Coordination of benefits

If you or your dependants are covered under more than one Group Health Plan, you may be able to coordinate your benefits coverage. Coordination of benefits ensures that you can maximize your reimbursement while claims are made fairly under all plans. Total reimbursement received may not exceed the actual expenses incurred.

Here's how it works

If coordinating between a CWB Retiree and a Non-CWB Retiree spouse:

1. Each of you should send your own claims through your own insurance carrier for payment. Keep a copy of the claim form and any receipts.
2. If a balance remains once the claim is processed by each insurance carrier, then the outstanding balance can be submitted to your spouse's insurance carrier. Copies of the original claim form and receipts, and the explanation of benefits received from the other insurance carrier should be sent along with a claim form which shows your spouse's group policy number and certificate number (contract number).
3. For dependent children, the claim should be filed first by the parent whose birthday is earliest in the calendar year. Procedures for claiming are the same as above.

If coordinating between two CWB Retirees:

1. Each of you should send your own claims under your own certificate number (contract number). When completing the form, make sure you include your spouse’s certificate number (contract number) under the question: "Are any benefits or services provided under any other insurance or plan for the expenses claimed?" Blue Cross will automatically coordinate your benefits coverage.
2. For dependent children, the parent whose birthday is earliest in the calendar year should enter their certificate number (contract number) and name on the top of the claim form. Fill in the other parent's certificate number (contract number) under the coordination of benefits question, "Are any benefits or services provided under any other insurance or plan for the expenses claimed?" Blue Cross will automatically coordinate your benefits coverage.