If you have another health plan or insurance coverage that provides benefits that are the same or similar to your HMSA plan, HMSA will coordinate your HMSA benefits with your other coverage.

Other coverage includes:

• Group health plan or insurance.
• Other group benefit plans.
• Non-group health plan or insurance.
• Medicare or other governmental benefits.
• The medical benefits coverage in your automobile insurance (whether issued on a fault or no-fault basis).

When you have coverage under two group health plans (also known as dual coverage), one plan is primary and the other plan is secondary. In general, the primary plan applies benefits first and the secondary plan applies benefits on the remaining portion not paid by the primary plan. Primary plan payments plus secondary plan payments won’t exceed the eligible charge for the covered service provided. See your Guide to Benefits for more important information on coordination of benefits. A Guide to Benefits is your reference guide and legal document that explains your plan coverage and is available for most plans.

To enable HMSA to coordinate your benefits, you must:

• Present all medical plan membership cards when you visit your doctors. This will help them file your claims accurately, make sure that you get all the benefits you’re entitled to, and prevent delays or denials.
• Complete, print, and mail the Coordination of Benefits Form to HMSA. You can also complete and submit the online form in My Account (from the Forms tab, click Coordination of Benefits).

Note: Refer to your Guide to Benefits for more information on coordinating benefits with automobile insurance (fault or no-fault) and workers’ compensation insurance. Third-party liability coverage is subject to guidelines stated in your Guide to Benefits.