Section 760 IAC 1-38.1-16 - Order of benefits for longer/shorter length of coverageAuthority: IC 27-1-3-7
Affected: IC 27-8-5-19
Sec. 16.
(a) If the provisions of sections 12 through 15.5 of this rule do not determine the order of benefits, the benefits of the plan that covered the person for the: (1) longer period of time is the primary plan; and(2) shorter period of time is the secondary plan.(b) To determine the length of time a person has been covered under a plan, two (2) plans shall be treated as one (1) plan if the claimant was eligible under the second plan within twenty-four (24) hours after the first plan ended.(c) The start of a new plan does not include a change:(1) in the amount or scope of a plan's benefits;(2) in the entity that pays, provides, or administers the plan's benefits; or(3) from one (1) type of plan to another, such as from a single employer plan to that of a multiple employer plan.(d) The claimant's length of time covered under a plan is measured from the claimant's first date of coverage under the plan. If that date is not readily available, the date the claimant first became a member of the group shall be used as the date from which to determine the length of time the claimant's coverage under the present plan has been in force.Department of Insurance; 760 IAC 1-38.1-16; filed Feb 14, 1990, 3:30 p.m.: 13 IR 1173; readopted filed Sep 14, 2001, 12:22 p.m.: 25 IR 531; filed Sep 15, 2006, 2:02 p.m.: 20061011-IR-760050265FRA; readopted filed Nov 21, 2012, 4:15 p.m.: 20121219-IR-760120454RFAReadopted filed Nov 13, 2018, 10:02 a.m.: 20181212-IR-760180372RFAReadopted filed 10/31/2024, 3:52 p.m.: 20241127-IR-760230814RFA