Medical Expense✓ Verified · outline & fact-checked · Sep 2026Difficulty 2/5
An insured is covered under two group health plans. The coordination of benefits (COB) provision is designed to:
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
Coordination of benefits is an anti-duplication provision: when a person is covered by more than one group plan, COB rules establish which plan pays first (primary) and which pays second (secondary), so that combined payments do not exceed 100% of the actual covered expenses. The insured receives full reimbursement of the covered loss — but never a profit from having two policies.
Why the other options are wrong
- B) COB prevents double payment; the total from both plans is capped at the actual expenses incurred.
- C) COB lets the insured keep both plans and simply orders the order of payment; there is no 30-day election to drop one.
- D) COB affects how claims are paid, not the premiums charged under either plan.
Memory hook
COB = two plans, one bill, zero profit. Primary pays first, secondary mops up the rest — never more than 100 cents on the dollar.