According to the birthday rule, who is considered the primary policyholder when both parents have group health insurance policies?

The birthday rule is a guideline used in health insurance to determine which parent's policy is considered primary for covering a dependent child when both parents have health insurance. This rule specifies that the primary policyholder is the parent whose birthday falls earlier in the calendar year, irrespective of the year they were born. This means that if one parent has a birthday in January and the other in March, the parent with the January birthday would be designated as the primary policyholder.

This approach helps streamline processes for claims and coordination of benefits between insurance plans, ensuring that both parents’ coverage is maintained effectively without ambiguity. The focus of the rule is purely on the order of the calendar year rather than other factors such as age or income, which eliminates unnecessary complications.

Other considerations, like the order of birth or financial contribution to the policy, do not influence the designation of the primary policyholder. Therefore, the rule is a straightforward method for deciding which policy kicks in first when there are claims for medical services for the child.