If an individual is covered under Plan A through her employment and is covered under Plan B through her spouse's employment:

Question

Quizplus · Accepted Answer

When an individual is covered under two plans, primary and secondary coverage is determined. The primary plan is responsible for paying the benefits first, up to the limits of its coverage. The secondary plan is responsible for paying the remaining costs up to the limits of its coverage. In this scenario, Plan A would be considered the primary plan since it covers the individual based on her own employment. Plan B, which covers the individual based on her spouse's employment, would be considered the secondary plan. Therefore, Plan A would pay for the benefits first, up to the limits of its coverage, and Plan B would pay for any remaining costs up to the limits of its coverage.

If an Individual Is Covered Under Plan a Through Her