TN 27 (06-24)

DI 40510.145 Enrollment Periods

A. Policy

1. Initial Enrollment Period (IEP)

An individual's IEP begins with the month they are notified about the loss of Premium-free HI and continues for 7 full months after that month.

2. General Enrollment Period (GEP)

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.

3. Special Enrollment Period (SEP)

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.

B. Procedure

Review the left side of the folder to confirm that the individual filed in a proper enrollment period, as defined in HI 00805.276.

1. Application not filed in proper enrollment period

If the application is not filed in the proper enrollment period:

  1. a. 

    Forward the folder to a DE for partial completion of an SSA-831-U3 (DI 40510.175).

  2. b. 

    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.

  3. c. 

    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).

2. Application filed on a timely basis

If the application is filed on a timely basis, forward the folder to the DE for processing.

To Link to this section - Use this URL:
DI 40510.145 - Enrollment Periods - 06/26/2024
Batch run: 06/26/2024