State RegulationsFL specificDifficulty 1/5
What is the primary purpose of the coordination-of-benefits provisions found in Florida group health policies?
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Answer & full 3-part explanation (select an option above, or peek)
Why D is correct
Coordination of benefits (COB) prevents a claimant from collecting more in total benefits than the actual covered expense: one plan pays as primary and the other as secondary, and the secondary plan pays no more than the balance it would have paid as primary. Under Chapter 627, Florida Statutes, group health policies contain COB provisions for exactly this purpose. The provisions do not reduce premiums, allocate commissions, or let the insured select the paying carrier.
Why the other options are wrong
- A) COB affects how claims are paid when coverage overlaps; it does not reduce the premium charged for multiple policies.
- B) COB has nothing to do with commission allocation among agents.
- C) The insured does not choose which insurer is primary; the order-of-benefits rules determine that.
Memory hook
Two plans, one bill — no double dip.