GN 02330.100 Trust Fund Accounting and Adjustment of the Hospital and/or Medical Insurance Premium Data on the BCM Record
AUDIENCE: HIE, EHS, BA, BATA, RECOVR, IES
A medical insurance premium refund involving a deceased enrollee will be certified for payment from either the Federal Old-Age and Survivors Insurance Trust Fund (FOASI) or the Federal Disability Insurance Trust Fund (FDI) depending on the type of benefit the deceased enrollee was receiving at the time of his death. For example, a disabled WE would have been paid from the FDI, trust fund while an aged WE would have been paid from the FOASI trust fund.
A medical insurance refund, paid from the appropriate trust fund (as outlined above) will not require a trust fund reversal. This is because the termination of the beneficiary's benefits acted to prompt a reversal of monies in the trust funds automatically by the SOBER System. That is, the excess premium amount was taken out of the Federal Supplementary Medical Insurance Collection Account (either 20 ×8004.5 or 20 ×8004.7) and deposited in the FOASI or FDI trust fund, whichever is appropriate.
A Hospital Insurance excess premium refund will be paid from the FOASI trust fund. However, this will necessitate a trust fund reversal action via Form SSA-666 which would take the monies out of the Federal Hospital Insurance Collection Account 20 ×8005.9 and deposit them in the FOASI trust fund 75-20 ×8006.
When an excess refund is added to an LSDP or a payment to a beneficiary (in the form of an AA), it will be necessary to do a trust fund reversal if the payment to which it (the refund) is added is paid from a trust fund other than the one to which the funds were originally deposited (as outlined above).
It will also be necessary to remove the excess (refunded) amount from the BCM for the account involved. This can be accomplished by preparing an SSA-1592, Premium Accounting Card, for the amount of the refund. If the refund involves both a hospital insurance and a medical insurance refund, two SSA-1592's are required, one with the appropriate Record Identification Code (RIC) for premium Part A (HI) and the other with the appropriate RIC for Part B (SMI). The instructions for completing the SSA-1592 can be found in section 760.02.A. of the Health Insurance and Inquiries Manual.