In a policy with multiple insurers, what is the purpose of coordination of benefits (COB)?

• A. To decide which insurer pays first and how much.
• B. To increase premiums.
• C. To deny all dual-coverage claims.
• D. To automatically switch coverage to a single insurer.

Answer: (A)

Coordination of benefits is about how two or more health insurance plans share payment for a single claim. When you’re covered by multiple plans, COB decides which plan pays first (the primary payer) and how much it will pay, with the other plan(s) paying any remaining eligible expenses up to their limits. This prevents duplicate payments and makes sure total benefits don’t exceed the allowed charges. It isn’t about increasing premiums, denying all dual-coverage claims, or automatically switching coverage to one insurer. For example, if a $500 bill is processed and the primary plan pays $400, the secondary plan may cover part of the remaining $100 according to its rules, reducing the patient’s out-of-pocket cost.