Frequently Asked Questions

Coordination of Benefits

How are my claims paid if I have other insurance which is primary on myself or my dependents?
My spouse has family coverage, I have LINECO—who is the primary carrier on our children?
My spouse has an HMO plan but we don't like our choice of doctors. Can we just choose any doctor?
Is there a Blue Cross/Blue Shield crossover when both plans use the Blue Cross network?
Medicare is the primary carrier on my claim—how do I get Lineco to pay as secondary?




QUESTION: How are my claims paid if I have other insurance which is primary on myself or my dependents?

ANSWER: Lineco will coordinate benefits, which allows benefits to be paid by two or more Plans up to but not exceeding 100% of the allowable expenses of the claim. If Lineco is secondary, the bill and the other carrier's explanation of benefits is needed.

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QUESTION: My spouse has family coverage, I have LINECO—who is the primary carrier on our children?

ANSWER: Usually the parent whose birthday comes earliest in the year is the primary carrier on the children.

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QUESTION: My spouse has an HMO plan but we don't like our choice of doctors. Can we just choose any doctor?

ANSWER: It depends on how exactly the HMO Plan works. Some HMO Plans do make referrals. To avoid out of pocket expenses, please contact both Plans ahead of time to discuss the issue because the Lineco Plan will not make payment for any amount the Primary Plan did not cover because the Primary Plan's rules or procedures were not followed.

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QUESTION: Is there a Blue Cross/Blue Shield crossover when both plans use the Blue Cross network?

ANSWER: No, at this time there is not any automatic crossover. The claims must be filed with the primary carrier first and then with the secondary carrier. Please refer to the FAQs section of this website for details as to how to file a COB claim.

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QUESTION: Medicare is the primary carrier on my claim—how do I get Lineco to pay as secondary?

ANSWER: If Medicare is primary, then you or your provider should send a copy of the bill and the Medicare explanation of benefits to the Fund office. Note: If you and/or your spouse are eligible to participate in Medicare, this Plan's benefits will be calculated as though benefits under Medicare Part A and Part B have been paid, whether or not you actually enrolled in both Parts. You and your spouse should enroll in both Part A and Part B as soon as you are eligible to do so.

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