The State of California is required to provide hospital insurance to retired State
employees by paying the Part A premium on their behalf. The State also pays the Part
B premium surcharge for individuals who are subject to a premium increase. The State
will not pay the basic Part B premium. The State also will pay the Part A premium
and any Part B surcharge effective July 2001 if the retirees enroll in Premium-HI.
If you are contacted by a retiree and he/she is not already enrolled in Part A or
Part B, take an application for premium-HI and Part B. If the individual is already
enrolled in Part B but not enrolled in Part A, take an application for premium-HI
and process it through the Postentitlement Operating System (POS).
For general enrollment period elections, the HI START date on the application or POS
screen will be July 2001, which is when the State will start paying the premium. If
an initial enrollment period (IEP) election HI START date is prior to July 2001, the
beneficiary will be liable for premiums prior to July 2001. This should be discussed
with the beneficiary and he/she should consider filing in the IEP month that results
in an enrollment month closest to July 2001 based on the IEP rules. (See HI 00805.165)
Inform the beneficiary that SSA will take and process the application for premium-HI,
and that CMS and the State are making arrangements for the State to pay the premiums
directly to CMS on his/her behalf. Inform him/her that he/she will be responsible
for any premiums due prior to July 2001.
Teleservice center representatives and SPIKES should handle calls from affected individuals
who need to file for premium-HI as a claims referral and follow normal procedures
for setting up an appointment.