Which rule determines primary coverage for a dependent child?

• A. Birthday Rule
• B. First-Come rule
• C. Co-pay rule
• D. The child's own plan

Answer: (A)

When a dependent child is covered by two plans, the way to decide which plan pays first is called coordination of benefits. The specific rule used here is the Birthday Rule: the plan of the parent whose birthday comes earlier in the year is the primary plan for the child. For example, if Mom’s birthday is January 8 and Dad’s is June 14, the child’s care would be billed to Mom’s plan first, and Dad’s plan would pay second as secondary. This simple rule helps prevent duplicate payments and keeps coverage coordinated between both plans. The child’s own plan would only be primary if the child has a separate policy independent of the parents; the other options listed aren’t standard rules for determining which plan pays first.