Up dating health insurance benefits
A dependent includes a spouse, child or dependent post-secondary student.
“Spouse” with respect to another person means a resident of B. who is married to or is living and cohabiting in a marriage-like relationship with the applicant and may be of the same gender as the applicant.
Certain life events such a marriage or the birth of a child or divorce should also trigger a review of your beneficiary information.
This will save your family members a lot of unnecessary grief later on.
COB relies on many databases maintained by multiple stakeholders including federal and state programs, plans that offer health insurance and/or prescription coverage, pharmacy networks, and a variety of assistance programs available for special situations or conditions.
Some of the methods used to obtain COB information are listed below: IRS/SSA/CMS Claims Data Match - The law requires the Internal Revenue Service (IRS), the Social Security Administration (SSA), and CMS to share information about beneficiaries and their spouses.
"Qualifying Spouse", in relation to an eligible person, means a beneficiary who: (a) is the spouse of the eligible person, and (b) is not a minor or a dependent post-secondary student.
“Child”, for the purpose of determining who may be included on a member’s premium account, means a resident of B. who: (a) is a child of a beneficiary or a person in respect of whom the beneficiary stands in place of a parent, (b) is a minor, (c) does not have a spouse, and (d) is supported by the beneficiary.
Over the past five years, premiums on employer-provided insurance plans rose 20 percent, according to the Kaiser Family Foundation.
If so, those plans need to work together to make sure you’re getting the most out of your coverage. It’s important that we keep your information up-to-date. If you have a PPO or EPO plan through Blue Cross Blue Shield of Michigan, check out our coordination of benefits FAQ (PDF).
Then the second plan may pay toward the remaining cost, depending on the plan. Coordinating your benefits helps us process your claims faster and maximizes your benefits, which can lower your out-of-pocket costs.
Unfortunately, there’s a trade-off because between out-of-pocket expenses and premiums.
Coordination of benefits (COB) allows plans that provide health and/or prescription coverage for a person with Medicare to determine their respective payment responsibilities (i.e., determine which insurance plan has the primary payment responsibility and the extent to which the other plans will contribute when an individual is covered by more than one plan).
"Dependent post-secondary student", for the purpose of determining who may be included on a member's premium account, means a resident of BC who is: (a) older than 18 and younger than 25 years of age, (b) in full-time attendance at a recognized post-secondary institution, and (c) supported by a beneficiary who is the person's parent or who stands in place of the person's parent.