Depends which truck you buy. When I installed a Super Hitch on my Ford I had to remove the factory hitch. When I installed the Super Hitch on my 2013 Ram I left the stock hitch and installed another receiver below the stock one so this gave my another receiver to use a Super Truss with. I think GM you also remove the factory one.
If you leave off the factory hitch you also might no get the 7 pin/4pin plugs and would have to wire your own. I'm not sure if you can get the integrated brake controller.