This bulletin is issued in accordance with Sections 59-2-8, 59A-2-10, 59A-16-11(B) and 59A-46-31 NMSA 1978, and 13.1.2 and 13.10.13.11(B)(2) NMAC.

The purpose of this bulletin is to clarify the position of the Office of Superintendent of Insurance (OSI) regarding allowable coordination of benefits provisions for a dependent child covered under more than one health insurance plan. OSI will accept coordination of benefits language that is consistent with Section 6(D)(2) of the NAIC’s Coordination of Benefits Model Regulation (No. MO-120) dated October 2013, see below:

Section 6. Rules for Coordination of Benefits

. . .

D. Order of Benefits Determination

. . .

(2) Dependent Child Covered Under More Than One Plan

Unless there is a court decree stating otherwise, plans covering a dependent child shall determine the order of benefits as follows:

For complete content please see PDF below.

CLARIFICATION ON COORDINATION OF BENEFITS (COB) PROVISIONS FOR MINOR CHILDREN