When SSA is assuming HI/SMI jurisdiction via the MADCAP program, and an SOC of “P” is on the MBR, MADCAP will deduct 1 month's premium from the next CMA check. The
Health Insurance and Inquiries Examiner must enter an “SU” amount equal to the month following the month indicated in item 14 of the RR-80 through
the current operating month. A form SSA-666 must also be prepared to transfer the
“SU” amount from the FOASI trust fund to the FSMI collection account. It is also necessary
to prepare an SSA-1592 with a RIC 3 equal to the premiums paid from the DOES through
COM. This is required because the SOBER system will develop a CPDA for that period.
When the action to transfer the jurisdiction is passed to the SOBER system, a SOBER
alert is produced in the heading “RRB CONVERSION ALERT”.
If a MADCAP action is taken in the next COM and no action has been taken to record
the premiums paid, a “make-whole” SOBER alert is produced. This alert can be cleared, assuming the correct amount of
premiums has been deducted, by preparing a form SSA-1592 with a RIC 3. If the CPDA
is not correct, adjust the CPDA by means of an SSA-1592.
A Form RR-80 is received for a D beneficiary. Item 14 reflects that RRB collected
premiums through 5/76. Item 11 shows the first date of entitlement to SMI is 6/74.
The MBR shows an SOC of “P.” The COM is 10/76. When the HI/SMI coding is entered on the SSA-2795U2, MADCAP will
deduct 1 month's premium (for 11/76). As premiums are due for 6/76 through 10/76,
the Health Insurance and Inquiries Examiner must enter an “SU” amount of $35.50. A form SSA-666 must be prepared to transfer $35.50 from the FOASI
trust fund to the FSMI collection account. Also, a Form SSA-1592 with a RIC 3 must
be prepared for premiums paid for 6/74 through 10/76 ($203.10).
In some instances, the Claims Authorizer will indicate the necessity of preparing
an award or amended award for a previously terminated beneficiary on SSA rolls. It
is important to remember that the HIC code of “F” must be coded on the SSA-2795U2 whenever an option code of “P” is being changed to any other SOC.
Regardless of whether the processing of the form RR-80 requires a transfer of jurisdiction
or an award with a previous SOC of “P” on the MBR, a special BCM alert “RRB CONVERSION ALERT” will be generated. The CPDA of record must be cleared by preparing a Form SSA-1592
with a RIC 3.