Coordination of Benefits

The coordination of plan benefits, meaning which plan pays primary, for your dependents are determined as follows:

1. If your spouse has group insurance coverage and he/she is not eligible for Medicare, his/her employer’s plan is always the primary plan for your spouse.
2. The primary plan for your dependent child(ren) is the parent’s plan whose birthday occurs first in the calendar year. If both parents have the same birthday, the plan that has been in force for the longest period of time is the primary carrier.
   
   Example: If the mother’s birthday is March 15 and the father’s birthday is June 24, the mother’s insurance plan is the primary plan for the dependent children.
   
   
3. If there is a court decree which establishes financial responsibility for a dependent child’s health care expenses, the plan of the parent with that responsibility is primary.

It is likely your medical plan will require you to complete a questionnaire asking if you or your dependents have other insurance coverage. If you have other coverage your plan will ask for the name of the company. This verifies how benefits are coordinated and must be answered BEFORE claims are paid.