Section R590-131-9 - COB ScenariosThe scenarios identified in this section are provided to demonstrate the possible use of the COB rules.
(1) Parents Not Married, Living Together, No Court Order. The order of benefits under Subsection R590-131-6(2)(a) is: (a)(i) the parent whose birthday falls earlier in the calendar year; then(ii) the parent whose birthday falls later in the calendar year; or(b)(i) if the parents have the same birthday, the plan that has covered the parent the longest; then(ii) the plan that has covered the parent the shortest.(2) Parents Divorced, Separated, or Not Living Together.(a) A court order awards joint custody to the parents, the father is responsible for the child's health care expenses or health care coverage, and the father has health care coverage. The order of benefits under Subsection R590-131-6(2)(b)(i) is: (b) A court order awards joint custody to the parents, the order specifies the father is responsible for the child's health care expenses or health care coverage, the father does not have health care coverage, and the father's wife has health care coverage. The order of benefits under Subsection R590-131-6(2)(b)(i) is:(c) A court order awards custody to the father and requires both parents to share responsibility for the child's health care expenses or health care coverage. The father's birthday is December 1, the stepmother's birthday is February 17, the mother's birthday is August 23, and the stepfather's birthday is January 1. The order of benefits under Subsection R590-131-6(2)(b)(ii) is:(d) A court order awards joint custody, the father physical custody, and does not specify responsibility for the child's health care expenses or health care coverage. The father's birthday is December 1, the stepmother's birthday is February 17, the mother's birthday is August 23, and the stepfather's birthday is January 10. The order of benefits under Subsection R590-131-6(2)(b)(iii) is: (e) A court order awards joint custody and requires both parents to share responsibility for health care expenses or health care coverage. The child lives with the mother 51% of the year. The father's birthday is December 1, the stepmother's birthday is February 17, the mother's birthday is August 23, and the stepfather's birthday is January 10. The order of benefits under Subsection R590-131-6(2)(b)(ii) is: (3) Parents Never Married, Not Living Together.(a) No court order exists. The order of benefits under Subsection R590-131-6(2)(b)(iv) is; (ii) custodial parent's spouse;(iii) non-custodial parent; (iv) non-custodial parent's spouse.(b) A court order awards custody to the mother, and does not address the child's health care expenses or health care coverage. The order of benefits under Subsection R590-131-6(2)(b)(iv) is: (4) Child No Longer a Minor. (a) A court orders the natural father to provide health care coverage for a child up to age 18 or while attending high school, whichever is later, and custody is awarded to the natural mother. The child is now age 18, or older, no longer attends high school, and resides with the natural mother. The order of benefits under Subsection R590-131-6(2)(b)(iv) is:(b) A court orders the natural father to provide health care coverage for a child up to age 18 or while attending high school, whichever is later, and custody is awarded to the natural mother. The child is now age 18, or older, no longer attends high school, and does not reside with either parent. The order of benefits under Subsection R590-131-6(5) is: (i) the plan covering an enrollee for the longest period;(ii) the plan covering an enrollee for the shortest period.Utah Admin. Code R590-131-9
Amended by Utah State Bulletin Number 2020-15, effective 7/22/2020Amended by Utah State Bulletin Number 2022-17, effective 8/22/2022