This provision establishes a system of primary and secondary insurers.The primary insurer pays the normal benefit amount, as if no other insurance were in force.Then the secondary insurer pays the balance of the covered health care expenses.The total payments by the primary and secondary insurers are limited to 100 percent of the covered charges for the applicable policies.Identify this provision.

Question

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The described provision is the Coordination of Benefits (COB), which outlines how insurance policies work together when an individual is covered by more than one policy. It ensures that the total amount paid does not exceed 100% of the covered charges.

This Provision Establishes a System of Primary and Secondary Insurers