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Coordination of Benefits: 1 Plan for 2 Plans?

September 27, 2016 By Shelby Tatomir

Do you and your family have more than one dental plan? Maximize coverage from both with a COB.

Coordination of benefits (COB) means integrating benefits for one person under more than one plan. Proper COB ensures plans do not duplicate or make unnecessary payments for services.

With proper coordination, 1 plan becomes your primary – paying your claims first, then the second plan then pays the remaining balance.

Primary plan, secondary plan…

When both plans have COB provisions, your primary plan is the one that has you as the main policyholder (the plan from your job, not your spouse’s). The plan you’re enrolled in as a dependent serves as the secondary.

COBs are 2 plans for 1 person. Knowing how to manage COBs can lower out-of-pocket costs for your dental care.

For example:

Let’s say you take your child to the dentist for sealants. The office will send the bill to your primary dental plan. If that plan covers preventive at 80%, and it was a $100 procedure, the plan will pay your dentist $80. Normally, you would owe $20. But, since you have more than one dental plan, you can send the dentist’s bill to your secondary plan. Then, the second company will pay the remaining claim balance according to your coverage.

Find out if your plan includes COB. Sign in and review your plan today.

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Delta Dental of Wyoming is the leading dental benefits carrier in the state, providing quality, affordable dental plans for both companies and individuals. We are a non-profit … Read More...

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