Principles of Risk Management and Insurance 13th Edition by George Rejda,Michael McNamara

Exercise 4

Maria, age 28, and Mike, age 30, are married and have a 1-year-old son. Maria is covered under her employer's group medical expense plan as an employee. She is also covered under Mike's plan as a dependent. The son is covered under both plans as a dependent. Maria's birthday is January 10, and Mike's birthday is November 15. Both plans have the same coordination of benefits provision.
a. If Maria is hospitalized, which plan is primary? Which plan is excess?
b. If the son is hospitalized, which plan is primary? Which plan is excess?
c. Assume that the couple gets a divorce, and Maria is awarded custody of her son. A court decree states that Mike must provide health insurance on his son. If the son is hospitalized after the divorce, which plan is primary? Which plan is excess?