double coverage insurance questions

[blaze100]

Help. My husband and I both work at the same college, so we have double coverage through our employer.

Usually my bills are paid 100%. However, more and more they are altering the rules on how they calculate coordination of benefits. They just say they are not paying more than XXX dollars for a service outside my Preferred Provider list and it doesn't matter if we have double coverage or not.

Is anyone out there an expert on how double coverage benefits for employer based health insurance is legally calculated? I really would appreciate any info on this.

Barb

[chloesmom]

Where I work, we are self-insured, but Blue Cross/Blue Shield administers our health plan.

With couples I know who are both employed here, there is no double coverage. It's like they each only have one insurance so any co-pay that someone like me, whose husband doesn't work here, has, they also have.

We have never thought that was fair, but I think it's not a question of legality here in Illinois, it's how the provider of the insurance, which in this case is my employer, chooses to administer the benefits.

I know when my husband and I both had insurance benefits, both with different employers, we never, ever paid a cent for anything.

Cindy

[blaze100]

Thanks Cindy. We are self-funded bc too, so looks like it is starting to make sense... Barb