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 his SMI
coverage (e.g., premiums paid for months after the month of his 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 his estate.
Mrs. Fran Smoot is the wife of Mr. Joe Smoot, a retiree of Corporation X, which pays
premiums on behalf of all its retirees and their dependents. She obtains a divorce
on 10/20/76 and thus disqualifies herself for further premium payments by the Corporation.
The Corporation gives notice on 11/10/ 76 that a refund is due because Mrs. 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.