Billing notices are prepared according to premium information carried in the direct
billing system (DBS). Premium payments are due by the 25th of the month the bill is mailed.
If an enrollee has made an advance premium payment for a quarter, a subsequent billing
notice for future billing will not occur until his/her premium liability is $10.00
or more. However, if the enrollee submits a payment shortly before the billing selection
date, it is likely he/she will receive a billing notice, as the payment is still in
the processing stages.
Example: Mrs. Martin, an "M" beneficiary, is on a quarterly "A" billing cycle. She is billed
in January. She paid her premiums in February for 8 months (February through September).
She will not receive a bill in April. However, her next bill will be sent in July
for premiums due for 1 month, October. The due date of all billing notices is the
25th of the month in which it is received.
Explain to the enrollee the importance of prompt payment of Supplementary Medical
Insurance (SMI) premiums; i.e., payment should be made upon receipt of the bill; and
failure to pay premiums timely may result in termination of SMI coverage. Tell the
enrollee when coverage is expected to start and that they may receive the billing
notice within 30 days after receipt of the SMI award notification. If the notice or
other advice is not received within 60 days after the beginning of SMI coverage, the
enrollee should contact the field office regarding his/her SMI premium billing. Inform
the enrollee about the rules in HI 01001.025 concerning payment by remittance since
those rules apply regardless of whether the premium is being paid by the enrollee
or by someone on his/her behalf.
Information regarding the grace period should not be provided to the enrollee unless
specifically requested. Otherwise, the enrollee may be inclined to put off making
the payment until later or may even forget making the payment, causing termination
of his/her coverage and loss to the trust fund. In this event, the enrollee loses
the real advantage of the long grace period. For example, if an emergency arises which
prevents him/her from making payments when due, the enrollee has an extra 2 months,
if necessary, in which to catch up.