Coordination of Benefits (COB)
COB is the process used to pay healthcare expenses when you or an eligible dependent are covered by more than one healthcare insurance policy (including Medicare). The Third Party Administrator (TPA) follows state law rules to determine which policy pays first (primary) and the obligations of the other policy (secondary). The combined payments will not exceed the actual amount of your bills.
Aetna and COB Smart
Aetna – our Third Party Administrator (TPA) – is partnered with COB Smart® to more efficiently identify EHP members who have other insurance coverage. Aetna receives weekly files from COB Smart® with those EHP members matching other insurance and will automatically update your record. This means less paperwork for most EHP members. Some smaller insurance companies may not currently participate in COB Smart®. In these instances, you will be asked by Aetna to complete the COB form. Detailed instructions on how to complete the process are on the form.
How and When to Complete the COB Process
Each year, the member is responsible for making sure their COB information is updated with the health plan’s TPA. COB also needs to be updated when a life event occurs involving the addition/deletion of a dependent or if other insurance is acquired. By doing so you can avoid any delay of payment of claims for your dependents.
If you have questions about the annual COB process, please contact Aetna at 833.414.2331.
