TN 18 (08-14)

NL 00730.005 Title II Redesign (T2R) Automated Notices

A. Language in Title II redesign (T2R) notices

NOTICE LANGUAGE:

The T2R notice process generates automated notices in both English and Spanish. When the language (LANG) field on the updated Master Beneficiary Record (MBR) = Spanish (S), the T2R notice process will generate both a Spanish and English notice. We send both versions of the notice to the beneficiary. We print the Spanish notice first, followed by the English notice.

ENCLOSURE LANGUAGE:

When we generate “enclosures,” the name of the enclosure appears on the first page of the Spanish notice. If there is a Spanish version, the beneficiary receives only the Spanish enclosure. If there is no Spanish version, we include the English version.

REFUND ENVELOPES:

Although some refund envelopes (e.g. CMS Refund Envelope) have both a Spanish and English version, policy requires that we use only the English version of the envelope.

B. Actions generating automated notices

The T2R system produces a notice when we update the MBR in the following situations:

  • Medicare Part A (hospital insurance or HI) - and Part B (medical insurance or SMI) enrollments, withdrawals, and terminations

  • Reducing the Part B premiums because of the Medicare Modernization Act;

  • Part B premium deductions start for cases where the Railroad Retirement Board has jurisdiction;

  • Maturing actions when Part B premium or Voluntary Tax Withholding (VTW) deductions are involved;

  • Deductions of Medicare health premiums (Part C) and Medicare prescription drug premiums (Part D) from SSA benefits;

  • Part B premium changes from Income Related Monthly Adjustment Amount (IRMAA); and

  • The Part B premium is greater than the Monthly Benefit Amount (MBA) and a suspension of monthly benefits occurs. We send an automated billing notification.

Begining with T2R Release 3 in June 2004, we expanded T2R to include post entitlement processing. T2R generates notices for student awards, disabled child awards, parent awards, entitlement conversions based on full retirement age (FRA), other age attainments and death of the number holder (NH). For some entitlement conversion situations, T2R will convert the old Payment Identification Code (OLD-PIC) to a NEW-PIC. However, because of a suspension for a developmental reason, we cannot tell the beneficiary of the new type of benefit. If T2R resumes benefits, it only addresses the resumption of benefits. It does not explain the new type of benefit based on the prior entitlement conversion.

T2R generates notices for suspensions, terminations, voluntary tax withholding, workers compensation, public disability benefits, direct deposit, domestic to foreign address changes, payee changes, death terminations, and other post entitlement actions that update the MBR.

T2R generates a notice when the beneficiary’s MBA changes for any effective date. Policy requires this notification of the MBA change even if the Monthly Benefit Credited (MBC) does not change. T2R addresses reasons for MBA changes, including:

  • benefits to another entitled person stop due to death or another reason,

  • benefits to an auxiliary decrease due to the entitlement of another beneficiary,

  • cost of living increase,

  • adjusted reduction factor (ARF) or delayed retirement credits (DRCs) are applied,

  • workers’ compensation and public disability benefits are factored in,

  • an incorrect MBA determined by the T2R RATES business process, and

  • a zero MBA when the Primary Insurance Amount (PIA) equals the MAX and the History Reason for Suspension or Termination (HRFST) is Technical Entitlement (TECENT).

We generate a T2R notice for suspense-to-suspense status (Ledger Account File (LAF) S to LAF S) when the MBA changes. For example, if pre MBR LAF = S and post MBR LAF = S and the only change is an MBA change because another beneficiary terminated, the T2R notice will address the MBA change(s) for each effective date. The T2R notice will not repeat the reason the beneficiary is in suspense. The notice states benefits will not be paid at this time. Whenever an effective date in MBR History Data (HIST) shows a HRFST posted, but not posted for the same effective date on the pre MBR, the T2R notice does give the new suspension reason.

With the November 2005 Release, based on legislation, T2R generates notices relating to:

  • fugitive felon suspensions,

  • garnishment and levy deductions, and

  • CDR Failure to Cooperate suspensions and terminations.

Beginning with the November 2007 release, T2R generates an overpayment Payment Stub for new T2 overpayments. The Payment Stub ap