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Can Someone Have Two Plans From Same Self-Insured Plan?

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Good morning everyone.  I know someone can have primary and secondary insurance, but we have a participant in a self-insured Plan asking if they can take out a second policy from our Plan to help diffuse some of the costs.  The argument is that you are allowed to have two plans, but I can't seem to find anything that says the primary and secondary can't come from the same Plan.

Does anyone have any guidance?

Thanks in advance!

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A few suggestions for ways to think about your question:

Many BenefitsLink neighbors remind us that an answer to a question about a retirement plan often might be answered by RTFD—Read The Fabulous Document. That reminder might help too with a health plan.

If the employer’s or labor union’s health plan is self-insured—that is, the benefit is provided other than by a health insurance contract, the plan’s documents state which coverage or coverages a participant (or continuee) may or must not choose.

Would it be odd for one health plan to allow more than one non-insured general medical coverage?

Because such a self-insured health plan’s benefits are not paid by a health insurer, might a coordination between distinct coverages be awkward because all benefits are paid by the same obligor?

Peter Gulia PC

Fiduciary Guidance Counsel

Philadelphia, Pennsylvania



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