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I am looking at a law which motivation I don't understand:

WAC 284-51-205

Rules for coordination of benefits.

(1) When a person is covered by two or more plans, the rules for determining the order of benefit payments are as follows:

(a) The primary plan must pay or provide its benefits as if the secondary plan or plans did not exist.

I'm pretty sure there are some historical records about how this rule was born. I mean, the discussions about the rule before it was legislated. Could anyone point to those?

I'd really like to know why is the person covered by more than one insurance can't choose which insurance to use first, if that same exact person is paying for the insurance company service. That doesn't make much sense to me, but I'm a first generation immigration and know to little about the US law in general. This seems to be violating the ideas of private property in my mind -- one is not in control of own money when uses publicly available services.

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It is typically impossible to find a satisfactory answer to such questions about administrative rules, but there is usually some trace. At the federal level, an agency promulgates rules and (these days) leaves an ample trace of statutory authority and departmental reasoning. In this case, there is an analogous trace for the state. WSR 07-13-008 sets forth the rule and authorities. The "why" question is addressed in RCW 43.20.050 under "findings". To get to the undistilled bill that was passed, you go here (Chapter 492, Laws of 1993). That is probably as far as you can go: you won't find committee reports, floor debates etc. on the internet. It is possible that there are additional notes in Olympia. The specific question you raise is not addressed in the available documents, and it is generally unwise to wonder "What were they thinking?" with respect to our legislature. There are a number of political reasons why this provision exists, and it does not egregiously violate any existing legal concepts, primarily because it does not harm the insured, and states have broad powers to regulate all businesses.

  • Thank you so much for your brilliant answer!! This is definitely a good reading! On note on it does not harm the insured. It actually can harm the insured, because different plans have different conditions (including the out-of-pocket limit). – Igor Soloydenko Dec 1 '17 at 18:00
  • Good point, and I don't know how the law (contract) adjudicates that matter. – user6726 Dec 1 '17 at 20:34
  • @IgorSoloydenko: If both primary and secondary insurances apply, then it shouldn't harm the consumer, as the secondary insurance would be covering the remainder, subject to its deductable. If plan A has a $1000 deductible, and plan B has a deductible of $600, then for a $5000 event, the consumer should be out $600 either way. Either plan A pays $4000 and plan B pays $400, or plan B pays $4400 and plan A doesn't pay anything. – sharur Dec 11 at 0:42

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