POMS Reference

HI: Health Insurance

 

To: Railroad Retirement Board
  Health Benefits
  844 Rush Street
  Chicago, Illinois 60611
From: SSA PSC NE MAT SE GL MAM WN DBP DIO
RE: RR No. (RRB Annuity No.)
  SSA CAN (SSN/BIC)
  Name                     

SMI jurisdiction transfer processed (mo/da/yr). The correct premium due amount as of SOM (mo/yr) was ($$$¢¢) (overage, arrearage). SSA collected premiums through coverage month (mo/yr).