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Health & Welfare - Coordinating Payments with Other Health Insurance

When your family is covered by more that one health insurance plan, claims should be submitted to the primary payor first. The Alaska Electrical Health & Welfare Plan is usually the primary payor on the employee (participant) and the secondary payor on the spouse. 

The “birthday rule” is applied when determining which plan is primary on covered dependent children. The health plan of the parent whose birthday falls earlier in the year is the primary payor.   In the case of covered step-children, the natural parent's plan is primary and step-parent's plan is secondary, regardless of birth dates.

When the Alaska Electrical Health & Welfare Plan is the primary payor, submit your claims in the usual fashion.  If the Alaska Electrical Health & Welfare Plan is not primary, you or your doctor should submit the claim to the other plan first.  Once the primary plan pays the claim and sends an Explanation of Benefits, you or your doctor may submit a copy of the original claim, along with a copy of the Explanation of Benefits, to the Administrative Office. 

Benefit credits are earned when the Alaska Electrical Health & Welfare Plan is secondary and your other insurance plan pays for health services the Alaska Electrical Health & Welfare Plan would have otherwise paid.  Benefit credits may be used to fulfill your deductible and out-of-pocket limits with the Alaska Electrical Health & Welfare Plan.  If you have already paid your deductible and subsequently earn benefit credits, your deductible will be refunded to you.

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