Utah Administrative Code (Current through November 1, 2019) |
R590. Insurance, Administration |
R590-131. Accident and Health Coordination of Benefits Rule |
R590-131-9. COB Scenarios
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The following scenarios are provided to assist in demonstrating the use of the COB rule:
A. Parents Not Married, Living Together, No Court Decree. The order of benefits pursuant to R590-131-6.B.1. shall be:
1. the parent whose birthday falls earlier in the calendar year; then
2. the parent whose birthday falls later in the calendar year; or
3. if the parents have the same birthday, the plan that has covered the parent longest; then
4. the plan that has covered the parent the shortest.
B. Parents Divorced, Separated, Or Not Living Together.
1. The court decree gives joint custody with the father responsible for the child's health care expenses or health care coverage, and the father has health care coverage. The order of benefits pursuant to R590-131-6.B.2.a. shall be the:
a. natural father;
b. step-mother;
c. natural mother; then
d. step-father.
2. The court decree gives joint custody with father responsible for the child's health care expenses or health care coverage, the father does not have health care coverage, but his wife does. The order of benefits pursuant to R590-131-6.B.2.a. shall be the:
a. step-mother;
b. natural mother; then
c. step-father.
3. The court decree gives custody to the father and requires both parents to be responsible for health care expenses or coverage. The father's date of birth (DOB) 12/01, the step-mother's DOB 02/17, the mother's DOB 08/23, and the step-father's DOB 01/10. The order of benefits pursuant to R590-131-6.B.2.b. shall be the:
a. step-father;
b. step-mother;
c. natural mother; then
d. natural father.
4. A court decree awards joint custody and the father physical custody. The court decree does not address health care expenses or coverage. The father's DOB is 12/01, the step-mother's DOB is 02/17, the mother's DOB is 08/23, and the step-father's DOB is 01/10. The order of benefits pursuant to R590-131-6.B.2.c. shall be the:
a. step-father;
b. step-mother;
c. natural mother; then
d. natural-father.
5. A court decree awards joint custody and requires both parents to be responsible for health care expenses or coverage. The child lives with the mother 51% of the year. The father's DOB is 12/01, the step-mother's DOB is 02/17, the mother's DOB is 08/23, and the step-father's DOB is 01/10. The order of benefits pursuant to R590-131-6.B.2.b. shall be the:
a. step-father;
b. step-mother;
c. natural mother; then
d. natural father.
C. Parents Never Married.
1. The parents are not living together and no court decree exists. The order of benefits pursuant to R590-131-6.B.2.d shall be the;
a. custodial parent;
b. custodial parent's spouse;
c. non-custodial parent; and then
d. non-custodial parent's spouse.
2. The parents are not living together and the court decree awards custody to mother, but the decree does not address health care expenses or coverage. The order of benefits pursuant to R590-131-6.B.2.d. shall be the:
a. natural mother;
b. step-father;
c. natural father; then
d. step-mother.
D. Children No Longer Minors. A court decree orders that the natural father is to provide insurance for the minor children and custody is awarded to the natural mother. The dependents are age 18 and older. The order of benefits pursuant to R590-131-6.B.2.d shall be the:
1. natural mother;
2. step-father;
3. natural father; then
4. step-mother.