In determining the amount to be paid by the secondary plan
on a claim, should the plan wish to coordinate benefits, the secondary
plan must calculate the benefits it would have paid on the claim in
the absence of other health care coverage and apply that calculated
amount to any allowable expense under its plan that is unpaid by the
primary plan. The secondary plan may reduce its payment by the amount
that, when combined with the amount paid by the primary plan, results
in the total benefits paid or provided by all plans for the claim
equaling 100 percent of the total allowable expense for that claim.
In addition, the secondary plan must credit to its plan deductible
any amounts it would have credited to its deductible in the absence
of other health care coverage.
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