A method of coordinating medical expense benefit payments between two insurance carriers that allows the secondary carrier to pay the difference, if any, between the amount paid by the primary plan and the amount that would have been payable by the secondary plan had that plan been the primary plan.----------[ Back
A part of a contract that relieves a third-party payer of liability for cost of services, if the services are covered under another program. Nonduplication of Benefits is distinct from Coordination of Benefits because reimbursement is limited to the larger benefit allowed by the two plans, rather than a total of 100 percent of the charges. Also referred to as Benefit-Less-Benefit or Carve Out.
This may apply if a subscriber is eligible for benefits under more than one plan. A dental benefit contract provision relieving the third-party payer of liability for cost of services if the services are covered under another program. Distinct from a coordination of benefits provision, because reimbursement would be limited to the greater level allowed by the two plans, rather than a total of 100% of the charges. Also referred to as "benefit-less-benefit" or "carve-out".
Often called coordination of benefits or COB, this is a health insurance clause that prevents duplicate benefit payments. The benefits of one policy are reduced by the benefits paid in another policy.
A provision in some Health Insurance policies specifying that benefits will not be paid for amounts reimbursed by others. In Group Insurance, this is usually called coordination of benefits (COB).