Coordination of benefits.

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  • (1) The commissioner shall:
    • (a) adopt rules concerning the coordination of benefits between accident and health insurance policies;
    • (b) publish a coordination of benefits guide;
    • (c) post the coordination of benefits guide on the state insurance exchange; and
    • (d) work with the Health Data Authority, health care provider groups, and with state and national organizations that are developing uniform standards for the electronic exchange of health insurance claims to develop standardized language regarding coordination of benefits for the purpose of including the standardized language in an insurer's explanation of benefits.
  • (2) Rules adopted by the commissioner under Subsection (1):
    • (a) may not prohibit coordination of benefits with individual accident and health insurance policies;
    • (b) shall apply equally to all accident and health insurance policies without regard to whether the policies are group or individual policies; and
    • (c) shall include standardized language regarding the coordination of benefits process that shall be included in each insurer's accident and health insurance policy.




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