8.0 Coordination of Benefits (COB)
8.1 CLHIA Guidelines
If a Member has coverage under more than one benefits contract (each, a "Plan"), whether administered by Pacific Blue Cross or otherwise, then the Provider must submit Claims in accordance with the Canadian Life and Health Insurance Association coordination of benefits ("COB") Guideline G4 – Group Health and Dental located at the following link:
8.2 Coverage with Another Insurance Carrier
A Member whose additional coverage is with another health benefits carrier, continue to submit two Claims with the pertinent Plan information with each Claim to each benefits carrier.
8.3 Dual Pacific Blue Cross Coverage
8.4 Provide all COB Information
To prevent the delay of assessment please provide any pertinent information that will assist Pacific Blue Cross in determining the order of payment.
It is a requirement to retain proof of payment (copy of the Explanation of Benefits) when another health benefits carrier is involved. This assists with the processing of a Claim when Deductibles or limitations are reached under the primary Plan.
8.5 Some Plans May Not Allow COB
The Member should verify COB eligibility with applicable Plan administrator as some Plans do not allow duplicate coverage.
8.6 Some Plans are Always Primary
A Plan that does not have a COB provision is always primary and pays before a Plan that does have a COB provision.
8.7 Some Plans are Always Secondary
Some plans always pay last.