02-031 C.M.R. ch. 790, § 3 - Information Sharing
A.
General. A carrier whose plan contains a coordination of benefits
or COB provision may require covered persons to disclose whether they are
covered by other plans and to provide sufficient information to determine which
plan is primary. A secondary plan may require a covered person to claim
benefits under the primary plan as a condition of coverage under the secondary
plan.
B.
Streamlined Benefit
Administration. Carriers are encouraged to develop procedures for
coordinating claims processing when claimants are insured by multiple plans and
reimbursement from another carrier is known to be available.
C.
Information Sharing. Each
carrier shall provide to any other carrier with which it seeks to coordinate
benefits, to any carrier which seeks information to determine whether it has a
right to coordinate benefits with it, any information it acquires that the
other carrier needs or may consider relevant to determining priority of
payment. Relevant information includes, but is not limited to, the identity of
other carriers and plans and the identity of a claimant's custodial parent.
Such information must be provided promptly after receiving a request to provide
information to the other carrier and receiving complete information from the
claimant.
D.
Suspension of
filing deadlines. Submission of a timely claim to one carrier when there
is multiple coverage shall suspend all other applicable filing deadlines for a
minimum of 120 days after that carrier has adjudicated the claim, as long as
the claimant provides all information requested by all carriers within a
reasonable time after the request.
Notes
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