Subscriber

So now I mentioned the subscriber and this is different from our guarantor. Our subscriber is the individual that signs the contract with a specific health insurance plan. Then under that we have our enrollees, which might be their spouse or their children. We also have the primary payer. Now, what the primary payor is, is this is an insurance policy that will pay first when a claim is filed. Now, sometimes you'll have where let’s say a husband and wife and they both have an insurance plan, vision and/or medical, through their work and then they are on each other's plan. When this happens, the individuals say I have an insurance plan as well as I have my husband on it and vice versa. If I go in for a comprehensive eye exam or medical exam, we're going to bill my insurance first and then once that insurance company pays, then it will bill to the secondary insurance, which would be the plan my husband has. there is something also notated as the birthday rule and what this is for is when you have both parents who have dependents and they both have insurance plans that their child is on. Basically, to determine which insurance is the primary, whether it's the mother or the father, we follow the birthday rule and basically whichever birthday, the month and day falls first in the calendar year, will be the primary.