Question
b. Esther, age 42, and Peter, age 39, are married and have a son, Jimmy, age 4. Esther works at a bank, and is covered
b. Esther, age 42, and Peter, age 39, are married and have a son, Jimmy, age 4. Esther works at a bank, and is covered under her employers group medical insurance plan as a full-time employee. Esther is also covered under her husband, Peters group medical insurance plan, as a dependent. Also, Peter works at a hospital, and is covered under his employers group medical insurance plan as a full-time employee. Peter is also covered under his wife, Esthers group medical insurance plan, as a dependent. Their son, Jimmy, is covered under both Esthers and Peters group medical insurance plan as a dependent. Esthers birthday is 1 October 1980 while Peters birthday is 15 March 1983. The group medical insurance plans of both Esther and Peter have the same coordination-of-benefits provision.
i. If Esther is hospitalized, in response to her medical bills/ expenses, which group medical insurance plan is the primary and which group medical insurance plan is the excess? 2 marks
ii. If Peter is hospitalized, in response to his medical bills/expenses, which group medical insurance plan is the primary and which group medical insurance plan is the excess? 2 marks
iii. If the son, Jimmy, is hospitalized, in response to his medical bills/expenses, which group medical insurance plan is the primary and which group medical insurance plan is the excess? 3 marks
iv. If Esther and Peter get divorced, and Peter is awarded custody of his son, Jimmy. However, there is no court order specifying who is responsible for Jimmys medical/health care expenses. If Jimmy is hospitalized after the divorce, in response to his medical bills/expenses, which group medical insurance plan is the primary and which group medical insurance plan is the excess? 3 marks
v. Suppose that Esther and Peter get divorced, and Peter is awarded custody of his son, Jimmy. There is a court order specifying that Esther must provide health/medical insurance for her son, Jimmy. If Jimmy is hospitalized after the divorce, in response to his medical bills/expenses, which group medical insurance plan is the primary and which group medical insurance plan is the excess? 3 marks
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