How does coordination of benefits work between two employer-sponsored plans?

• A. The secondary plan pays first
• B. The primary plan pays first; the secondary pays remaining costs, often up to its own limits
• C. Costs are split equally
• D. The plan with higher premium pays all costs

Answer: (B)

Coordination of benefits is about which plan pays first when two employer-sponsored plans cover the same person. The plan designated as primary pays first, up to its allowed amount (considering deductible, coinsurance, and limits). The secondary plan then covers any remaining eligible expenses, up to its own limits. This arrangement prevents double payment and helps control overall costs. For example, if a $1,000 bill is submitted and the primary plan would pay $700, the secondary plan would cover the remaining $300 (subject to its own deductible and coinsurance rules and limits). Premium amounts don’t determine which plan pays first—the order is set by COB rules and plan language.