Which of the following does Coordination of Benefits allow?

• A. Allows the Secondary Payer to Reduce Their Benefit Payments So No More Than 100% of the Claim Is Paid
• B. Allows the Primary Payer to Pay More Than 100% of the Claim
• C. It Eliminates All Deductibles
• D. It Doubles the Total Payments

Answer: (A)

Coordination of Benefits ensures that when more than one insurer covers a claim, the total payments do not exceed the allowed charges. In practice, the secondary plan determines its payment after the primary has paid its share and may reduce its own payment so that the combined payments equal no more than 100% of the bill. For example, if a service costs $1,000 and the primary plan pays $700, the secondary plan would pay up to the remaining $300, not more. This prevents paying more than the claim amount. It doesn’t allow the primary payer to pay more than the bill, it doesn’t automatically eliminate deductibles, and it doesn’t double the total payments. If applicable, deductibles and coinsurance from each policy still apply per their terms.