Delaware Administrative Code
Title 18 - Insurance
1300 - Health Insurance General Provisions
1307 - Group Coordination Benefits [Formerly Regulation 61]
Appendix A - MODEL COB PROVISIONS
Section 1307-A-I - Applicability
Current through Register Vol. 28, No. 3, September 1, 2024
A This Coordination of Benefits "COB" provision applies to This Plan when an employee or the employee's covered dependent has health care coverage under more than one Plan. "Plan" and "This Plan" are defined below.
B If this COB provision applies, the order of benefit determination rules should be looked at first. Those rules determine whether the benefits of This Plan are determined before or after those of another plan. The benefits of This Plan:
(1) Shall not be reduced when, under the order of benefit determination rules, This Plan determines its benefits before another plan; but
(2) May be reduced when, under the order of benefits determination rules, another plan determines its benefits first. The above reduction is described in Section IV "Effect on the Benefits of This Plan."
