284-51-205 The plan of the parent whose birthday falls earlier in the (4)(b)(i)(A) calendar year is the primary plan; or 284-51-205 If both parents have the same birthday, the plan that has (4)(b)(i)(B) covered the parent longest is the primary plan. Coordination WAC For a dependent whose parents are divorced or separated of Benefits 284-51-205 or are not living together, whether or not they have ever been (Cont’d) (4)(b)(ii) married: WAC If a court decree states that one parent is responsible for the 284-51-205 dependent child's health care expenses or coverage and the (4)(b)(ii)(A) plan of that parent has actual knowledge of those terms, that plan is primary. If the parent with responsibility has no health care coverage for the dependent child's health care expenses, but that parent's spouse does, that parent's spouse's plan is the primary plan. This does not apply to any plan year during which benefits are paid or provided before the plan has actual knowledge of the court decree provision; WAC If a court decree states one parent is to assume primary 284-51-205 financial responsibility for the dependent child but does not (4)(b)(ii)(B) mention responsibility for health care expenses, the plan of the parent assuming financial responsibility is primary; WAC If a court decree states that both parents are responsible for 284-51-205 the dependent child's health care expenses or coverage, the (4)(b)(ii)(C) provisions above for parents married or living together determine the order of benefits; WAC If a decree states that the parents have joint custody (4)(b)(ii)(D) without specifying that one parent has financial responsibility or responsibility for the health care expenses or health care coverage of the dependent child, the above provisions for
Coordination of Benefits (Cont’d) 284-51-205 (4)(b)(i)(A) The plan of the parent whose birthday falls earlier in the calendar year is the primary plan; or 284-51-205 (4)(b)(i)(B) If both parents have the same birthday, the plan that has covered the parent longest is the primary plan. WAC 284-51-205 (4)(b)(ii) For a dependent whose parents are divorced or separated or are not living together, whether or not they have ever been married: WAC 284-51-205 (4)(b)(ii)(A) If a court decree states that one parent is responsible for the dependent child's health care expenses or coverage and the plan of that parent has actual knowledge of those terms, that plan is primary. If the parent with responsibility has no health care coverage for the dependent child's health care expenses, but that parent's spouse does, that parent's spouse's plan is the primary plan. This does not apply to any plan year during which benefits are paid or provided before the plan has actual knowledge of the court decree provision; WAC 284-51-205 (4)(b)(ii)(B) If a court decree states one parent is to assume primary financial responsibility for the dependent child but does not mention responsibility for health care expenses, the plan of the parent assuming financial responsibility is primary; WAC 284-51-205 (4)(b)(ii)(C) If a court decree states that both parents are responsible for the dependent child's health care expenses or coverage, the provisions above for parents married or living together determine the order of benefits; WAC (4)(b)(ii)(D) If a decree states that the parents have joint custody without specifying that one parent has financial responsibility or responsibility for the health care expenses or health care coverage of the dependent child, the above provisions for
checklist-forms-2018-hcsc-small-group-analyst-checklist.docx