(a) Actual deduction. A premium is considered paid if it is actually deducted from a monthly benefit check. Therefore -
(1) The premium is “paid” even if SSA later finds that the benefit was paid in error; but
(2) A finding that a monthly benefit was erroneously withheld does not constitute payment of the premium for that month. Since there was no payment, there was no deduction. The enrollee is billed and continuance of coverage depends on payment of premiums before the end of the grace period or extended grace period.
(b) Payment within the grace period. Overdue premiums are considered paid within the grace period in the following situations:
(1) Benefits are resumed during the grace period.
(i) Monthly cash benefit payments are payable for the last month of the initial grace period or for earlier months on the basis of a notice filed by the enrollee before the initial grace period ends; and
(ii) Those payments are sufficient to permit deduction of all overdue premiums.
(2) Annual earnings report or other report submitted during the grace period shows a benefit is due.
(i) Before the end of the grace period, the enrollee submits a report clearly showing that monthly cash benefits, previously withheld, are payable; and
(ii) Those benefits are sufficient to permit deduction of the full amount of the overdue premiums.
(3) Premium arrears are paid by direct remittance. The enrollee makes a direct remittance payment of all overdue premiums before the end of the grace period.
[52 FR 48115, Dec. 18, 1987; 53 FR 4159, Feb. 12, 1988; 56 FR 48112, Sept. 24, 1991]