McKesson 2005 Annual Report Download - page 207

iii. Medicare benefits will be taken into account for any person while he or she is eligible for Medicare, regardless of whether the
person is entitled to Medicare benefits.
iv. Any rule for coordinating “other plan” benefits with those under the Plan will be applied after the Plan’s benefits have been
figured under the rules of this Section K.2. Allowable Expenses will be reduced by any Medicare benefits available for those expenses.
A person is “eligible for Medicare” if the person is covered under Medicare or is eligible for Medicare but has refused Medicare coverage,
dropped Medicare coverage or failed to make a proper requires for Medicare coverage.
Coverage will not be changed at any time when the Company’s compliance with federal law requires this Plan’s benefits for a person to be
figured before benefits are figured under Medicare.
3. Effect on Benefits.
When the provisions of Section K. operate to reduce the total amount of benefits otherwise payable to a person covered under this Plan
during a calendar year, each benefit that would be payable in the absence of this provision will be reduced proportionately, and such reduced
amount will be charged against any applicable benefit limit of this Plan.
4. Right to Information and Recovery.
a. Whenever payments which should have been made under this Plan in accordance with Section K. have been made under any other
plans, the Insurance Company has the right to transfer to any organizations making these payments any amounts the Insurance Company
determines to be warranted in order to satisfy the intent of the above provisions, and amounts paid in this manner will be considered to be
benefits paid under this Plan and, to the extent of these payments, the Insurance Company will be fully discharged from liability under this
Plan.
b. Whenever payments have been made by the Insurance Company, at any time, for Allowable Expenses in a total amount at any time in
excess of the maximum amount of payment necessary at that time to satisfy the intent of the above provisions, the Insurance Company will
have the right to recover these payments to the extent of such excess, from among one or more of the following as the Insurance Company
shall determine: any individuals to or for or with respect to whom these payments were made, any insurance companies, health care service
plans or any organizations.
1. Payment of Claims. The Insurance Company will process a claim in accordance with this Section L promptly after it receives complete
proof of the claim. If the Insurance Company finds that the claim is payable under the Plan, it will send payment to the Executive. The
Insurance Company has the right to pay any benefits directly to the provider of services or
28
L. PAYMENT OF BENEFITS