The Coordination of Benefits provision in dental benefits plans is a set of rules that are followed when a patient is covered by more than one dental benefits plan. These rules determine the order in which the plans will pay benefits. If the MetLife dental benefit plan is primary, MetLife will pay the full amount of benefits that would normally be available under the plan. If the MetLife dental benefit plan is secondary to the other dental plan, according to the rules, MetLife will pay the benefits under this plan reduced by the amount of benefits paid by the secondary dental insurance plan.
Under the Cigna Prepaid (DHMO) dental plan, Coordination of Benefits rules apply to specialty care only. The primary plan determines and provides or pays benefits without taking into consideration the existence of any other plan. The secondary plan determines, and may reduce its benefits after taking into consideration, the benefits provided or paid by the primary plan.