CLHIA-ACCAP - Consumer Information

A guide to the coordination of benefits

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3 Claims for Dependent Children When both parents have plans and their children are covered under both as dependents, the plan of the parent with the earlier birth date in the calendar year pays first. WHO PAYS FIRST? Example 1: • Father's birthday – October 11 • Mother's birthday – September 21 Therefore - Mother's plan pays first - Mother's birthdate comes before Father's in the calendar year. If both parents have the same birth date, the plan paying first is based on the parent's given name that occurs first in the alphabet. Example 2: • Mom's given name is Jane • Dad's given name is Stephen Therefore - Jane's plan pays first - the name Jane comes first alphabetically. In cases of Single Custody i.e., when one parent has custody of the child(ren), the plan of the parent with whom the child resides, i.e., the plan of the parent with custody, pays first. The plan of the spouse of the parent with custody pays second. The plan of the parent not having custody pays third. Example 3: A child lives with mother and her new spouse. Therefore - Mother's plan pays first. Mother's spouse's plan pays second. Father's plan pays third.

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