Section R590-131-7 - Procedure to be Followed by Secondary Plan to Calculate Benefits and Pay a Claim(1) If a secondary plan coordinates benefits, the secondary plan shall: (a) calculate the plan benefits it would have paid absent any other health care coverage; and(b) apply the amount calculated in Subsection (1)(a) to any allowable expense unpaid by the primary plan.(2) The secondary plan may reduce its payment amount so that when combined with the primary plan's payment, the total benefits paid or provided by all plans for the claim do not exceed 100% of the total allowable expense for that claim. (3) The secondary plan shall credit to the plan deductible any amounts it would have credited to the plan deductible in the absence of other health care coverage.Utah Admin. Code R590-131-7
Amended by Utah State Bulletin Number 2020-15, effective 7/22/2020Amended by Utah State Bulletin Number 2022-17, effective 8/22/2022