The beneficiary may have had previous entitlement to social security benefits with
RRB jurisdiction of HI/SMI, but the HOC/SOC of “P” was never recorded and an amended award is being processed. Also, the action may
be an initial award for SSA where RRB has had jurisdiction; or an adjustment action
to transfer jurisdiction is being taken, but the “P” option was never recorded on the MBR.
For beneficiaries in current payment status, there are certain procedures to be followed
which will depend on the information recorded on the MBR. When the above types of
cases are processed through MADCAP, all premiums due will be deducted by MADCAP, usually
from the date of entitlement to SMI through COM + 1. Therefore, it will be necessary
to offset the amount MADCAP deducts by the amount that has already been paid. This
adjustment can be accomplished by entering an “AA” amount equal to the amount of premiums already paid. An SSA-666 must be prepared
to adjust the trust funds by charging the “AA” amount from the FSMI collection account and depositing to the FOASI trust fund.
Example:
A Form RR-80 is received for a D beneficiary. Item 14 reflects that the RRB collected
premiums through 5/76. Item 11 shows the first date of entitlement to SMI is 6/74.
The MBR shows a refusal of SMI. The COM is 10/76. By examining the folder, it is determined
that D refused SMI based on RRB involvement. Therefore, when the HI/SMI coding is
entered on the SSA-2795U2, MADCAP will deduct all premiums due from 6/74 through COM
+1 (11/76) To offset this deduction, enter an “AA” amount equal to premiums paid for 6/ 74 through 5/76 ($160.40) and prepare an SSA-666.