TN 14 (08-92)
An individual's IEP begins with the month he/she is notified about the loss of Premium-free
HI and continues for 7 full months after that month.
The GEP occurs during January through March of each year. For 1990, the GEP for this
new category of benefit was extended through July 2, 1990.
Individuals who defer enrollment in Premium-HI because they have Large Group Health
Plan or Employer Group Health Plan coverage are eligible for a 7-month SEP following
termination of employment coverage if they meet the requirements.
Review the left side of the folder to confirm that the individual filed in a proper
enrollment period, as defined in HI 00805.276.
If the application is not filed in the proper enrollment period:
Forward the folder to a DE for partial completion of an SSA-831-U3 (DI 40510.175).
Request the typist to send disallowance notice to the individual per Exhibit 1, DI 40510.185. Instruct the typist to retain a copy of the notice in the claim folder for documentation.
Forward the folder to the appropriate technician to complete an SSA-2795-U2 to post
the “denial” to the RDD field of the MBR. (See SM 00380.100).
If the application is filed on a timely basis, forward the folder to the DE for processing.