Coordination of Benefits (COB)

COB is the process used to pay healthcare expenses when you or an eligible dependent are covered by more than one healthcare insurance policy (including Medicare). The Third Party Administrator (TPA) follows state law rules to determine which policy pays first (primary) and the obligations of the other policy (secondary). The combined payments will not exceed the actual amount of your bills.

UMR - Employee Questionnaire

UMR is the health plan’s Third Party Administrator (TPA). Coordination of Benefits is one of the many administrative functions they provide which helps achieve cost savings for both the health plan and the member.  

UMR utilizes the Employee Questionnaire  below to complete the COB process. You can also complete the process via their website at UMR.com or by calling 800.826.9781.

How and When to Complete the COB Process

Members are required to complete the COB process upon initial enrollment and reviewed each year. You must also complete the process if you experience a life event such as adding or deleting dependents due to marriage, divorce, etc.

The Employee Questionnaire form explains how to complete the COB process. If the process is not completed, payment of medical claims for your dependents may be delayed.

Coordination of Benefits Form for 2021