(a) The benefits of a plan which covers the person upon whose medical expense the claim is based other than as a dependent shall be determined before the benefits of a plan which covers such person as a dependent;
(b) Until June 30, 1985, the benefits of a plan which covers the person upon whose medical expenses the claim is based as a dependent of a male person shall be determined before the benefits of a plan which covers such person as a dependent of a female person; provided, that in the case of a person for whom claim is made as a dependent child: - (i) when the parents are separated or divorced and the parent with custody of the child has not remarried, the benefits of a plan which covers the child as a dependent of the parent with custody of the child will be determined before the benefits of a plan which covers the child as a dependent of the parent without custody;
- (ii) when the parents are divorced and the parent with custody of the child has remarried, the benefits of a plan which covers the child as a dependent of the parent with custody shall be determined before the benefits of a plan which covers that child as a dependent of the stepparent, and the benefits of a plan which covers that child as a dependent of the stepparent will be determined before the benefits of a plan which covers that child as a dependent of the parent without custody.
- (iii) Notwithstanding paragraphs (i) and (ii) herein, if there is a court decree which would otherwise establish financial responsibility for the medical, dental or other health care expenses with respect to the child, the benefits of a plan which covers the child as a dependent of the parent with such financial responsibility shall be determined before the benefits of any other plan which covers the child as a dependent.
(c) On and after July 1, 1985, the following provisions shall govern: - (i) Except for cases of a person for whom claim is made as a dependent child whose parents are separated or divorced, the benefits of a plan which covers the person upon whose medical expenses the claim is based as a dependent of a person whose date of birth, excluding year of birth, occurs earlier in a calendar year, shall be determined before the benefits of a plan which covers such person as a dependent of a person whose date of birth, excluding year of birth, occurs later in a calendar year. If a plan does not have the provisions of this paragraph and such absence would result either in each plan determining its benefits before the other or in each plan determining its benefits after the other, this paragraph shall not apply and the order of benefit determination of the plan not having the provisions of this paragraph shall be utilized.
- (ii) In the case of a person for whom claim is made as a dependent child whose parents are separated or divorced and the parent with custody of the child has not remarried, the benefits of a plan which covers the child as a dependent of the parent with custody of the child will be determined before the benefits of a plan which covers the child as a dependent of the parent without custody;
- (iii) In the case of a person for whom claim is made as a dependent child whose parents are divorced and the parent with custody of the child has remarried, the benefits of a plan which covers the child as a dependent of the parent with custody shall be determined before the benefits of a plan which covers that child as a dependent of the stepparent, and the benefits of a plan which covers that child as a dependent of the stepparent will be determined before the benefits of a plan which covers that child as a dependent of the parent without custody;
- (iv) In the case of a person for whom claim is made as a dependent child whose parents are separated or divorced, where there is a court decree which would otherwise establish financial responsibility for the medical, dental or other health care expenses with respect to the child, then, notwithstanding paragraphs (ii) and (iii) herein, the benefits of a plan which covers the child as a dependent of the parent with such financial responsibility shall be determined before the benefits of any other plan which covers the child as a dependent child.
- (v) When the application of these provisions is not dispositive, the benefits of a plan which has covered the person on whose expenses claim is based for the longer period of time shall be determined before the benefits of a plan which has covered such person the shorter period of time, provided that:
- (A) If the person upon whose expenses the claim is based is a laid-off or retired employee, or the dependent of same, the benefits of the plan providing coverage to him or his dependent as such shall be determined after the benefits of any other plan covering such person as an employee, other than as a laid-off or retired employee, or dependent of same. If neither plan has a provision regarding laid-off or retired employees and such absence would result in each plan determining its benefits after the other, this subparagraph shall not apply.
(d) When a claim under a plan with a COB provision involves another plan which also has a COB provision, the carriers involved shall use the above rules to decide the order in which the benefits payable under the respective plan will be determined.
044-10 Wyo. Code R. § 10-6