TN 3 (10-22)

GN 02330.080 When Relief from Repayment Will Be Considered

AUDIENCE: BA, BATA, HIE, EHS, RECOVR, IES

When an individual receives a premium refund which is not due to the individual, a benefit overpayment has not been received nor has true premium arrearage been created. However, the individual does owe SSA the excess amount received. Accordingly, when a premium refund is identified as incorrect or erroneous, the program service center will compare the erroneously refunded amount with the enrollee's SMI premium rate to determine if it exceeds the tolerance amount in GN 02330.090 and thus requires recovery action. Where the amount does not exceed the tolerance, action will be taken to adjust SSA's records for the amount of the refund, but no attempt will be made to recover from the individual. If the amount does exceed the tolerance, the individual will be notified of the amount the individual erroneously received, asked to return it, and told of the individual's right to request relief from repayment of the incorrectly refunded amount.