I cover my children on my plan and my spouse also covers the children through his employer’s plan. How does this work and which insurance plan should pay for medical expenses first?

Determining the order of coordination of benefits requires “the birthday rule.” Because both parents are insuring the children, the parent’s birthday that falls first in the year would be primary. For example, if your birthday is July 5th and your spouse’s birthday is March 15th, your spouse’s plan would be primary for the children.