Jane, age 28, and John, age 30, are married and have a son, age one. Jane is

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

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Principles of Risk Management and Insurance

ISBN: 978-0132992916

12th edition

Authors: George E. Rejda, Michael McNamara

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