HI 01001.125 Attainment Cases

Individuals who have established entitlement to retirement or survivors insurance (RSI) benefits are usually selected in the 4th month prior to attainment of age 65 or their 25th month of disability entitlement. Eligible RRB annuitants will be selected in the 5th month prior to attainment. When SSA records are screened, those individuals who have been selected for RRB jurisdiction will be excluded from enrollment by SSA. When RRB selects an individual for automatic enrollment, they will direct a notification to SSA through a daily operating program called JURIS. This will preclude the issuance of an automatic HI/SMI enrollment package to the beneficiary from SSA and will result in the appropriate record being established on the MBR and the generation of a notice to the beneficiary (HCFA-L623, Notice Regarding Collection of Medicare Premiums) plus a folder documentation Form (HCFA-L623A, Record Regarding Collection of Medicare Premiums).

Although RRB established a date of birth (DOB) based on the same criteria used by SSA, there will be instances when a DOB established by RRB will differ from that established by SSA. Entitlement to HI/SMI will be based on the DOB most advantageous to the beneficiary. Therefore, if the DOB established by RRB is earlier than that of SSA records, it is possible for a “P” option to be present on the MBR even though the beneficiary is under age 65.

When SMI entitlement has been established on SSA records, and RRB subsequently establishes their award, jurisdiction will be transferred from SSA to RRB when we receive the initial notice from RRB.

NOTE: A. “P” option will be manually established only when:


coding an initial award, or


a specific request is received from Central Office, or


a JURIS action has resulted in a Post-Entitlement Scheduling Operation (PESO) or Regular Transcript exception (see HI 01001.145.B.).

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HI 01001.125 - Attainment Cases - 03/15/1999
Batch run: 01/27/2009