State RegulationsMI specificDifficulty 1/5
After coordinating benefits between two group health plans, a Michigan plan determines it paid more than it owed on a claim. Under Michigan's coordination of benefits rules, what may the plan generally do?
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Answer & full 3-part explanation (select an option above, or peek)
Why C is correct
Michigan's coordination of benefits framework, MCL 550.251-.255 as applied through M.C.L. 500.3402b, gives a coordinating plan the right to recover overpayments, so a plan that pays more than its coordinated share may seek the excess back from the person to whom it was paid. This keeps coordination honest without penalizing plans that paid before learning of the other coverage.
Why the other options are wrong
- A) Coordinated plans are not required to let overpayments stand as extra benefits; recovery of the excess is permitted.
- B) Recovery runs against the person who received the payment, not merely through offsets against the other plan.
- D) The other plan already owes at most its coordinated share; a second payment would defeat the statute's purpose.
Memory hook
Overpaid under COB? The plan can claw it back.