A Toledo employee is covered under her own employer's group health plan and also as a dependent under her spouse's employer plan. She incurs covered medical expenses. Under the coordination-of-benefits provision, how are the plans applied?

Why B is correct

COB rules order the plans: the plan that covers the person as an employee is primary, and the plan covering the person as a dependent is secondary. The secondary plan considers what the primary plan paid and pays only toward the remaining allowable expense, so the combined payment never exceeds the allowable cost. This is the anti-duplication structure the Ohio Department of Insurance expects plans to administer.

Why the other options are wrong

• A) Paying full benefits from both plans would duplicate payment, which COB exists to prevent.
• C) Dependent coverage is generally secondary to the person's own employee coverage; the dependent plan does not automatically go first.
• D) The order of benefits is fixed by the provision's rules, not by the insured's preference at claim time.

Memory hook

Own plan first, spouse's plan second — never both at full.