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WHO PAYS FIRST?
Retiree Coverage
A retiree plan will always pay second after any group plan that covers the same
individual as an active full-time or part-time employee.
Example:
A retired individual has a part-time job with benefits and also has retiree coverage
with a previous employer.
Therefore - The plan the individual has with his part-time employer pays first. The
retiree plan pays second.
If an individual has retiree coverage with more than one plan, the plan that has
been in effect the longest pays first.
Example:
In a case where you may have two retiree plans:
Retiree plan one – member of plan since January 3, 1992
Retiree plan two – member of plan since September 2, 2001
Therefore - Retiree plan one pays first. The more recent retiree plan pays second.
If Both Individual and Group Coverage
If a person has individual coverage (i.e., they have purchased a plan on their
own outside of any group coverage), as well as coverage under a group health
or dental plan, the group health or dental plan may pay first. Please review the
provisions in your policy.
