Schedule L Coordination of Benefits.docx
DOCX document 16 KB Posted
- Attached to
- MPSERS Dental Benefit Plan Administration
- Solicitation number
- RFP-171-200000001290-3
- Issued by
- Grand Traverse County, Lansing City, Michigan
About this file
This is a Schedule L document detailing Coordination of Benefits requirements for the State of Michigan's RFP No. 200000001290, specifically addressing benefits coordination under the Public School Employees Retirement Act (PA 300 of 1980, Section 38.1391).
The document outlines the hierarchy of benefits coordination for hospital, medical-surgical, sick care, dental, and vision plans covering retirants, retirement allowance beneficiaries, and health insurance dependents. The primary stipulation is that Medicare or Medicaid benefits must be determined before the benefits provided under this plan. When a person is covered under multiple plans with coordination of benefits provisions, the benefits must be coordinated according to the Coordination of Benefits Act (1984 PA 64, MCL 550.251 to 550.255). Additionally, if a person is covered under another plan without a coordination of benefits provision, that plan's benefits must be determined before the benefits provided under this plan.
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Text version
STATE OF MICHIGAN
RFP No. 200000001290
SCHEDULE L
Coordination of Benefits
The Public School Employees Retirement Act (PA 300 of 1980)
Section 38.1391 Sec. 91
13) The hospital, medical-surgical, and sick care benefits plan, dental plan, and vision plan that covers retirants, retirement allowance beneficiaries, and health insurance dependents pursuant to this section shall contain a coordination of benefits provision that provides all of the following:
a) If the person covered under the hospital, medical-surgical, and sick care benefits plan is also eligible for medicare or medicaid, or both, then the benefits under medicare or medicaid, or both, shall be determined before the benefits of the hospital, medical-surgical, and sick care benefits plan provided pursuant to this section.
b) If the person covered under any of the plans provided by this section is also covered under another plan that contains a coordination of benefits provision, the benefits shall be coordinated as provided by the coordination of benefits act, 1984 PA 64, MCL 550.251 to 550.255.
c) If the person covered under any of the plans provided by this section is also covered under another plan that does not contain a coordination of benefits provision, the benefits under the other plan shall be determined before the benefits of the plan provided pursuant to this section.
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