Nowadays, many married couples work outside the home to make a living. Therefore, both husband and wife usually have their group medical insurance, which is provided by the employer, and one depends on the other. This type of "double insurance" will lead to over-insurance of individuals, thus creating the temptation to try to profit from illness.

To avoid the temptation, most states have special provisions required by law. The Welfare Coordination Regulation aims to provide the insured with the most prominent insurance coverage. And at the same time, through the formulation of guidelines, it will determine which company will pay as the primary insurer. It will also determine which needs to pay as the secondary insurer when a working couple (or their families) are insured in multiple group insurance policies. It shows that when a person has dual insurance, the insurance company that owns the employee who claims is automatically designated as the primary insurance company. The host company must pay the same claims according to its policy limit. To understand how this works, let's look at the following examples:

Bob and Lily are a couple working in different companies. They are covered by their employer group plans, which also apply to dependents, so they have dual insurance. Let's assume that Bob's illness caused $2200 in medical expenses. According to the welfare coordination clause, his policy automatically becomes primary. Bob's medical insurance plan includes primary medical insurance and a deductible of $200, so the primary insurance company (Bob's insurance company) deducts this amount from the bill of $2200 (Bob must pay first), leaving $2000. The leading insurance company will then pay for its co-insurance. Assuming that the policy requires an 80%/20% split, the insurance company will pay $1600, which is 80% of $2000. It leaves $600 unpaid, which is Bob's share of the remaining $2000 bill (after deducting the deductible), including the $200 deductible plus the other $400.

But Lily's company also provides insurance for Bob, just as a family member. Therefore, Lily's insurance company is the second (or excess) insurance company for his claim. The tier two company will pay any amount the tier one company has yet to pay under its policy. Therefore, assuming that the remaining $600 (Bob's share of total expenses) is below the limit, Lily's company will pay $600. Because of double insurance, Bob's costs were paid in full. But the money he received should be, at most, the actual out-of-pocket expenses.

In addition, when a working couple enjoys the double protection of group insurance, any children born to them will also enjoy the double protection. Before 1985, the coordination of children's welfare often automatically took the father's group plan as the primary plan and the mother's plan as the secondary plan. However, this gender-based program is very different from dinosaurs. Today, parents' dates of birth are also often used as determinants. The plan's first parent in the calendar is designated as the primary insurer. Another parent's plan is secondary. Therefore, if the child of our previous couple is ill, if Lily's birthday is July 5 and Bob's birthday is July 6, Lily's insurance plan will be primary.

（Writer：Frid）