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Broker News | Vol. 9, No. 6 | May 16, 2014
Broker News | Vol. 9, No. 6 | May 16, 2014

Important Reminder Regarding Medicare Group Disenrollment

Please be aware there are requirements defined by CMS (Centers for Medicare & Medicaid Services) that we must comply with to disenroll or terminate a member from an Employer or Union Sponsored Medicare Plan.

If you send an individual disenrollment request to us for processing, it should be signed by the member or the member’s legal representative. It is never acceptable to sign a member’s name to any document. When a group wants to terminate a member for failure to pay premiums, the correct process will need to be followed. 

After the grace period, notice must be sent to the individual a minimum of 21 days prior to the disenrollment date, before a disenrollment can be processed.

A group is allowed to disenroll its retirees from a group sponsored plan for failure to pay premiums as long as it complies with the disenrollment process. After a grace period of at least 60 days, the group must provide notice to all individuals that it intends to disenroll from the group sponsored plan. This notice must be provided at a minimum of 21 calendar days prior to the effective date of the individual’s disenrollment from the group sponsored plan. The notice must include:

  • An explanation that the individual will be disenrolled and the reason for the disenrollment (e.g. premiums are not paid)
  • Effective date of the disenrollment
  • An explanation of how to contact Medicare for information about other Medicare Advantage plan options that could be available to the individual
  • If the plan is an Medicare Advantage Prescription Drug Plan or Prescription Drug Plan, an explanation that the termination means the individual will not have Medicare drug coverage and information about the potential for late-enrollment penalties that could apply in the future

The group must provide all required documentation and beneficiary information to our Medicare Enrollment and Reconciliation Department so we can submit a complete disenrollment request to the Centers for Medicare & Medicaid Services.   

If there are any questions on enrollment or disenrollment processes, please contact the Medcare Enrollment and Reconciliation Department at at 1-877-240-1320.  Our office hours are Monday through Friday, 9:00 a.m to 5:00 p.m. TTY users should call 1-800-421-1220.


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