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Coordination of Benefits

You and other members of your household may be covered by more than one health insurance plan. Coordination of benefits is a way to coordinate all of your benefits when you have dual coverage.

Please take a few moments to complete our COB forms. After we receive your information, we'll be able to ensure that you have the best possible coverage from your plans. Together, we can work to control the increasing cost of health care and minimize your out-of-pocket expenses.

We encourage you to submit your information online using our secured COB form. Start by clinking the Login button on the left of this page to access this and other features of Member Secured Services. Then go to the Coordination of Benefits page under the Manage My Plan tab.

To submit by mail or fax, download and complete a Coordination of Benefits Questionnaire (PDF).

Use our Secure Online COB Form        - OR - Download & Mail PDF Form (PDF)

Note: Before you start the Online COB Form, please gather your ID cards for each of your health care plans.

If you have questions, please refer to our FAQs.