BNY Mellon Benefits Guide
When You Have Other Medical Coverage Available
If you enroll in the Lower Deductible HSA Plan or the Higher Deductible HSA Plan, which includes a Health Savings Account, you cannot make or receive any contributions to your Health Savings Account if you have coverage under any other plan, such as your spouse's/qualified domestic partner's or any part of Medicare Part A, Part B, etc. or TRICARE, unless it also meets the IRS definition of a "high-deductible health plan."
When you have other coverage for yourself or your dependents, BNY Mellon benefits will be coordinated with your other plan's benefits. Depending on the covered individual (you, your spouse, your qualified domestic partner or your other dependent), one of the plans will be designated as the primary coverage and will be responsible for paying benefits first; the other plan will be considered secondary (which means it will only pay benefits after the primary plan has paid, and up to a maximum amount of the actual charge).
When your spouse or qualified domestic partner has other coverage, this is how BNY Mellon determines which plan is primary:
- If you are the patient, BNY Mellon coverage is primary.
- If your spouse or qualified domestic partner is the patient, your spouse's or qualified domestic partner's coverage is primary.
- If your child is the patient and is covered by both parents' plans, the birthday rule applies. This means that the plan of the parent with the earlier birthday in the calendar year (using month and date only, not year) will be considered primary.
When a child is claimed as a dependent by parents who are separated or divorced, the primary plan is the plan of the parent who has court-ordered financial responsibility for the dependent child's health care expenses. When a child's parents are separated or divorced and there is no court decree, then the primary plan will be determined in the following order:
- the plan of the parent with custody of the child;
- the plan of the spouse of the parent with custody of the child; and
- the plan of the parent not having custody of the child.
The birthday rule described above applies if a court decree awarding joint custody does not stipulate that one parent is responsible for the child's health care.
Please note: if you enroll in other medical coverage, such as through your spouse's or qualified domestic partner's plan, including a general-purpose health care flexible spending account or health reimbursement account, or are covered by Medicare or TRICARE, by federal law, you are not eligible for the Health Savings Account. (While you can still enroll in the Lower Deductible HSA Plan or the Higher Deductible HSA Plan, you will not be eligible to open or contribute to ththe Health Savings Account.)