State RegulationsMI specificDifficulty 3/5
A Dearborn employee is covered under group plans from two employers. Plan A is determined to be primary and pays its full obligation on an allowable claim. As the secondary plan under Michigan coordination of benefits rules, what is the most Plan B may pay?
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
Michigan's coordination of benefits statute, MCL 550.251-.255, applied through M.C.L. 500.3402b to group accident and health coverage, caps the secondary plan at the amount it would have paid as the primary plan; the two plans together may not pay more than the allowable expenses for the claim. This anti-duplication ceiling is what distinguishes coordination from simply stacking coverages.
Why the other options are wrong
- B) Coverage from two employers is precisely the situation the coordination rules are designed to govern.
- C) Duplicate coverage never doubles recovery; the statute caps combined payment at the allowable expenses.
- D) Plan B never owes more than its own coordinated obligation, regardless of the balance left unpaid.
Memory hook
Secondary pays what it would have paid first — never more.