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Determining Primary Coverage
To determine which health care plan pays first as the primary plan, here are some general guidelines:
  • If you are enrolled in the JPMorgan Chase plan and another plan and your other health care plan doesn't have a coordination of benefits provision, that plan will be considered primary, and it will pay first for you and your covered dependents.
  • If your covered dependent has a claim, the plan covering your dependent as an employee or retiree will be considered primary to this plan.
  • If your claim is for a covered child who is enrolled in coverage under both parents' plans, the plan covering the parent who has the earlier birthday in a calendar year (based on the month and date of birthday only, not the year) will be considered primary. In the event of divorce or legal separation, and in the absence of a qualified medical child support order, the plan covering the parent with court-decreed financial responsibility will be considered primary for the covered child. If there is no court decree, the plan of the parent who has custody of the covered child will be considered primary for the covered child. (Please see "Qualified Medical Child Support Orders" in the Health Care Participation section.)
  • If payment responsibilities are still unresolved, the plan that has covered the claimant the longest pays first.
After it is determined which plan is primary, you'll need to submit your initial claim to that plan.
After the primary plan pays benefits (up to the limits of its coverage), you can then submit the claim to the other plan (the secondary plan) to consider your claim for any unpaid amounts. You'll need to include a copy of the written Explanation of Benefits from your primary plan.