IRS data matches beneficiary report
OR
IRS data is different, but does not change the IRMAA level
|
Make no change in the IRMAA
|
None needed
|
If SSA is Using PY-3 MAGI for the Current Year Determination and
|
|
|
IRS PY-2 MAGI is significantly higher than IRS PY-3
IRS PY-3 = Level 1
IRS PY-2 = Level 2
|
Identify the Arrearage
Send an IRMAA Annual Verification Predetermination Notice
If no protest after 20 days from date of the notice, send an Annual Verification Correction
Notice
Send T2R notice of premium collection or notify the other agency (CMS, RRB) of the
new IRMAA determination.
|
CMS notifies direct bill beneficiaries and collects premium arrearage.
For OPM, SSA notifies CMS and CMS notifies OPM of IRMAA level change. OPM notifies
annuitants of new IRMAA deduction change and collects premium arrearage.
SSA notifies RRB who notifies annuitant and collects premium arrearage.
|
IRS PY-2 MAGI is significantly lower than IRS PY-3
IRS PY-3 = Level 3
IRS PY-2 = Level 2
|
Identify the Overage
Send an IRMAA Annual Verification Overage Notice
Send T2R notice and refund the appropriate premium amount or notify the other agency
(CMS, RRB) of the new IRMAA determination
|
CMS notifies direct bill beneficiaries and refunds premium overage.
For OPM, SSA notifies CMS and CMS notifies OPM of IRMAA level change. OPM notifies
annuitants of new IRMAA deduction change and refunds premium overage.
SSA notifies RRB who notifies annuitant and refunds premium overage.
|
IRS provides SSN (no PY-2 MAGI information)
|
Identify the Overage
Send an IRMAA Annual Verification Overage Notice
Send T2R notice and refund the appropriate premium amount or notify the other agency
(CMS, RRB) of the new IRMAA determination
|
CMS notifies direct bill beneficiaries and refunds premium overage.
SSA notifies CMS and CMS notifies OPM of IRMAA level change. OPM notifies annuitants
of new IRMAA deduction change and refunds premium overage.
SSA notifies RRB who notifies annuitant and refunds premium overage.
|
If SSA Originally Used PY-3 MAGI and is now using Beneficiary Supplied PY-2 MAGI for
the Current Year Determination and
|
|
|
IRS PY-2 MAGI is significantly higher than beneficiary provided PY-2 MAGI
Bene PY-2 = Level 1
IRS PY-2 = Level 2
|
Identify the Arrearage
Send an Annual Verification Predetermination Notice
If no protest after 20 days from the date of the notice, send an Annual Verification
Correction Notice
Send T2R notice and collect the additional premium amount or notify the other agency
(CMS, RRB) of the new IRMAA determination.
|
CMS notifies direct bill beneficiaries and collects premium arrearage.
SSA notifies CMS and CMS notifies OPM of IRMAA level change. OPM notifies annuitants
of new IRMAA deduction change and collects premium arrearage.
SSA notifies RRB who notifies annuitant and collects premium arrearage.
|
IRS PY-2 MAGI is significantly lower than beneficiary provided PY-2 MAGI
Bene PY-2 = Level 2
IRS PY-2 = Level 1
|
Identify the Overage
Send an IRMAA Annual Verification Overage Notice
Send T2R notice and refund the appropriate premium amount or notify the other agency
(CMS, RRB) of the new IRMAA determination
|
SSA will not determine a higher IRMAA than that determined using IRS provided PY-2.
(Exceptions – Amended Return – HI 01120.045 and Corrected IRS Tax Information – HI 01120.050)
CMS notifies direct bill beneficiaries and refunds premium overage.
SSA notifies CMS and CMS notifies OPM of IRMAA level change. OPM notifies annuitants
of new IRMAA deduction change and refunds premium overage.
SSA notifies RRB who notifies annuitant and refunds premium overage.
|
IRS provides no PY-2 MAGI information (SSN only) when beneficiary has provided PY-2
MAGI that resulted in IRMAA
Bene PY-2 = Level 1
IRS PY-2 = Level 0
|
Identify the Overage
Send and IRMAA Annual Verification Overage Notice
Send T2R notice and refund appropriate premium amount or notify the other agency (CMS,
RRB) of the new IRMAA determination
|
SSA will not determine a higher IRMAA than that determined using IRS provided PY-2.
(Exceptions – Amended Return – HI 01120.045 and Corrected IRS Tax Information – HI 01120.050)
CMS notifies direct bill beneficiaries and refunds overage.
SSA notifies CMS and CMS notifies OPM of IRMAA level change. OPM notifies annuitants
of new IRMAA deduction change and refunds overage.
SSA notifies RRB who notifies annuitant and refunds premium overage.
|
If SSA Originally Used PY-3 MAGI and is now using Beneficiary Supplied PY-1 MAGI for
the Current Year Determination and
|
|
|
IRS PY-2 MAGI is significantly higher than IRS PY-1 MAGI
AND
IRS PY-1 MAGI is significantly higher than beneficiary provided PY-1 MAGI
IRS PY-3 = Level 2
Bene PY-1 = Level 1
IRS PY-2 = Level 3
IRS PY-1 = Level 2
|
The IRMAA system will use IRS PY-1 MAGI to determine the IRMAA
Identify the Arrearage
Send an Annual Verification Predetermination Notice
If no protest after 20 days from the date of the notice, send an Annual Verification
Correction Notice
Send T2R notice and collect the additional premium amount or notify the other agency
(CMS, RRB) of the new IRMAA determination.
|
IRS PY-1 MAGI significantly lower than IRS PY-2 MAGI validates the New Initial Determination.
IRS data is the standard in the law.
CMS notifies direct bill beneficiaries and collects premium arrearage.
SSA notifies CMS and CMS notifies OPM of IRMAA level change. OPM notifies annuitants
of new IRMAA deduction change and collects premium arrearage.
SSA notifies RRB who notifies annuitant and collects premium arrearage.
|
IRS PY-2 MAGI is significantly higher than or the same as IRS PY-1 MAGI
AND
IRS PY-1 MAGI is significantly lower than beneficiary provided PY-1 MAGI
IRS PY-3 = Level 4
Bene PY-1 = Level 3
IRS PY-2 = Level 2 or 1
IRS PY-1 = Level 2 or 1
|
The IRMAA system will use IRS PY-1 MAGI to determine the IRMAA
Identify the Overage
Send an Annual Verification Overage Notice
Send T2R notice and refund the appropriate premium amount or notify the other agency
(CMS, RRB) of the new IRMAA determination.
|
CMS notifies direct bill beneficiaries and refunds the overage
SSA notifies CMS and CMS notifies OPM of IRMAA level change. OPM notifies annuitants
of new IRMAA deduction change and refunds the overage.
SSA notifies RRB who notifies annuitant and refunds premium overage.
|
IRS PY-2 MAGI is significantly lower than IRS PY-1 MAGI
AND
IRS PY-1 MAGI is significantly lower than or the same as beneficiary provided PY-1
MAGI
IRS PY-3 = Level 3
Bene PY-1 = Level 2
IRS PY-1 = Level 2 or 1
IRS PY-2 = Level 0
|
SSA uses PY-2 MAGI to determine IRMAA and identifies the Overage
Send an IRMAA Annual Verification Overage Notice
Send T2R notice and refund the appropriate premium amount or notify the other agency
(CMS, RRB) of the new IRMAA determination.
|
SSA will not determine a higher IRMAA than that determined using PY-2. (Exception
– Amended Return – HI 01120.045 and Corrected IRS Tax Information – HI 01120.050)
CMS notifies direct bill beneficiaries and refunds premium overage.
SSA notifies CMS and CMS notifies OPM of IRMAA level change. OPM notifies annuitants
of new IRMAA deduction change and refunds premium overage.
SSA notifies RRB who notifies annuitant and refunds premium overage.
|
IRS provides no PY-2 MAGI (SSN)
AND
IRS provides no PY-1 MAGI (SSN) when beneficiary has provided PY-1 MAGI that resulted
in IRMAA
IRS PY-3 = Level 2
Bene PY-1 = Level 1
IRS PY-2 = Level 0
IRS PY-1 = Level 0
|
SSA uses PY-2 MAGI and identifies the Overage
Send and IRMAA Annual Verification Overage Notice
Send T2R notice and refund the appropriate premium amount or notify the other agency
(CMS, RRB) of the new IRMAA determination
|
SSA will not determine a higher IRMAA than that determined using PY-2. (Exceptions
– Amended Return – HI 01120.045 and Corrected IRS Tax Information – HI 01120.050)
CMS notifies direct bill beneficiaries and refunds overage.
SSA notifies CMS and CMS notifies OPM of IRMAA level change. OPM notifies annuitants
of new IRMAA deduction change and refunds overage.
SSA notifies RRB who notifies annuitant and refunds premium overage.
|
IRS provides no PY-2 MAGI (SSN)
AND
IRS provides PY-1 MAGI higher, lower, or the same as beneficiary provided PY-1 MAGI
IRS PY-3 = Level 2
Bene PY-1 = Level 1
IRS PY-2 = Level 0
IRS PY-1 = Level 1
|
SSA uses PY-2 MAGI and identifies the Overage
Send and IRMAA Annual Verification Overage Notice
Send T2R notice and refund the appropriate premium amount or notify the other agency
(CMS, RRB) of the new IRMAA determination
|
SSA will not determine a higher IRMAA than that determined using PY-2. (Exceptions
– Amended Return – HI 01120.045 and Corrected IRS Tax Information – HI 01120.050)
CMS notifies direct bill beneficiaries and refunds overage.
SSA notifies CMS and CMS notifies OPM of IRMAA level change. OPM notifies annuitants
of new IRMAA deduction change and refunds overage.
SSA notifies RRB who notifies annuitant and refunds premium overage.
|
If SSA Originally Used PY-2 MAGI and is now using Beneficiary Supplied PY-1 MAGI for
the Current Year Determination and
|
|
|
IRS PY-1 MAGI is significantly higher than beneficiary provided PY-1 MAGI but significantly
lower than original IRS PY-2
IRS PY-2 = Level 2
Bene PY-1 = Level 0
IRS PY-1 = Level 1
|
The IRMAA system will use IRS PY-1 MAGI to determine the IRMAA.
Identify the Arrearage
Send an IRMAA Annual Verification Predetermination Notice.
If no protest after 20 days, send an Annual Verification Correction Notice
Send T2R notice and collect the appropriate additional premium amount or notify the
other agency (CMS, RRB) of the new IRMAA determination.
|
IRS PY-1 MAGI significantly lower than IRS PY-2 MAGI validates the New Initial Determination.
IRS data is the standard in the law.
CMS notifies direct bill beneficiaries and collects premium arrearage.
SSA notifies CMS and CMS notifies OPM of IRMAA level change. OPM notifies annuitants
of new IRMAA deduction change and collects premium arrearage.
SSA notifies RRB who notifies annuitant and collects premium arrearage.
|
IRS PY-1 MAGI is significantly higher than beneficiary provided PY-1 MAGI and significantly
higher than original IRS PY-2 MAGI
IRS PY-2 = Level 2
Bene PY-1 = Level 1
IRS PY-1 = Level 3
|
SSA uses PY-2 MAGI and identifies the Arrearage
Send an IRMAA Annual Verification Predetermination Notice.
If no protest after 20 days from the date of the notice, send an Annual Verification
Correction Notice
Send T2R notice and collect the additional premium or notify the other agency (CMS,
RRB) of the new IRMAA determination.
|
SSA will not determine a higher IRMAA than that determined using PY-2 (Exception –
Amended Return HI 01120.045 and Corrected IRS Tax Information – HI 01120.050)
CMS notifies direct bill beneficiaries and collects premium arrearage.
SSA notifies CMS and CMS notifies OPM of IRMAA level change. OPM notifies annuitants
of new IRMAA deduction change and collects premium arrearage.
SSA notifies RRB who notifies annuitant and collects premium arrearage.
|
IRS PY-1 MAGI is significantly lower than beneficiary provided PY-1 MAGI and significantly
lower than IRS PY-2 MAGI
IRS PY-2 = Level 3
Bene PY-1 = Level 2
IRS PY-1 = Level 1
|
The IRMAA system will use IRS PY-1 MAGI to determine the IRMAA.
Identify the Overage
Send an IRMAA Annual Verification Overage Notice.
Send T2R notice and refund appropriate premium amount or notify the other agency (CMS,
RRB) of the new IRMAA determination
|
IRS PY-1 MAGI significantly lower than IRS PY-2 MAGI validates the New Initial Determination.
IRS data is the standard in the law.
CMS notifies direct bill beneficiaries and refunds overage.
SSA notifies CMS and CMS notifies OPM of IRMAA level change. OPM notifies annuitants
of new IRMAA deduction change and refunds overage.
SSA notifies RRB who notifies annuitant and refunds premium overage.
|
IRS does not return PY-1 MAGI (SSN is returned) when beneficiary has provided PY-1
MAGI that resulted in IRMAA
Example:
IRS PY-2 = Level 2
Bene PY-1 = Level 1
IRS PY-1 = Level 0
|
SSA uses PY-1 MAGI to identify the Overage
Send an IRMAA Annual Verification Overage Notice.
Send T2R notice and refund appropriate premium amount or notify the other agency (CMS,
RRB) of the new IRMAA determination
|
IRS PY-1 MAGI significantly lower than IRS PY-2 MAGI validates the New Initial Determination.
IRS data is the standard in the law.
CMS notifies direct bill beneficiaries and refunds overage.
SSA notifies CMS and CMS notifies OPM of IRMAA level change. OPM notifies annuitants
of new IRMAA deduction change and refunds overage.
SSA notifies RRB who notifies annuitant and refunds premium overage.
|