The following list contains the sequencing of captions and paragraphs for BRI Income-Related
Monthly Adjustment Amount (IRMAA) notices. An “R” indicates a required paragraph,
while an “O” indicates an optional caption or paragraph that is placed in the notice
and is dependent upon business rules. Spanish language notices will use the same sequencing.
Headers: These are all required
SSAH16 Displays the BNC + BIC at the top of each notice after the first page
MESH03 Displays the heading "Social Security Administration" at the top of each notice
SSAH05 Displayes the heading that indicates type of notice is "Important Information"
HDR030 Displays the notice date and the BNC number
SSAH32 Displays the payment legend and address data for IRMAA notices
SNO002 O
SNO0004 0
Introductory (no caption)
MIR028 O Displayed if there is a COLA increase
MIR127 O Displayed if there is no COLA increase
MIR220 R
Caption English: MIRC06 – How Much You Will Get?
Spanish: MIRC06 Cuanto *F1 recibira
MIR221 R
MIR031 O
MIR032 O
MIR208 O
MIR131 O
MIR222 R
Caption English: MIRC19 – How We Figured Your IRMAA
Spanish: MIRC19 - Cómo calculamos las cantidades del IRMAA
MIR047 R
MIR020 R
MIR090 R
Caption English: MIRC20 – Some Special Situations That May Apply to You
Spanish: MIRC20 - Salvedades a la regla que posiblemente apliquen en su caso
MIR046 O
MIR047 R
MIR048 R
Caption English: MIRC07 – If Your Income Has Gone Down
Spanish: MIRC07 - Si sus ingresos han disminuido
MIR054 R
Caption English: MIRC39 - Other Information About IRMAA
Spanish: MIRC39 Otra información sobre IRMAA
MIR130 R
MIR131 O
MIR134 R
Caption English: MIRC09 – If You Disagree With Our Decision
Spanish: Si no está de acuerdo con nuestra decisión
MIR091 R
Caption English: MIRC21 - If You Want To Appeal This Decision
Spanish: Si desea apelar esta decisión
ALS095 R
Caption
English REPC01 - If You Want Help With Your Appeal
Spanish Caption REPC01 - Si quiere ayuda con su apelación
REP002 R
Caption English MIRC34 - Working and Getting Social Security At The Same Time
Spanish Caption MIRC34 - Trabajando y recibiendo Seguro Social al mismo
tiempo
MIR212 O
Caption English INFC68 - If You Receive A Pension From Employment Not Covered By
Social Security
Spanish Caption INFC68 - Si *F1 una pensión de empleo no cubierta por el Seguro
Social
INF207 R
English Text Caption MIRC38 - Information About Your Medicare Coverage
Spanish Text Información sobre la cobertura de Medicare
MIR223 R
English Text Caption MIRC31 - my Social Security Online Services.
Spanish Text Los servicios por internet de la cuenta «my Social Security»
MIR207 R
English Text Caption - MIRC32 - Life Changes May Affect Your Benefits
Spanish Text Los cambios de vida pueden afectar sus beneficios
MIR210 R
MIS159 R
INFC57 R
INF143 R
REFC07 R
English Text: Caption – REFC07 - If You Have Questions
Spanish Text: Caption – REFC07 - Si tiene preguntas
MIR217 R
MIR218 R
SSAS30 R This is the generic Social Security Administration signature for all IRMAA
notices.
English Text: Social Security Administration
Spanish Text: Administración del Segura Social