For IPF:
Phone: 1-888-880-8222
Fax: 202-347-7339

For IHF:
Phone: 1-888-880-8222
Fax: 202-383-3905

620 F Street, NW
Washington, DC 20004

About Us

Summary Plan Description

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Coordination of Benefits

Occasionally, a patient entitled to receive benefits under this plan will also be eligible to get similar benefits under another group health insurance plan. Generally, this coverage is available from their spouse’s plan.

If this happens, the two plans will coordinate their benefit payments so that the combined payments of both plans will not be more than the actual expenses. One plan (the primary plan) will pay its full benefits. The other plan (the secondary plan) will pay any expenses over the primary plan benefits up to the maximum amount that it would pay if this provision were not in force.

The order of payment is determined as follows:

  • if one plan does not have a coordination of benefits provision, it is the primary plan.
  • if the other plan includes a coordination of benefits or non-duplication provision, the plan covering the patient as an employee will be considered the prime plan.

With respect to dependent children, the plan covering the parent whose birthday falls earlier in the calendar year will be considered the primary plan. If both parents have the same date of birth, the plan that covered one of the parents longer will be considered primary. (A person’s year of birth is not relevant to application of this rule.)

When parents are separated or divorced, the order of coverage is as follows:

  • the plan of the parent with custody is primary;
  • the plan of the spouse of the parent with custody pays secondary; and
  • the plan of the parent without custody pays last