The Purpose of a Coordination-Of-Benefits Provision in Group Health Insurance

question 41

Multiple Choice

The purpose of a coordination-of-benefits provision in group health insurance plans is to

• A)determine which plan pays first if more than one plan covers a loss.
• B)determine which health care provider an insured may use for his or her care.
• C)determine if the calendar-year deductible has been satisfied by the insured.
• D)determine if the employee is eligible for coverage under the group health plan.

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Definitions:

Rationalization

Rationalization is a defense mechanism in which controversial behaviors or feelings are justified and explained in a seemingly rational or logical manner to avoid the true explanation.

Chronic Use

The long-term, persistent use of a substance or engagement in a behavior, often leading to dependency or addiction.

Inadequacy

The feeling or state of being insufficient or not good enough to meet a standard or fulfill a need.

Self Help Group

Peer-led groups that offer support and mutual aid for individuals facing similar issues, such as addiction or mental health challenges.