Coordination of Benefits (COB) is a process by which two or more insurers who are insuring the same person for the same or similar group health coverage limit the total benefits received by the insured. The primary health care is the health insurance that will pay first on medical claims. Secondary health insurance will pay after the primary health insurance pays their portion. At no point will the combination of primary and secondary health insurance pay more than 100% of the claim that is being paid.
An employee is always primary on his or her own coverage. A spouse who is covered under a group plan would be secondary on the spouse's plan. Dependents are covered on a primary basis by the health plan of the spouse with the earliest birthday during a calendar year also known as the birthday rule.
For example, Jim Ventrusca has health insurance for himself through his employer and he is also covered under his wife's plan. If Jim, had gall bladder surgery that cost $5,000 his plan would be primary and pay after he has met his deductible. Let's say Jim's health plan had a $500 deductible and his wife's plan had a $250 deductible. Jim's primary health care plan by definition will pay after his $500 deductible is met. Once the coinsurance maximum is met then the secondary payor will pay on the claim.
In our example above, the surgery cost was $5,000 and Jim will pay the first $500 fully out of his pocket. The remainder is $4,500 which in our example is paid at 80% up to an annual out of pocket maximum of $2,500. So Jim is responsible for 20% of the remaining $4,500 or $900.
Jim's wife has a plan that he is secondary on and this plan will pay the $250 deductible that Jim has through his wife's employer. This secondary payment allows Jim to collect back a portion of his $500 claim. There may also be coordination of benefits on the coinsurance depending upon the plans that are being coordinated by the two health insurers involved. Coordination of benefits also occurs on other claims for dental, vision and other employee benefits offerings.
The definition of primary health care or health insurance is a complex transaction. Talk to your human resources department if you want more information on how coordination of benefits will work for your specific case. Understanding which plan is primary and how the coordination of benefits process works can save you money in the long run. However, you should always evaluate what the cost of insurance is for you. How much do you pay per pay period and how much does your spouse pay as well. You may be overspending relative to the potential payout from coordination of benefits.
There are currently some 15 million Americans who own real estate investment property, and more and more of them are discovering the advantages of using 1031 tax-free exchanges for deferring capital gains taxes when they sell. A 1031 exchange is a provision in the IRS code that permits investment property owners to sell properties and buy new ones without having to pay taxes on the sale of the old properties, assuming stipulations concerning the use of the proceeds and time limits have been met.
Investors have 45 days following the sale of their old properties to find a new one and to comply with particular written notice provisions, as outlined by the IRS. The purchase of the new property must then close within 180 days. If those provisions are met, the investor will pay no federal income taxes on the property, assuming the new property is an investment like the one just sold. The replacement property must be of equal or greater value.
The property can be multiple houses, farms, or other real estate, but it can't be the investor's principle residence. The IRS prohibits using a 1031 exchange for the purchase of a new home. However, there is an exception to that rule. If the investor rents out a home for two years following the exchange, that house can then be converted to the investor's place of residence, since the home was initially used to fulfill the stipulations of a 1031 exchange, which specify that an investment house must be replaced with another investment house.
If an investor chooses to take that route, after five years from the date of the new home's purchase, that home can then be sold and the taxes excluded, due to an IRS exclusion for the sale of a primary residence, which can be $500,000 for married couples and $250,000 for an individual.
This can be a great way to avoid taxes on a significant amount of profit from investment in houses, but you'll want to make certain you have followed the tax code meticulously. If you want to learn more about 1031 tax-free exchanges, you can visit www.irs.gov and consult with your own tax consultant, accountant, or attorney. It could save you thousands of dollars while you're moving up the ladder in your overall real estate investment strategy.
Both Scott Cooper & Jeanette Joy Fisher are contributors for EditorialToday. The above articles have been edited for relevancy and timeliness. All write-ups, reviews, tips and guides published by EditorialToday.com and its partners or affiliates are for informational purposes only. They should not be used for any legal or any other type of advice. We do not endorse any author, contributor, writer or article posted by our team.
Scott Cooper has sinced written about articles on various topics from Health Insurance, Insurance and Wellness. Scott is a partner in ESP Benefit Design, an employee benefits insurance firm based in Westerville, Ohio. (614-882-8535) Scott has an MBA from Franklin University. Scott has worked with over 6,000 customers. Email Scott at scott@espbd.comVisit. Scott Cooper's top article generates over 201000 views. to your Favourites.
Jeanette Joy Fisher has sinced written about articles on various topics from Real Estate, Network Marketing and Real Estate. Jeanette Fisher, author of interior design, real estate investing, and home staging books teaches home sellers five ways to get more money from their home sale.. Jeanette Joy Fisher's top article generates over 135000 views. to your Favourites.