Congress also decided that the “working aged” who are covered under GHPs from employers
of any size, based on their own or their spouse's current employment, will not be
subject to the enrollment limitations or premium surcharge requirements for the period
of time in which they have GHP coverage.
Thus, even though Medicare is secondary payer only when an individual is enrolled
in a plan that covers 20 or more employees, an SEP and premium surcharge relief are
possible for all those covered under a GHP of any size based on current employment.
A “catch up” SEP beginning 8/86 and a recalculation of the premium surcharge for premiums
due beginning 6/86 was made available for everyone who met these new requirements
but had not met the old rules.