[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: 42CFR408.88]



[Page 284]

 

                         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. 408.88  Refund of group payments.



    (a) Basis for refund. Group payments are refunded only in the 

following circumstances:

    (1) The premium was for a month after the month in which the 

enrollee's SMI coverage terminated or the enrollee died.

    (2) The premium was for a month after the month in which the group 

payer gave notice (before the 26th day of that month) that the enrollee 

was no longer eligible for group payment and was being dropped from the 

group.

    (b) Example. F is the wife of J who is a retiree of Corporation X. 

That corporation pays premiums on behalf of all of its retirees and 

their dependents. F obtains a divorce from J on October 20 and thus 

disqualifies herself for further premium payments by the corporation. 

The corporation gives notice on November 10 that a refund is due because 

F has been dropped from the list of persons for whom it has agreed to 

pay premiums. The premium paid for December would be refunded to the 

group payer.

    (c) To whom refund is made. (1) CMS ordinarily refunds to the group 

payer the premiums specified in paragraph (a) of this section.

    (2) However, if CMS has information that clearly shows those 

premiums were paid from the enrollee's funds, it sends the refund to the 

enrollee.