policyholder or retiree) is the primary plan and the plan that covers the person as a dependent is the secondary plan. WAC If the person is a Medicare beneficiary, and, as a result of the 284-51-205 provisions of Title XVIII of the Social Security Act and (4)(a)(ii) implementing regulations, Medicare is: (4)(a))(ii)(I) Secondary to the plan covering the person as a dependent; and (4)(a)(ii)(II) Primary to the plan covering the person as other than a dependent (e.g., a retired employee); WAC Then the of benefits is reversed so that the plan covering 284-51-205 the person as an employee, member, subscriber, policyholder or (4)(B) retiree is the secondary plan and the other plan covering the person as a dependent is the primary plan. WAC Dependent child covered under more than one plan. Unless there is a court decree stating otherwise, plans covering a dependent child must determine the order of benefits as follows: Rules for WAC For a dependent child whose parents are married or are living Coordination of Benefits Coordination together, whether or not they have ever been married: (Cont’d) of Benefits 284-51-205 The plan of the parent birthday falls earlier in the calendar (Cont’d) (4)(b)(i)(A) 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. WAC For a dependent child whose parents are divorced or separated 284-51-205 or are not living together, whether or not they have ever been (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
policyholder or retiree) is the primary plan and the plan that covers the person as a dependent is the secondary plan. WAC 284-51-205 (4)(a)(ii) If the person is a Medicare beneficiary, and, as a result of the provisions of Title XVIII of the Social Security Act and implementing regulations, Medicare is: (4)(a))(ii)(I) Secondary to the plan covering the person as a dependent; and (4)(a)(ii)(II) Primary to the plan covering the person as other than a dependent (e.g., a retired employee); WAC 284-51-205 (4)(B) Then the of benefits is reversed so that the plan covering the person as an employee, member, subscriber, policyholder or retiree is the secondary plan and the other plan covering the person as a dependent is the primary plan. WAC Dependent child covered under more than one plan. Unless there is a court decree stating otherwise, plans covering a dependent child must determine the order of benefits as follows: Coordination of Benefits Rules for Coordination WAC For a dependent child whose parents are married or are living together, whether or not they have ever been married: (Cont’d) of Benefits (Cont’d) 284-51-205 (4)(b)(i)(A) The plan of the parent 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 child 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
checklist-forms-2018-disability-sg-analyst-checklist.docx