Order of Benefit Determination definition

Order of Benefit Determination means the procedure used to decide which plan will determine its benefits before any other plan.
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Order of Benefit Determination means the procedure used to decide which plan will determine its benefits before any other plan. Each policy, contract or other arrangement for benefits or services will be treated as a separate plan. Each part of The Empire Plan that reserves the right to take the benefits or services of other plans into account to determine its benefits will be treated separately from those parts that do not.
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Order of Benefit Determination means the procedure used to decide which plan will determine its benefits before any other plan. Each policy, contract or other arrangement for benefits or services will be treated as a separate plan. Each part of The Empire Plan that reserves the right to take the benefits or services of other plans into account to determine its benefits will be treated separately from those parts that do not.C. When coordination of benefits applies and The Empire Plan is secondary, payment under The Empire Plan will be reduced so that the total of all payments or benefits payable under The Empire Plan and under another plan is not more than the total allowable charge for the service you receive.D. Payments under The Empire Plan will not be reduced on account of benefits payable under another plan if the other plan has a Coordination of Benefits or similar provision with the same order of benefit determination as stated in Item E. and under that order of benefit determination, the benefits under The Empire Plan are to be determined before the benefits under the other plan.E. When more than one plan covers the person making the claim, the order of benefit payment is determined using the first of the following rules that applies:1. The benefits of the plan that covers the person as an enrollee are determined before those of other plans that cover that person as a dependent;2. When this Plan and another plan cover the same child as a dependent of different persons called “parents” and the parents are not divorced or separated (For coverage of a dependent of parents who are divorced or separated, see paragraph 3. below)
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Examples of Order of Benefit Determination in a sentence

  • The Order of Benefit Determination Rules govern the order in which each Contract will pay a claim for benefits.

  • If an Insured is covered by more than one Secondary Plan, the Order of Benefit Determination rules in this provision shall decide the order in which the Secondary Plan’s benefits are determined in relation to each other.

  • Order of Benefit Determination - Each Plan determines its order of benefits using the first of the following rules that apply: 1.

  • The Order of Benefit Determination Rules state whether This Plan is a Primary Plan or Secondary Plan as to another Plan covering the person.

  • The Plan that, according to the rules for the Order of Benefit Determination, pays benefits before all other Plans.

  • Contract is defined below.The Order of Benefit Determination Rules govern the order in which each Contract will pay a claim for benefits.

  • If this COB provision applies, the Order of Benefit Determination Rules should be reviewed first.

  • You will find the rules under Order of Benefit Determination Rules in this section.The Order of Benefit Determination Rules will be used to determine which plan is the primary plan.

  • The Order of Benefit Determination Rules will be used to determine which Plan is the Primary Plan.

  • This Section applies when, in accordance with the Section "Order of Benefit Determination", This Plan is a Secondary Plan as to one or more other Plans.


More Definitions of Order of Benefit Determination

Order of Benefit Determination means the order in which each Group Plan pays benefits, i.e. which plan pays first (primary); which plan pays second (secondary).
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Related to Order of Benefit Determination

  • Disability Benefit means the benefit set forth in Article 8.

  • Reset Determination Date means, in respect of the First Reset Period, the second Business Day prior to the First Reset Date and, in respect of each Subsequent Reset Period thereafter, the second Business Day prior to the first day of each such Subsequent Reset Period;

  • Interest Determination Date means, with respect to a Rate of Interest and Interest Accrual Period, the date specified as such hereon or, if none is so specified, (i) the first day of such Interest Accrual Period if the Specified Currency is Sterling or (ii) the day falling two Business Days in London for the Specified Currency prior to the first day of such Interest Accrual Period if the Specified Currency is neither Sterling nor euro or (iii) the day falling two TARGET Business Days prior to the first day of such Interest Accrual Period if the Specified Currency is euro.