These factors make up the order of benefit determination rules, described in greater detail below:
Cooperation with Inspector General Grantee understands its duty, pursuant to Section 20.055(5), Fla. Stat., to cooperate with Florida Housing’s Inspector General in any investigation, audit, inspection, review, or hearing. Grantee will comply with this duty and ensure that any contracts issued under this Agreement impose this requirement, in writing, on its subcontractors.
What Will Happen After We Receive Your Letter When we receive your letter, we must do two things:
Contact Us If You Have a Question If you have questions about your benefits or anything in this agreement, we are happy to help. Simply call our Customer Service Department or visit one of our Your Blue Store locations. As a BCBSRI member, you may also log in to our secure member website to find out BCBSRI news, get plan information or use many of our self-service options.
