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IBEW Local 11-LA NECA Retiree Health Plan
Summary Plan Description (SPD)


Coordination of Benefits

Some individuals have dental expense coverage in addition to coverage under this Plan. When this happens, the benefits from "Other Plans" will be taken into account. The purpose of the coordination of benefits assures that no participant will receive more money than 100% of reasonable dental charges through payment from both Plans and not allow for payment of more than 100% of charges.

This may require a reduction of benefits under this Plan. "Other Plans" means any plan providing primary coverage on yourself or your dependent.

Benefit Determination

  1. When both plans have coordination of benefits provisions, benefits will be determined first under this Plan if the claimant is covered:
    1. As a participant under this Plan and as a dependent under the other program
    2. As a participant under both plans but has been covered longer under this Plan
  2. When one plan has no coordination of benefits provision, benefits will be determined first under such plan.