When an Individual Is Eligible for Coverage Under Two Different

question 47

Multiple Choice

When an individual is eligible for coverage under two different health insurance policies,____________________ limits the total benefits an insured individual can receive from both plans to not more than 100% of the allowable expenses.

• A) COBRA
• B) coordination of benefits
• C) the health reimbursement arrangement
• D) medical necessity

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Definitions:

Inadequate Consideration

A situation in a contractual agreement where the value exchanged between parties is significantly disproportionate or deemed insufficient.

Fraud

Deliberate deception to secure unfair or unlawful gain, or to deprive a victim of a legal right.

Contract

A legally binding agreement between two or more parties that is enforceable by law, characterized by an offer, acceptance, consideration, and mutual intent to be bound.

Objective Determination

A decision made based on unbiased evidence and facts, without influence from personal feelings or opinions.