HI 01001.140 Processing JURIS Alerts

Input to the JURIS program is initiated by RRB. There will be situations where the fact of transfer can be accomplished, but certain characteristics prevent total systems processing. For example, if RRB attempts to accrete an annuitant for whom we locate the matching MBR record, but the Billing and Collection Master (BCM) cannot be accessed, the transfer will be processed and the HIM annotated with jurisdiction on the RRB number. The communication to RRB will assume that the premiums were paid through the transfer month. A Form HCFA-L623 /623A will be produced to document the transfer to RRB, and a 5 ×8 informational alert form will be produced to determine the proper PDA status. If an arrearage or overage existed at the time of transfer, the premium status must be sent to RRB for appropriate adjustment (see the exhibits at the end of this chapter for the method of communicating with RRB).

The 5 ×8 informational alert forms will be produced in the same format as that illustrated in HIIM 250.01. with the exception of line 1. Line 1 will contain the following entries: “ECPEATA,” “RRB JURISDICTION TRANSFER” and “ECJURIS.”

The following categories of alert forms will be generated to the program service center for processing.

A. Code 02—Life/Death

This alert is generated whenever the record received from RRB is for a survivor annuitant and the individual is a spouse on the MBR (life AB claims). In this case, since the fact of jurisdiction can be determined for the individual, the response to RRB will provide for the complete transfer. A Form HCFA-L623/623A will be generated to document the transfer, and the MBR will be updated with the SMI option “P.”

Prepare a Form SSA-5075 requesting the district office to develop the fact and the date of death of the wage earner. The request should inform the district office of the source of our information and advise that RRB will have jurisdiction of the survivor claim. The death notice can be input directly into the death termination program by the district office. No further reply to the SSA-5075 is required.

B. Code 05—Uninsured Term

This alert will be produced whenever a jurisdiction record is received from RRB and the MBR is for an uninsured (T, M, or M1) beneficiary or a special age 72 payment (J or K) beneficiary. The JURIS program will produce a Form HCFA-L623/623A to document the fact of transfer to RRB. This record provides evidence that the individual is entitled to a pension or annuity under the Railroad Retirement Act.

For T, M, or M1 cases, prepare an SSA-2795 U2 MADCAP coding form to terminate for reason “X-O, Transfer to RRB.” The Form SSA-1795 will show the appropriate PIC, a monthly rate of O, the effective date of the transfer to RRB (as shown in the “Payment Discontinued” block of the HCFA-623A) in the “From” column, CON in the “To” column, and a TOCA/RFCA of “X-O.”

Special age 72 payment cases must be given to the Claims Authorizer requesting a determination as to whether a government pension offset has been imposed based on the RRB annuity.

C. Code 06—Questionable PDA

This alert is generated whenever a PDA alert condition exists in the Separate Operation for Billing, Entitlement and Remittances (SOBER) record at the time of transfer, or there is no matching BIC in the BCM, or SOBER does not have a record, but the MBR billing information and earmark (BIER) code indicates the existence of a SOBER record. The JURIS program has processed the transfer to RRB showing a 1-month arrearage only.

Secure a BCM printout to determine the correct PDA status.

The CPDA and all special action codes (SAC) have been set to zero (000) as a result of the update record from the JURIS program. The INCPDA field in the Event History can be used to determine the SOBER PDA status at the time of transfer. Reconcile any questionable data which caused the alert condition.

When the correct PDA status has been determined and an overage exists or an arrearage is due for more than 1 month, send a teletype message to RRB (see HI 01001.381) supplying the correct PDA status.

Exception:

If the PDA status is equal to a 1-month arrearage, do not send a teletype to RRB. A 1-month arrearage was the amount assumed when the transfer was accomplished.

When it is necessary to send a teletype, the SOBER Operating Month (SOM) used in the communication must be the same as the date shown under the SOM filed on the alert informational. The RRB begins collecting premiums for the SOM month. For example, if the transfer is processed