The claim determination period as described in §3.3503 of this title (relating to Definitions) may be used in a plan, with respect to coordination of benefits (COB), in accordance with the following paragraphs (1) and (2) of this subsection.

1. (1) The claim determination period is usually a calendar year, but a plan may use some other period of time that fits the coverage of the group contract. A person may be covered by a plan during a portion of a claim determination period if that person's coverage starts or ends during the claim determination period.
2. (2) As each claim is submitted, each plan is to determine its liability and pay or provide benefits based upon allowable expenses incurred to that point in the claim determination period. That determination is subject to adjustment as later allowable expenses are incurred in the same claim determination period.

Source Note:The provisions of this §3.3505 adopted to be effective June 3, 1994, 19 TexReg 3938.