[Code of Federal Regulations]

[Title 42, Volume 2]

[Revised as of October 1, 2005]

From the U.S. Government Printing Office via GPO Access

[CITE: 42CFR408.80]



[Page 283]

 

                         TITLE 42--PUBLIC HEALTH

 

                    CHAPTER IV--CENTERS FOR MEDICARE

                          & MEDICAID SERVICES,

                        DEPARTMENT OF HEALTH AND

                             HUMAN SERVICES

 

PART 408_PREMIUMS FOR SUPPLEMENTARY MEDICAL INSURANCE--Table of Contents

 

               Subpart E_Direct Remittance: Group Payment

 

Sec. 408.80  Basic rules.





    (a) Sources of group payment. An employer, a lodge, union, or other 

organization may pay SMI premiums on behalf of one or more enrollees.

    (b) Informal arrangement. Enrollees may turn over their premium 

notices to their employer, union, lodge, or other organization and that 

organization may send a single payment (with the premium notices 

attached so that the payments can readily be identified with the 

appropriate enrollees) to the CMS Premium Collection Center. Prompt 

payment is essential since SMI coverage terminates if premiums are not 

paid by the end of the grace period.

    (c) Group billing arrangement. CMS may send a single notice for the 

premiums due from a group of enrollees if the following conditions are 

met:

    (1) The group payer--

    (i) Uses funds other than the enrollees' to pay all or a substantial 

part of the premiums; or

    (ii) Deducts the premiums from periodic payments it makes to the 

enrollees in the group.

    (2) The enrollee's rights are protected and enrollees are not 

required to pay the costs of having their premiums paid on a group 

basis.