Birthday Rule Clause Samples
The Birthday Rule is a coordination of benefits guideline used by health insurance providers to determine which parent's plan is primary when a dependent child is covered by more than one policy. Under this rule, the plan of the parent whose birthday falls earlier in the calendar year is considered the primary coverage for the child, regardless of the year of birth. For example, if one parent's birthday is in March and the other's is in July, the March birthday parent's plan pays first. This rule helps prevent duplicate payments and clarifies responsibility between insurers, ensuring efficient claims processing and reducing confusion for families with dual coverage.
Birthday Rule. This rule determines whether a plan is primary or secondary for a dependent child who is covered by both parents' benefit plans and those parents live together. The plan covering the parent whose birthday (month and day only) falls first in a calendar year provides primary coverage for the child. If both parents have the same birthday, then the plan that has been in effect the longest pays as primary. A different set of rules applies to a dependent child whose parents are divorced or separated or are not living together, whether or not they have ever been married:
Birthday Rule. If both parents have medi- cal coverage, the primary plan for dependent children is the plan of the parent whose birth- day occurs first in the calendar year. If birth- days occur on the same day, the parent’s cov- erage that has been in effect longest is primary.
Birthday Rule. The Primary Plan is the Plan of the parent whose birthday is earlier in the year if: The parents are married; The parents are not separated (whether or not they ever have been married); or A court decree awards joint custody without specifying that one party has the responsibility to provide health care coverage. If both parents have the same birthday, the plan that covered either of the parents longer is primary.
Birthday Rule. If both parents have med- ical coverage, the primary plan for dependent children is the plan of the parent whose birth- day occurs first in the calendar year. If birth- days occur on the same day, the parent’s cov- erage that has been in effect longest is primary.
Birthday Rule. When two or more Plans cover the same child as a dependent of different persons who are called “parents” and are not separated or divorced: ♥ The benefits of the Plan of the parent whose birthday falls earlier in a calendar year are paid before those of the Plan of the parent whose birthday falls later in the year. So, if your birthday occurs on May 1st and your spouse’s birthday is on April 16th, then your spouse’s Plan would pay first. ♥ If both you and your spouse have the same birthday, the benefits of the Plan that covered the parent longer are paid before those of the Plan that covered the other parent for a shorter period of time. However, if the other Plan does not have the “Birthday Rule” described above, but instead has a rule based upon the gender of the parent, and if, as a result, the Plans do not agree on the order of benefits, the rule based upon the gender of the parent will determine the order of benefits.
Birthday Rule. The Open Division is available to Hitters who are at least eighteen (18) years of age by the first day of competition at any given event. The Masters Division is available to Hitters who are at least forty-five (45) years of age by the first day of competition at any given event. Hitters who are forty-five (45) years of age and older may elect to compete in both the Open Division and the Masters Division.
Birthday Rule a. The benefits of the plan of the parent whose birthday falls earlier in a year are determined before those of the plan of the parent whose birthday falls later in that year.
b. If both parents have the same birthday, the benefits of the plan that covered the parent longer are determined before those of the plan that covered the other parent for a shorter period of time.
c. If the other plan does not follow the birthday rule, but instead has a rule based upon the gender of the parent, and if as a result, the plans do not agree on the order of benefits, the rule based upon the gender of the parent will determine the order of benefits.