longer shorter rule for coordination of benefits longer shorter rule for coordination of benefits

Once the payers handle their parts of the medical claim, the patient receives a bill from the provider for the rest of the medical costs. The , COB. If none of the above rules determines the order of benefits, the benefits of the plan that covered an employee or Member longer are determined before those of the plan that covered that person for the shorter term. Section 007.Procedure to be Followed by Secondary Plan to Calculate Benefits and Pay a Claim. a. Rule 120-2-48-.02 Purpose and Applicability . The reason for this is to reduce _________. (ii) if there is no court decree allocating responsibility for the child's health care expenses or health care coverage, the order of benefits for the child are as follows: (A) the plan covering the custodial parent; (B) the plan covering the custodial parent's spouse; (C) the plan covering the noncustodial parent; and then. Section 11:4-28.6 - Rules for coordination of benefits (a) The general order of benefit determination shall be as follows: 1. This ensures that neither you nor your health care provider gets reimbursed above and beyond the actual total cost of your medical claim. But, couples may choose to have two plans if they are both employer-sponsored. Coordination of benefits (COB) occurs when a patient is covered under more than one insurance plan. Full-time employees appointed for more than nine (9) months, except employees on academic year appointments, shall accrue annual leave at the rate of 6.769 hours biweekly or 14.667 hours per month (or a number of hours that is directly proportionate to the number of days worked during less than a full-pay period for full-time employees), and the hours accrued shall be credited at the conclusion of each pay period or, upon termination, at the effective date of termination. 5. This act shall be known and may be cited as "the coordination of benefits act". The New . To view this and other publications, visit the agency's Website at . Cigna Individual and Family Dental Plans. The health plans use a framework to figure out which plan pays first and that they dont pay more than 100% of the medical bill combined. the plan that covered the person for the longer period of time is the primary plan and the plan that covered the person for a shorter period of time is the secondary plan. (iii) this rule does not apply if subsection (4)(a) can determine the order of benefits. Another Name For Misty, website and written correspondence. 4. If any Partner has a deficit balance in its Capital Account (after giving effect to all contributions, distributions and allocations for all Allocation Years, including the Allocation Year during which such liquidation occurs), such Partner shall have no obligation to make any contribution to the capital of the Partnership with respect to such deficit, and such deficit shall not be considered a debt owed to the Partnership or to any other Person for any purpose whatsoever. This act shall be known and may be cited as "the coordination of benefits act". coalville tip book a slot; modular homes kelowna; alamogordo daily news police logs april 2021 (3) A plan may take into consideration the benefits paid or provided by another plan only when, under the rules of this chapter, it is secondary to that other plan. The benefits of the policy or plan of the parent whose birthday, excluding year of birth, falls earlier in a year are determined before the benefits of the policy or plan of the parent whose birthday, excluding year of birth, falls later in that year; but. Quesos Para Gratinar Bajos En Grasa, 19138.15(509,514) Rules for coordination of benefits. Longer Shorter Rule If two or more plans cover a person as a dependent child of a divorced or separated parent and the dependent: Is over the age of 18; and There is no court decree/order in place The plan of the parent whose plan was effective first is primary over the plan of the parent whose plan was effective second. Coordination of Benefits 77. Beneficiaries may become entitled to Medicare based on ESRD. Rule changes put into effect 01/24/2022. Netextender Rolling Back, Nautical Science Salary In Nigeria, Sec. Coord. Rule 120-2-48-.02 Purpose and Applicability . If more than one issuer pays or provides benefits under the plan, the issuer designated as primary within the plan is responsible for the plan's compliance with this chapter. How do I sign up for Medicare when I turn 65? The primary plan picks up its coverage amount. Benefits of enrollees (whether active employees or retirees) with coverage both through FEHB and through a spouse's private sector employer are coordinated according to the NAIC guidelines. the plans do not agree on the order of benefits, this Rule (4) is ignored. : "uIl_. +DzuXn2i' 6\ endstream endobj startxref 0 %%EOF 108 0 obj <>stream on the order of benefits, this rule is ignored. This is called coordination of benefits. Reasonable transportation expenses up to $1,000. triangle veterinary hospital; less competitive speech pathology graduate programs 2020; what does the bible say about being disinherited; patent attorney trainee; osrs plank sack worth it; examples of sincerely held religious belief covid vaccine; joe mclemore obituary detroit, michigan. (5) Longer or Shorter Length of Coverage. hVmoH+1Qyw-U%E|pXzYvd Between the ages of 19 and 65, a worker in America is more likely to be disabled rather than die. To view this and other publications, visit the agency's Website at . In a statement, Blue KC acknowledged that coordination of benefits can be confusing for members and that the company follows rules of state and federal regulators, modeled on standards set by the . R590-131 Accident and Health Coordination of Benefits Rule. You're insured through your employer and your . This rule does not apply if the rule labeled D(1) can determine the order of benefits. Privacy Accessibility California Office of Administrative Law Accessibility California Office of Administrative Law This is called coordination of benefits. ABC 80839 2018/04 Toll free 1-800-661-6995 ab.bluecross.ca Note: Leave credits can be used during the seven-day waiting period for DI claims. Longer/Shorter If none of the above rules apply, the primary plan is the plan that has covered the member longer. Sample 1 Related Clauses Longer/Shorter Length of Coverage (II) if both parents have the same birthday, the plan that has covered the parent longest is the primary plan. (d) regarding COBRA or state continuation coverage: (i) if a person whose coverage is provided pursuant to COBRA or under a right of continuation pursuant to state or other federal law is covered under another plan, the plan covering the person as an employee, member, subscriber, or retiree, or covering the person as a dependent of an employee, member, subscriber, or retiree is the primary plan and the plan covering that same person pursuant to COBRA or under a right of continuation pursuant to state or other federal law is the secondary plan; (ii) if the other plan does not have this rule, and if, as a result, the plans do not agree on the order of benefits, this rule is ignored; and. Code A - MODEL COB PROVISIONS; . Please refer to your policy for more information on "Coordination of Benefits." First, benefits of a plan covering a person as an employee, member, or subscriber. However, two health plans may also help reduce out-of-pocket expenses when you need health care. 1. The goal is to make sure that the combined payments of all plans do not add up to more than your covered health care expenses. the plan that covered the person for the longer period of time is the primary plan and the plan that covered the person for a shorter period of time is the secondary plan. Longer Shorter Rule If two or more plans cover a person as a dependent child of a divorced or separated parent and the dependent: Is over the age of 18; and There is no court decree/order in place The plan of the parent whose plan was effective first is primary over the plan of the parent whose plan was effective second. Termination Prior to Maturity Date; Survival All covenants, representations and warranties made in this Agreement shall continue in full force until this Agreement has terminated pursuant to its terms and all Obligations have been satisfied. Short first; Long first; Coordination Abbreviation. fremont hospital deaths; what happened to tropical tidbits; chris herren speaking fee; boracay braids cultural appropriation; Note: Employees can use leave credits such as sick leave, vacation, and other paid time off to add to their claim benefits. R590-116, Valuation of Assets. b. Top-Heavy Rules 208 Effects on Other Benefits and Social Security 209 CLAIMS, APPEALS AND ADMINISTRATIVE 209 This process lets your patients get the benefits they are entitled to. (ii) If the other plan does not have this rule, and if, as a result, the plans do not agree on the order of benefits, this rule does not apply. It may include rules about who pays first. A. Blue Shield is a registered trade-mark of the Blue Cross Blue Shield Association. Coordination of Benefits G E T T I N G S T A R T E D Learn how Medicare works with other health or drug coverage and who should pay your bills first. Short first; Long first; Coordination Abbreviation. (b) If the primary plan is a closed panel plan and the secondary plan is not a closed panel plan, the secondary plan must pay or provide benefits as if it were the primary plan when a covered person uses a nonpanel provider, except for emergency services or authorized referrals that are paid or provided by the primary plan. The , COB. The regulation, at 2560.503-1 (e), defines a claim for benefits, in part, as a request for a plan benefit or benefits made by a claimant in accordance with a plan's reasonable procedure for filing benefit claims. Examples of these types of situations are major medical coverages that are superimposed over base plan hospital and surgical benefits, and insurance-type coverages that are written in connection with a closed panel plan to provide out-of-network benefits. Part 825.. 2 Pregnancy Discrimination Act of 1978 (PDA), 42 U.S.C. COB helps insurance companies with the medical claims billing process. Longer Shorter Rule If two or more plans cover a person as a dependent child of a divorced or separated parent and the dependent: Is over the age of 18; and There is no court decree/order in place The plan of the parent whose plan was effective first is primary over the plan of the parent whose plan was effective second. Coordination of benefits creates a framework for the two insurance companies to coordinate benefits so they pay their fair share when both plans pay. Coordination of Benefits G E T T I N G S T A R T E D Learn how Medicare works with other health or drug coverage and who should pay your bills first. For unemployment benefits, the general aggregation rules (Article 6 of the Coordination Regulation) do not apply. (IV) EFFECT ON THE BENEFITS OF THIS PLAN. 1307 - Group Coordination Benefits [Formerly Regulation 61] 18 Del. The . Short first; Long first; Coordination Abbreviation. (iv) The person's length of time covered under a plan is measured from the person's first date of coverage under that plan. 2601 et seq. . (c) regarding an active employee, or retired, or laid-off employee: (i) the plan that covers a person as an active employee, that is, an employee who is neither laid off nor retired or as a dependent of an active employee is the primary plan. Lil Jon What Sound, New York State Medicaid Requires Coordination of Benefits. R590-129 Unfair Discrimination Based Solely Upon Blindness or Physical or Mental Impairment. Death Benefits may cover funeral expenses or wage replacement to a spouse and/or dependent children under the age of 18 . on the order of benefits, this rule is ignored. Subject 120-2-48 GROUP COORDINATION OF BENEFITS Rule 120-2-48-.01 Authority. Bolt On Rake Kit For Harley Davidson, See the Coordination of Benefits Transactions Basics. a. The reason for this is to reduce _________. (ii) If the other plan does not have this rule, and as a result, the plans do not agree on the order of benefits, this rule does not apply. The benefits of the policy or plan of the parent whose birthday, excluding year of birth, falls earlier in a year are determined before the . Benefits by this Policy will not be increased by virtue of this coordination of benefits limitation. Coordination of benefits, Claims, The appeals process, and COBRA and . Coordination of benefits Coordination of benefits is the sharing of costs by two or more health plans Depends on Medicare eligibility Age Disability . What is coordination of benefits? Upon completion of the 18 or 30 month coordination period, Medicare will revert to primary payer status and will remain primary as long as dual entitlement exists. The plan that covered the parent the shorter time is the secondary plan. Casey Eye Institute Bend Oregon, History: 33-1-313, MCA; IMP, 33-15-304, 33-18-201, 33-22-225, 33-22-226, 33-22-502, MCA; NEW, 1987 MAR p. 1766, Eff. When both health plans combine coverage in the right way, you can avoid a duplication of benefits, while still getting the health care to which you're entitled. Understanding the Opting-out Options. Model Regulation to Implement Rules Regarding Contracts and Services of Health Maintenance Organizations. The other plan, (called the secondary plan) may then pay additional benefits. Coordination of Benefits G E T T I N G S T A R T E D Learn how Medicare works with other health or drug coverage and who should pay your bills first. (a) If the preceding rules do not determine the order of benefits, the plan that covered the person for the longer period of time is the primary plan and . Blue Shield is a registered trade-mark of the Blue Cross Blue Shield Association. on the order of benefits, this rule is ignored. If both parents have the same birthday, the benefits of the plan which covered the parent longer shall be determined before those of the plan which covered the other parent for a shorter period of time. Longer Shorter Rule If two or more plans cover a person as a dependent child of a divorced or separated parent and the dependent: Is over the age of 18; and There is no court decree/order in place The plan of the parent whose plan was effective first is primary over the plan of the parent whose plan was effective second. (d) If a person is covered by more than one secondary plan, the order of benefit determination rules of this subchapter decide the order in which secondary plans benefits are determined in relation to each other. Carlthorp School Uniform, longer shorter rule for coordination of benefits longer shorter rule for coordination of benefits. Shpallje publike N baz t skems organizative aktuale n fuqi dhe nevojs pr implementimin e kuadrit n Departamentin e Mjedisit duke u bazuar n nenin 8 t Ligjit t Puns dhe Pikn 3 (c) t Seksionit V t Rregullores s KEK Sh. Additionally, large employers may have their own COB rules for medical claims. (D) the plan covering the noncustodial parent's spouse. a. Blue Shield is a registered trade-mark of the Blue Cross Blue Shield Association. Medicare.gov. Health insurance plans have a coordination of benefits system when the member has multiple health plans. (iii) The start of a new plan does not include: (A) A change in the amount or scope of a plan's benefits; (B) A change in the entity that pays, provides or administers the plan's benefits; or. Posted at 18:48h in lilibet birth certificate tmz by 101 main street suite 110 medford, ma 02155. Exceptions to group health plan rules In this section, we talk only about Group Health Plans from current employment (not retiree or COBRA) Short-term disability payments are progressive - those who make more receive a lesser percentage of replaced wages. 10/16/87; AMD, 2010 MAR p. 2958, Eff. (5) Longer or shorter length of coverage. When a person is covered by two (2) or more plans, the rules for determining the order of benefit payments are as follows: 1. . Rule 5: Longer/Shorter Length of Coverage If none of the four previous rules determines the order of benefits, the plan that covered the person for the longer period of time pays first; and the plan that covered the person for the shorter period of time pays second. Latest version of the adopted rule presented in Administrative Rules of Montana (ARM): For questions regarding the content, interpretation, or application of a specific rule, please contact the agency that issued the rule. Neither plan will pay more than 100% of the total health care costs, so youre not going to get double the benefits if you have multiple health insurance plans. First, benefits of a plan covering a person as an employee, member, or subscriber. . A claim for group health benefits includes pre-service claims ( 2560.503-1 (m) (2)) and post-service claims ( 2560.503-1 (m) (3)). R590-155, Utah Life and Health Insurance Guaranty Association Summary Document. e. Longer or shorter length of coverage. Lorem ipsum dolor sit amet, consecte adipi. There are two different ways that you can opt-out of a group benefits plan, by waiving the benefit options or refusing benefits entirely. a. coordination period, Medicare will pay first for all Medicare-covered services. If your situation is not described, read your evidence of coverage or . R590-116, Valuation of Assets. Things That Are Soft And Fluffy; Metallic Smelling Discharge From Male Dog; Which Country Has The Most Centenarians Per Capita 2020; 7th House Lord In 5th House Love Marriage; John Keenan Catfish Parents; (1) When a person is covered by two or more plans, the rules for determining the order of benefit payments are as follows: (a) The primary plan must pay or provide its benefits as if the secondary plan or plans did not exist. If both parents have the same birthday, the benefits of the policy or plan which . Benefits Corporation for use in operating the Alberta Blue Cross Plan. b. This is one of the reasons a health plan wants to know if you or your spouse has other coverage; it's not just being curious. Do Not Sell or Share My Personal Information, Youre married and both you and your spouse have separate health plans, A child has dual coverage by married parents, Whichever parent has the first birthday in calendar year, A child has own policy (from school or work) and still on parents policy until 26, A child is married and on spouses policy and continues on parents policy until 26, A child under 26 is pregnant and on a parents plan, Workers compensation and health insurance plan, Medicare and a private health insurance plan, Medicare if employer has 100 or fewer employees; private insurer if more than 100 employees, Private insurer is 100 or fewer employees; Medicare if more than 100 employees, Veterans Administration (VA) and a private health insurance plan, Military coverage (TRICARE) and other health insurance. The primary payer pays what it owes on your bills first, up to the limits of its coverage, and then you or your provider submits the claim to the secondary payer if there are costs the primary payer didn't cover. Longer Shorter Rule If two or more plans cover a person as a dependent child of a divorced or separated parent and the dependent: Is over the age of 18; and There is no court decree/order in place The plan of the parent whose plan was effective first is primary over the plan of the parent whose plan was effective second. . Rule 5: Longer/Shorter Length of Coverage If none of the four previous rules determines the order of benefits, the plan that covered the person for the longer period of time pays first; and the plan that covered the person for the shorter period of time pays second. 550.251 Short title. The health plan coordination of benefits system is used to ensure both health plans pay their fair share. TTY users can call 1-855-797-2627. Here are just a few examples of how coordination of benefits works for dependents: Coordination of benefits is not one size fits all there are a few different types of COB coverages: You should discuss your best options and what your coordination of benefits offers with your benefits administrator or health insurance company. If the other plan's provision for coordination of benefits does not include the rule contained in this division because it is not subject to regulation under this division, but instead has a rule based on the gender of the parent, and if, as a result, the plans do not . You can think of the secondary payer as supplemental coverage to help you pay for out-of-pocket costs. CN. The Plan that covered the person as an employee, member, subscriber or retiree longer is the Primary plan and the Plan that covered . Compensation may impact where the Sponsors appear on this website (including the order in which they appear). Section 7. The Plan that covered the person as an employee, member, subscriber or retiree longer is the Primary plan and the Plan that covered . hb```Y@(Pq!%B `i$ //0~f:X,pKL92q-*y) fG4#n,; D@ Na R endstream endobj 68 0 obj <>/Metadata 4 0 R/OutputIntents 65 0 R/PageLayout/OneColumn/Pages 64 0 R/StructTreeRoot 9 0 R/Type/Catalog>> endobj 69 0 obj <>/Font<>>>/Rotate 0/StructParents 0/Type/Page>> endobj 70 0 obj <>stream Nys Retirement Tier 6 Overtime Limit, Rules for coordination of benefits. This material will be made available in alternative format 5.2.5 If the other plan does not have the rule described in sections 5.2.1, 5.2.2, and 5.2.3 above but instead has a rule based upon the gender of the parent; and if, as a result, the plans do not agree on the order of benefits, the rule based upon the gender of the parent will determine the order of benefits. Your spouse might be on Medicare and you have your own health plan. How does primary and secondary insurance work? Longer Shorter Rule If two or more plans cover a person as a dependent child of a divorced or separated parent and the dependent: Is over the age of 18; and There is no court decree/order in place The plan of the parent whose plan was effective first is primary over the plan of the parent whose plan was effective second. First, benefits of a plan covering a person as an employee, member, or subscriber. (IV) The plan covering the noncustodial parent's spouse, last. The benefits of the policy or plan of the parent whose birthday, excluding year of birth, falls earlier in a year are determined before the . One-Month LIBOR will be determined by using the Interest Settlement Rate for U.S. dollar deposits with a maturity of one month set by ICE Benchmark Administration Limited (ICE) as of 11:00 a.m. (London time) on the LIBOR Adjustment Date (the ICE Method). continuation rule (also known as COBRA) a member is covered under two medical plans with one of the plans being a COBRA plan. Coordination of Benefits rules can vary from state to state. The health plan that pays first depends on the type of plan, size of the company and location. 5. First send the claim to the plan of the parent with the birthday that comes first in the year. 12/24/10. The section provides guidance and instructions for investigating and analyzing issues that arise with regard to life and health insurance benefits, long-term and short-term disability benefits, severance benefits, pension or other retirement benefits, and early retirement incentives. The , COB. Code A - MODEL COB PROVISIONS; . Apr. It works this way: Health insurance companies have COB policies that allow people to have multiple health plans. Lets say you visit your doctor and the bill comes to $100. Those obligations that are expressly specified in this Agreement as surviving this Agreements termination shall continue to survive notwithstanding this Agreements termination. The two insurers pay their portions of the claim and then the member pays the rest of the bill. Coordination Number. When you're covered by two or more insurance plans, PEHP uses state guidelines to determine which portion of your claims each plan pays. The primary plan shall pay or provide its benefits as if the secondary plan or plans did not exist. Section 33-2-9. If a work-related death occurs, the following benefits may be payable: Burial expenses up to $10,000. Arizona Antenna Tv Guide, First, benefits of a plan covering a person as an employee, member, or subscriber. Second, benefits of a plan of an active worker covering a person as a dependent. Check with your plan's benefits administrator to see how your employer plan works with Medicare. 1. a. on the order of benefits, this rule is ignored. Longer or Shorter Length of Coverage. 2000(e) et seq. It may include rules about who pays first. This is only an outline of some of the most common ones. 4.1 Loss of Time (Short Term Disability) Benefits IV-1 4.2 Long Term Disability Benefits IV-2 4.3 Offset IV-2. H|UM0W`;!aJJH==%A|8L1b~Q<7`!_&2&|!E8uD&o&0%M0SZVVS\aim*A+(xam%F4EnJUjE;sYBqb+DZ~oYkE/!&Ru;k;39B!S6%C5LX=yr0yxlAyXhf]aQ4r'D)X;&KV3bn Rules for Coordination of Benefits . Longer or Shorter Length of Coverage. (7 . Then, the secondary insurance plan will pay up to 100% of the total cost of health care, as long as its covered under the plan. If none of these rules determines the order of benefits, the benefits of the plan that covered an employee, member, or subscriber longer are determined before those of the plan that covered that person for the shorter term. Part 825.. 2 Pregnancy Discrimination Act of 1978 (PDA), 42 U.S.C. Longer/Shorter Length of Coverage. The primary carrier covers the major portion of eligible bills, and the secondary carrier may cover any remainder. Duration of Coverage All required insurance shall be maintained during the entire term of the Agreement. Note: Leave credits can be used during the seven-day waiting period for DI claims. This is a comparison of: The Age Discrimination in Employment Act (ADEA) affects both the short- and long-term group disability benefits for people employed after age _______. (d) If a person is covered by more than one secondary plan, the order of benefit determination rules of this chapter decide the order in which secondary plans' benefits are determined in relation to each other. Short forms to Abbreviate Coordination. (a) If the preceding rules do not determine the order of benefits, the plan that covered the person for the longer period of time is the primary plan and . Yb+!Kn{m|p.~7S Chris Farley Brother Joe Dirt, This rule does not apply if the rule under section D(1) can determine the order of benefits. Second, benefits of a plan of an active worker covering a person as a dependent. E. Longer/Shorter Length of Coverage If none of the above rules determines the order of benefits, the benefits of the plan which covered an employee, member o subscriber longer are determined before those of the plan which covered that person for the shorter term. Q*u`m,(dMe]T.ri+sX#)x$0nk$xQ[5pJ%'Z|B . (2)(a) Except as provided in (b) of this subsection, a plan that does not contain order of benefit determination provisions that are consistent with this chapter is always the primary plan unless the provisions of both plans, regardless of the provisions of this section, state that the complying plan is primary. Our websites do not, and are not intended to, provide a comprehensive list of all companies that may provide the products and services you are seeking. Longer or Shorter Length of Coverage. Longer/Shorter If none of the above rules apply, the primary plan is the plan that has covered the member longer. longer shorter rule for coordination of benefits, co workers relationship and job satisfaction, Wake Forest Veterinary Pathology Residency, Nc Medicaid Eligibility Income Chart 2021. b. . This rule does not apply if the rule under section D(1) can determine the order of benefits. If you still need help, try calling the benefits coordination hotline at 1-855-798-2627. Lets say thats $50. Nc Medicaid Eligibility Income Chart 2021, DENSO Health & Welfare Plan DENSO Manufacturing Arkansas, Inc. (DMAR) DENSO Manufacturing Athens Tennessee, Inc. (DMAT) DENSO Manufacturing Michigan, Inc. (DMMI) 5. ; 29 C.F.R. The weekly benefit amount from DI or PFL is $275. This Regulation is adopted and promulgated by the Commissioner of Insurance pursuant to the authority set forth in O.C.G.A. MO-432 (PDF) ST-432 (PDF) . The coordination of benefits transaction is the transmission from any entity to a health plan for the purpose of determining the relative payment responsibilities of a health plan for health care claims or payment information. Large employer plans can create their own rules. If both parents have the same birthday, the benefits of the policy or plan which . The $500 minus $275 equals a $225 per week wage loss. Section 7. There are a few different ways to update your Medicare coordination of benefits. Longer or Shorter Length of Coverage - The plan that covered the patient longer is the primary plan and the plan that covered the patient the shorter period of time is the secondary plan. ; 29 C.F.R. Coordination Number. This is one of the reasons a health plan wants to know if you or your spouse has other coverage; it's not just being curious. On October 28, HHS, Labor, and Treasury released a final rule governing excepted benefits coverage, lifetime and annual limits, and short-term coverage. (i) If the preceding rules do not determine the order of benefits, the plan that covered the person for the longer period of time is the primary plan and the plan that covered the person for the shorter period of time is the secondary plan. Rule Title: RULES FOR COORDINATION OF BENEFITS. Coordination of Benefits. e. Longer or shorter length of coverage. The Plan shall pay benefits as provided in these Rules and Regulations only to the extent that the The benefits of the policy or plan of the parent whose birthday, excluding year of birth, falls earlier in a year are determined before the benefits of the policy or plan of the parent whose birthday, excluding year of birth, falls later in that year; but. (ii) if the person is a Medicare beneficiary; and if as a result of the provisions of Title XVIII of the Social Security Act and implementing regulations, Medicare is: (A) secondary to the plan covering the person as a dependent; (B) primary to the plan covering the person as other than a dependent (e.g.