TN 19 (03-93)

POLICY

A deemed IEP may be established for an individual born on the first day of a month who files an enrollment request in the first month after the IEP.

Since persons born on the first day of a month are ordinarily unaware that they actually attain a given age in the preceding month, the deemed IEP provision will be applied without further development.

IMPORTANT: If there is evidence in file that demonstrates that the enrollee knew the “prior-month” attainment rule, do not establish a deemed IEP.

EXAMPLE: Mr. Allen DB 3/1/20, enrolled on 6/22/85. Although his enrollment request was filed in the month after expiration of his actual IEP, a deemed IEP of 12/84-6/85 is established and SMI coverage is effective 9/1/85.

On the other hand, if Mr. Allen had enrolled in 3/85, his SMI coverage would be effective 5/1/85 (see HI 00805.165 B.3.). A deemed IEP could not be established since he enrolled during his actual IEP.