Coordination of Benefits (COB) occurs when 2 or more health plans cover the same individual.

When you are covered by more than one health plan, it is important to determine which plan pays first (primary) and which plan pays second (secondary). PHPMM follows the National Association of Insurance Commissioners (NAIC) guidelines and Michigan law when determining which plan pays primary and which pays secondary. By following these guidelines, health plans are able to coordinate policies together, eliminating or minimizing out-of-pocket costs (copays and deductibles) for members.

PHPMM is currently updating and verifying COB for many of our members.  We will be mailing letters to members along with a form that should be used to tell us if you do or do not have any other insurance coverage.  Similarly, we are also contacting our members who are seniors and who may be eligible for Medicare.  If you get either letter, just fill out the form, sign and date it, then send it back to us in the postage paid envelope that will be provided.  Providing the information on the form helps prevent delays with claim processing and incorrect payments to your doctor.

We need to know the following information about your other health insurance, which may be found on the health insurance identification card:

• The name of the insurance company
• The insurance company’s phone number
• The policy or identification number
• The name of the employer who holds the policy
• Who is covered on the policy
• When the policy became effective

Helping us maintain this information helps ensure that your claims are paid correctly the first time, with no unnecessary delays.

Click here to go directly to our Online Service Center and update your COB information.