Coordination of Benefits

Your Welfare Fund benefits contain a Coordination of Benefits or COB provision. BOLR Fund participants will be receiving information and questionnaires about this in the coming weeks, so it’s important that you understand the concept and your responsibilities with regard to COB.

Coordination of Benefits is a method used to prevent duplicate payments for health care services received by you, your spouse, or children when insured through more than one benefit plan. Insurance was designed to ensure that you receive the maximum benefit allowed for the service provided. It was never intended to pay more than the actual charge. For this reason, COB was established as a way for two or more carriers to coordinate their respective benefits so the total amount paid does not exceed 100% of the allowable payment while assuring you receive maximum coverage.

Nationally accepted COB guidelines determine which carrier is primary (pays first) and which is secondary (pays second). The primary carrier pays the maximum allowance under their plan and any remaining balance is then considered by the secondary plan. Keep in mind, only allowable charges are considered. COB does not allow for payment of services not normally covered under your policy.

Independence Blue Cross (IBC) will be requesting information from BOLR members concerning other insurance coverage from each of us soon. Effective July 1st, IBC will pend any claim received if they have not received a response to their questionnaire, so please respond promptly. COB can be confusing. If you have any questions concerning this please do not hesitate to contact the Fund Office at 215-568-3262 or 800-338-9025, if you are outside the 215 area.

Tips for reducing payment delays:

· Complete and return any COB questionnaires you receive as soon as possible;

· Understand your benefits and, if appropriate, which plan is primary;

· Provide all information to your doctor or service provider;

· If you are covered by more than one plan and the Fund is secondary be sure there is a copy of the primary insurers Explanation of Benefits (EOB) statement with any request for payment;

· Contact the Fund Office with any questions concerning COB.