Even though a surcharge agency is paying the Part B premium surcharge on behalf of a beneficiary, the beneficiary is still responsible for assuring that the surcharge is paid. Bills sent to the surcharge agency are considered as notice to the beneficiary and the beneficiary suffers any consequences in the event of default (nonpayment or incorrectly identified payment) on the part of the surcharge payer.

The beneficiary is also responsible for notifying the surcharge payer of any change of address.

The surcharge payer is obligated to make payments timely, to promptly notify both the beneficiary and Centers for Medicare & Medicaid Services (CMS) when removing the beneficiary from the surcharge account, and to protect the privacy of the beneficiary.

CMS is responsible for billing the surcharge payer no less often then if there were no surcharge payer; for notifying both the surcharge payer and the beneficiary of delinquency in the event that the surcharge payer does not make timely payments; and, issuing credit refunds for premium surcharges due in accordance with HI 01001.272F.