LLQP Accident & Sickness · Component 2.1 · 30% of the exam
The 'birthday rule' in coordination of benefits provides that for dependent children:
- ABoth parents' plans pay in full, so the family receives twice the eligible expense for the child
- BThe plan of the older parent pays first, on the basis of the parents' years of birth
- The plan of the parent whose birthday falls earlier in the calendar year pays first
- DThe child's own plan pays first, and the parents' plans pay only the remaining balance of the claim
Correct answer: C) The plan of the parent whose birthday falls earlier in the calendar year pays first
The birthday rule breaks ties for children's claims. Other rules govern separated parents. Total reimbursement is capped at the eligible expense.
Why the other options are wrong
- ACoordination of benefits prevents double recovery.
- BBirth year is ignored; only the month and day count.
- DChildren rarely have their own plans, and the rule is about the parents' plans.
Exam tip
Birthday rule: earlier birthday in the year (month/day) is primary for children.
Common mistake
Using the parents' ages rather than birthdays.
What this tests
CISRO competency component 2.1 — Analyze the available products that meet the client's needs — which is weighted at 30% of the Accident & Sickness module. Written against the published curriculum.
More from component 2
- A group benefits booklet lists AD&D coverage alongside life and LTD. The AD&D benefit pays:
- A hospital indemnity (hospital cash) policy pays:
- Employment Insurance sickness benefits are available to:
- Which government program coordinates with an individual DI policy through a possible offset AND also affects the definition of insurable income?
- A group plan's 'eligibility waiting period' (probationary period) is:
- A CI policy that is 'convertible' allows the insured to:
Practice the whole Accident & Sickness module
Timed sets weighted like the exam, and review of every question you miss. Free to start.