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Employer Services Coordination of Benefits

Guidance for information regarding the Coordination of Benefits program and Benefits Coordination and Recovery Center (BCRC).

Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: February 11, 2020

The Benefits Coordination & Recovery Center (BCRC) consolidates the activities that support the collection, management, and reporting of other insurance coverage for Medicare beneficiaries. The purpose of the coordination of benefits (COB) program is to identify the health benefits available to a Medicare beneficiary and to coordinate the payment process to prevent mistaken payment of Medicare benefits. The BCRC does not process claims or claim-specific inquiries. The Medicare Administrative Contractors, intermediaries and carriers are responsible for processing claims submitted for primary or secondary payment.

The BCRC should be contacted to:

  • Report employment changes, or any other insurance coverage information.
  • Report a liability, auto/no-fault, or workers compensation case.
  • Ask general Medicare Secondary Payer (MSP) questions.
  • Ask questions regarding Medicare Secondary Development letters and questionnaires.

Please click the Coordination of Benefits link in the Related Links section below for more information. Note: If Medicare paid primary when a Group Health Plan (GHP) had primary payment responsibility, CMS will request repayment. For more information on this process, click the Group Health Plan Recovery link in the Related Links section below.

Voluntary Data Sharing Agreements (VDSAs)

A VDSA is an agreement that allows employers and CMS to send and receive group health plan enrollment information electronically. CMS has entered into VDSAs with numerous large employers. Where discrepancies occur in the VDSAs, employers can provide enrollment/disenrollment documentation. The VDSA program includes Part D information, enabling VDSA partners to submit records with prescription drug coverage, be it primary or secondary to Part D. For more information, please see the Voluntary Data Sharing Agreements page.

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DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.