HI 01001.145 Processing JURIS Exceptions
There is only one code used to indicate an exception to JURIS processing Code 01. This 5 ×8 exception informational will be generated in the same format as that indicated in HI 00810.230 with the exception of line 1 which will be annotated “RRB JURISDICTION TRANSFER.”
A. Exception Code 01
This exception informational will be generated for any of the following reasons:
the claim is in advance filing status; or
the claim is in adjustment status (LAF code of “A”); or
the claim reflects a combined payment situation (PIC of “0” ) but there are less than two beneficiaries on the record; or
the MBR BIC is invalid (BIC is not A through F, J, K, M, T, or W; or
there is an intervening action.
When the RRB screening process encounters an intervening action, BDP sends the record back to RRB where it is rescreened once a month for 3 months. If, after 90 days, a condition still exists which precludes JURIS processing, RRB will send a teletype message to the program service center requesting that office to correct the MBR. Upon receipt of this message from RRB, the program service center must initiate whatever corrective action is necessary to allow subsequent activity on the record. When taking action to correct the MBR, do not establish the “P” option. After corrective action has been accomplished, send a teletype message to RRB (see HI 01001.381) informing RRB that the situation has been corrected and requesting that the accretion be resubmitted.
The legend on the Code 01 exception will always be “ADVANCE FILING OR INVALID MBR BIC.”
B. JURIS Actions Resulting in PESO or Regular Transcript Exceptions
When JURIS processes the transfer of jurisdiction, a record is forwarded to RRB advising that the action has been taken and RRB begins collecting premiums. However, if the JURIS action results in a PESO or Regular Transcript exception, SSA has not stopped deducting or billing, and premiums are being collected by both agencies. In this situation, a refund of any excess premiums must be made.
Examine theHCFA-L623A in file to determine the month in which the action should have updated to the MBR. This is located in the “Update Month” field of the HCFA-L623A. If the update month is the same as the current operating month (COM), do not initiate a premium refund; record the HOC and SOC of “P” and the DOES and DOEH. If the COM is later than the update month, the action required depends upon the type of exception (PESO or Regular Transcript) and whether premiums are being deducted from monthly benefits or the individual is in billing status.
1. PREMIUMS DEDUCTED FROM MONTHLY BENEFITS
When premiums are deducted from the individual's monthly benefits and the JURIS action results in either a PESO or Regular Transcript exception, a refund of premiums must be made for the month(s) beginning 1 month after the update month through the COM.
Process the action by preparing a MADCAP credit/debit with the appropriate BIC, HOC and SOC of “P,” and the DOES and DOEH reflected in RID 6 and the amount of the premium refund summarized as an “AA” in RID 5 (see HI 01001.115). Prepare a Form SSA-666 to transfer the amount from the FSMI collection account to the Old Age and Survivors or Disability Insurance trust fund.
2. INDIVIDUAL IS IN BILLING STATUS
a. PESO Exception
If the JURIS action resulted in a PESO exception, secure a BCM printout to determine if any premiums were received after the date of the JURIS action. When the JURIS action was processed, RRB was advised of the CPDA on the BCM at that time and RRB is responsible for collecting any arrearage. Therefore, the amount of the refund may only be determined by examining the premium history portion of the BCM and will include any premiums reflecting a SOBER processing date (SPD) which is later than the date appearing in the “Run No.” field of the HCFA-L623A.
If the action is for an insured individual, prepare a MADCAP credit/debit with the appropriate BIC, HOC and SOC of “P” and the DOES and DOEH coded in RID 6. If a refund is due, summarize the amount as an “AA” in RID 5 and prepare a Form SSA-666 to adjust the trust funds as indicated in 1. above.
b. Regular Transcript Exception
If the JURIS action resulted in a Regular Transcript exception, it will not be necessary to secure a BCM printout because a premium refund will not be applicable (i.e., the fact of the transfer has been communicated to the BCM setting the CPDA to “0” and thereby precluding any further billing). Establish the HOC and SOC of “P” and the DOES and DOEH (via MADCAP for insured claimants and MISCOR CIP R for uninsured individuals).