Any payment by a group payer is considered a payment by the enrollee. Once paid, premiums
will not be refunded, except (1) premiums paid for a month after the end of the enrollee's
SMI coverage (e.g., premiums paid for months after the month of their death), or (2)
premiums paid by a group payer for any months after the month in which the payer has
claimed refund and given notice by the 25th of the month that the enrollee is no longer
eligible for group payment. Such excess premiums when paid by a group will be refunded
to the group, except in the rare situation where we have information clearly showing
that the payment was made from an enrollee's funds, in which event the unearned premiums
will be refunded to the enrollee or a representative of their estate.
Fran Smoot is the spouse of Joe Smoot, a retiree of Corporation X, which pays premiums
on behalf of all its retirees and their dependents. Fran obtains a divorce on 10/20/76
and thus disqualifies Fran for further premium payments by the Corporation. The Corporation
gives notice on 11/10/ 76 that a refund is due because Fran Smoot has been dropped
from the list of persons for whom it has agreed to pay premiums. The premium paid
for 12/76 would be refunded to the group.