Where an individual's deemed IEP ended before the month of current filing, the person
will be deemed enrolled in the current GEP or, if filing in April-December and automatic
enrollment is applicable, during the next GEP. Where automatic enrollment is not applicable
(see HI 00805.050) and the individual files in April-December, he or she must enroll for SMI during
the next GEP.
Only months after the end of the deemed IEP are charged against the enrollee in computing
a premium increase based on enrollment during a GEP. If an erroneous surcharge comes
to the attention of the DO or processing center, the enrollee's premium rate will
be adjusted in accordance with HI 01001.010.
When an individual requests enrollment in a GEP and the FO record shows a prior enrollment
attempt was denied because the individual was older than alleged and outside his enrollment
period, an RC should be prepared to give the pertinent facts and alert the processing
center about evidence previously submitted.
The claim should be clearly identified as an “Alleged Date of Attainment case” to alert the processing center to the need for special handling.