In a multi-plan scenario, which statement about which plan pays first is correct?

In a multi-plan scenario, which statement about which plan pays first is correct?

• A. The secondary payer pays first.
• B. The primary payer pays first; the secondary pays remaining allowed expenses per COB rules.
• C. Both plans pay equal share regardless of order.
• D. The policyholder chooses the order for each claim.

Answer: (B)

Coordination of benefits sets the order in which plans pay. The primary plan pays first, up to its allowed amount. Then the secondary plan covers the remaining eligible expenses, applying its own deductible, coinsurance, and limits as applicable, for the charges that remain unpaid. This arrangement prevents double payments and ensures total benefits don’t exceed the charges. The idea that the secondary would pay first conflicts with how COB works; equal shares regardless of order ignores the established priority; and the order isn’t chosen by the policyholder but is defined by the plans’ COB rules.

Coordination of benefits sets the order in which plans pay. The primary plan pays first, up to its allowed amount. Then the secondary plan covers the remaining eligible expenses, applying its own deductible, coinsurance, and limits as applicable, for the charges that remain unpaid. This arrangement prevents double payments and ensures total benefits don’t exceed the charges. The idea that the secondary would pay first conflicts with how COB works; equal shares regardless of order ignores the established priority; and the order isn’t chosen by the policyholder but is defined by the plans’ COB rules.