In a scenario where an employee has two group plans, which plan is considered primary?

When an employee has two group health insurance plans, the primary plan is determined based on the coordination of benefits rules established by insurance companies. Typically, the plan that has been in effect for the longest period is designated as the primary plan. This is because insurers operate under the assumption that the longer a participant has been in a plan, the more likely that plan's benefits will align with the individual's healthcare needs and history.

Having the longest in-force coverage ensures that the primary plan, which pays first, takes into account the established relationship between the employee and that insurance provider. This arrangement helps streamline the claims process and establishes a clear hierarchy for coverage, reducing ambiguity about which plan to bill first.

The other options do not follow the standard coordination of benefits rules and do not specify criteria used in determining primary coverage. For instance, the duration of the coverage is more definitive than arbitrary choices such as which plan the employee selects or premium amounts.