When You Have More Than One Plan with BCBSRI If you are covered under more than one plan with us, you are entitled to covered benefits under both plans. If one plan has a benefit that the other(s) does not, you are entitled to coverage under the plan that has the benefit. The total payments you receive will never be more than the total allowable expense for the services you receive.
When You Are Covered by More Than One Insurer A healthcare coverage plan is considered the primary plan and its benefits will be paid first if: • the plan does not use similar COB rules to determine coverage; or • the plan does not have a COB provision; or • The plan has similar the COB rules and is determined to be primary under the order of benefit determination rules described below. Benefits under another plan include all benefits that would be paid if claims had been initially submitted under that plan. The following factors are used to determine which plan is primary and which plan is • if you are the main subscriber or a dependent; • if you are married, which spouse was born earlier in the year; • the length of time each spouse has been covered under the plan; • if a parental custody or divorce decree applies; or • if Medicare is your other coverage then Medicare guidelines will apply. These factors make up the order of benefit determination rules, described in greater detail below:
Policy Grievance – Union Grievance The Union may institute a grievance alleging a general misinterpretation or violation of this Agreement by the Employer by submitting a written grievance at Step No. 1 within twenty (20) days after the circumstances have occurred. This section shall not apply to disciplinary grievances or application of competitive clauses under this Agreement.
Union Grievance The Union may initiate a grievance if the grievance involves a group of employees and if the grievance is submitted in writing within fourteen (14) calendar days from the date the employees were or should have been aware that the grievance existed.
Association Grievance A grievance, as defined in Section 7.1, relating to occurrences actually involving at least three (3) nurses or arising under the Association Business article, may be initiated by the Association at Step 2 of the above-mentioned procedure by the filing of a written grievance, signed by a representative of the Association, within thirty (30) calendar days from the date of occurrence. Such grievance shall describe the problem and the contract provisions alleged to have been violated.