[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: 42CFR408.92]



[Page 285]

 

                         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. 408.92  Change from group payment to deduction or individual payment.



    (a) Enrollee excluded from group payment arrangement because of 

entitlement to monthly benefits. (1) When an enrollee becomes entitled 

to monthly benefits from which premiums can be deducted as specified in 

subpart C of this part, CMS notifies the group payer to discontinue 

payment for that enrollee.

    (2) In order to maintain confidentiality, CMS does not explain to 

the group payer the reason for excluding the enrollee from the group 

payment arrangement.

    (3) The enrollee's premiums are thereafter deducted from the monthly 

benefits, in accordance with subpart C of this part.

    (b) Enrollee no longer eligible for the group. (1) When an enrollee 

is no longer eligible to be included in the group (for instance because 

he or she is no longer employed by the group payer or has terminated 

union or lodge membership), the group payer must promptly notify CMS and 

the enrollee.

    (2) CMS or its agents resume sending individual bills to the 

enrollee, for direct remittance subject to the grace period and 

termination dates specified in Sec. 408.8.