What does the Birthday Rule determine?

• A. A rule that states that the policyholder whose birthday comes first in the year is the primary payer for all dependents.
• B. The policy that pays first in the calendar year for all dependents.
• C. The younger parent's policy is always primary.
• D. Covers dependents regardless of policy.

Answer: (A)

When two health plans cover the same dependent, the Birthday Rule decides which plan pays first. It says the policy of the parent whose birthday occurs earlier in the year is the primary payer for the dependent. The other plan is then secondary, picking up costs the primary plan doesn’t cover. This helps coordinate benefits and avoid duplicate payments.

This matches the correct choice because it describes determining the primary payer by which parent’s birthday comes first in the year. It’s not about paying first for all dependents in a calendar year, not about always using the younger parent’s policy, and not about covering dependents regardless of policy—coordination of benefits depends on the birthday order to establish primary vs. secondary.