HI 01001.381 Exhibit — Teletype Message to RRB Regarding PDA Status

 

To:Railroad Retirement Board
 Health Benefits
 844 Rush Street
 Chicago, Illinois 60611
From:SSA PSC NE MAT SE GL MAM WN DBP DIO
RE:RR No. (RRB Annuity No.)
 SSA CAN (Claim No./BIC)
 Name                     

SMI jurisdiction transfer processed (mo/da/yr). The correct premium due amount as of SOM (mo/yr) was ($$$¢¢) (overage, arrearage). SSA collected premiums through coverage month (mo/yr).


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0601001381
HI 01001.381 - Exhibit -- Teletype Message to RRB Regarding PDA Status - 03/15/1999
Batch run: 01/27/2009
Rev:03/15/1999