DEPARTMENT OF HEALTH  & HUMAN SERVICES  
Centers for Medicare & Medicaid Services  
7500 Security Boulevard,  Mail  Stop S2-26-12  
Baltimore, Maryland    21244-1850  
 
 
 
CMCS Informational Bulletin   
 
DATE:   October 12, 2017   
 
FROM:    Brian Neale, Director  
Center for Medicaid and CHIP  Services  
 
SUBJECT:   Reminder: Annual Reassignments for Certain Low-Income  Subsidy  Eligible  
Individuals  
 
Background  
 
Each year, the Centers for Medicare & Medicaid Services (CMS) processes reassignments for certain 
low-income subsidy (LIS)-eligible individuals.  This Bulletin provides an update on the next steps in 
the process to ensure that  States understand their role in ensuring that dual  eligible beneficiaries have  
timely, affordable, and comprehensive coverage under the Medicare Part D prescription drug benefit.   
 
CMS performs the  following tasks to reassign LIS-eligible beneficiaries:  
 
   Identifies  beneficiaries whose LIS eligibility will continue  in  2018;  
   Identifies which plans in each prescription drug plan (PDP) region have a 2018  premium at  
or below the LIS benchmark for that region (or have volunteered to waive a de  minimis  
amount above the benchmark);   
   Identifies non-renewing PDPs and Medicare Advantage (MA) plans;   
   Confirms  that beneficiaries are assigned to plans in  their region of residence, based on State  
Medicare Modernization Act (MMA) files; and  
   Determines which individuals are subject  to reassignment.  In general, we reassign only  full  
subsidy individuals who have not chosen a plan on their own in the  past.  In the case of plan 
non-renewals, we reassign all  individuals with full or partial subsidies.  
 
For your information, detailed guidance  and additional information can be found in following  
documents:   
 
   Section 40.1.5 of Chapter 3 (Eligibility, Enrollment, and Disenrollment) of the  Medicare 
Prescription Drug  Benefit Manual  
   Section 40.1.8 of Chapter 2 (Enrollment and Disenrollment) of the  Medicare Managed  
Care Manual   
   Guidance will be  available on memorandum dated September 26, 2017, 2018 
Reassignment of  Low-Income Subsidy  Beneficiaries in  Prescription Drug  Plans   
Guidance  will be  available on  memorandum  dated September 26, 2017, 2018 
Reassignment of  Low-Income Subsidy  Beneficiaries in Terminating Medicare Advantage 
Plans and Medicare Advantage Plans Reducing their Service Areas   
    CMCS Informational Bulletin Page 2  
 
 
CMS Notifications to Beneficiaries   
 
As provided in Chapter 3 of the Medicare Prescription Drug  Benefit Manual, section 40.1.5 - E,  
PDPs that are losing enrollees to a different PDP sponsor due to the annual  reassignment process  
have two options for  meeting the requirement to provide current  enrollees with the annual notice  
of change (ANOC):  
 
   Mail the standard ANOC by September  30, 2017; or  
   Mail the  alternative ANOC (see Exhibit 30, Optional Notice for Losing Plan to LIS 
Beneficiaries Re-Assigned to a Different PDP Sponsor (in lieu of Annual  Notice of 
Change)  in Chapter 3)  by November 7, 2017.  This option applies only to those PDP  
sponsors that are losing enrollees to a different PDP sponsor due to the annual  
reassignment process this  year and have  chosen to send the alternative ANOC document.  
 
In addition, CMS will mail the following notices to  affected beneficiaries:  
 
   PDP Reassignment Notice: In late October  2017, CMS will mail blue notices  to all LIS  
beneficiaries who will  be reassigned to a new PDP because the plan into which they were 
previously auto-enrolled  will have  a premium above the  regional LIS benchmark or their 
current PDP is terminating.  
 
   MA Reassignment Notice: Also in  late October  2017, CMS will mail blue notices to all LIS  
beneficiaries enrolled in an MA plan that is  terminating or has a service  area reduction.  
These  individuals will be  assigned to PDPs.  
 
Unless individuals  make an election on their  own, they  will be  automatically assigned to the  
plan identified in the notice with a January 1, 2018 effective date.  To assist  LIS beneficiaries  
in making an election, both of these blue  reassignment notices will include a  list of locally  
available plans that have no premium liability  for people eligible for the full premium 
subsidy in 2018. Beneficiaries can use this information to compare their plan options.  Except  
in plan termination situations, the notice also will inform them of the new monthly premium 
amount, if they stay in their current Part D plan.  
 
   Choosers Notice: In early November, CMS will  mail tan notices to LIS beneficiaries who 
are in a PDP in which they will have a premium liability, but are not being reassigned by  
CMS because  they actively chose their current plan. CMS refers to these beneficiaries as  
choosers.  Like the blue  reassignment notice, the  tan choosers notice will inform them of  
the new  monthly premium amount for which they will be  liable if they stay in their current  
PDP and include a  list of PDPs that have no premium liability  for people  eligible for the full  
premium subsidy in 2018.  
 
   Affordable Care Act (ACA) Formulary Notice: In December, CMS will mail  a second 
blue notice to all LIS beneficiaries who will be reassigned to a new PDP.  This includes those  
reassigned in the PDP and MA reassignments processes referenced above.  This second 
notice will identify which drugs in their current drug regimen are  covered in the 2018 plan to 
which they are being reassigned, and how to request  an exception to obtain a drug that is not  
included in the  plans formulary. 
 
  CMCS Informational Bulletin Page 3  
 
CMS has created a guide to 2017/2018 mailings sent  to consumers from CMS, the  Social Security  
Administration, and plans.  This guide summarizes  each notices message, explains when it will be  
sent, and includes the color of the paper on which the notice  is printed.  This guide is  available on our 
Limited Income  and Resources webpage. 
 
The model beneficiary letters  are also posted on this  webpage (in the LIS Notices and Mailings 
section)  as they become available.   
 
State Notification   
 
During the week of October 15, 2017, CMS will send  two  files, if applicable,  to each State.  The first  
will  list the LIS-eligible individuals  in  their State who will receive a blue PDP reassignment letter  
and the  second file will  list the  LIS-eligible individuals who will receive a  blue MA reassignment  
letter. Customer service representatives at 1-800-MEDICARE  will be prepared to answer questions  
about the reassignment process and about beneficiaries full range of options.  In addition, plan 
information will be  available at Medicare.gov.  
 
The reassignment files that CMS  sends  to States contains  a list of full duals, partial duals,  
Supplemental Security  Income (SSI)-only eligible  individuals, and approved LIS applicants  
residing in their State who will be receiving blue notices from CMS informing them that they  
will be reassigned.  Individuals  that  a State Pharmaceutical Assistance Program  (SPAP)  has  
requested CMS  to carve-out of the reassignment process, under  the SPAPs authority to enroll on 
behalf of its members, will not be included in this  file.   This exclusion will ensure that such 
beneficiaries are reassigned only once.  These reassignments will subsequently appear on the 
States  normal MMA response file starting  on or after October  15, 2017.  See the attachment for 
the State reassignment  file layout. 
 
Thank you for your continued assistance with our efforts to ensure that low-income Medicare 
beneficiaries, including dual eligibles, maintain affordable  and comprehensive  coverage under the  
Medicare Part D prescription drug benefit.  If you have specific questions about any of this  
information, please  contact Steve Ludwig at  Stephen.Ludwig@cms.hhs.gov or Nicole Gordon at  
Nicole.Gordon@cms.hhs.gov.  
  CMCS Informational Bulletin Page 4  
 
ATTACHMENT    STATE  REASSIGNMENT  FILE  LAYOUT   
 
Exchange Name: SRA (State Response)  
(where x can be H for header  and  T for trailer)  
Reassignment State Response Files - Header Record  
 
Data Field    Length   Position   Format   Valid Values   
Header Code   8   1   ...    8   CHAR   SRA for re-assign state 
notification file.   
Sending Entity   8   9   ...   16   CHAR   CMS   
(CMS + 5 spaces)   
File Creation Date    8   17   ...   24   CHAR   CCYYMMDD  
Date file was created.   
File Control Number    9   25   ...   33   CHAR   Spaces   
Filler    767   34   ...   800   CHAR   Spaces   
 
Data Field    Length   Position   Format   Valid Values   
Record Type   3   1   ...    3   CHAR   DTL  
 
Beneficiarys Health Insurance  12   4   ...    15   CHAR  
Claim  
Beneficiarys SSN    9   16   ...    24   CHAR   Filled  with  Spaces if the SSN  is  
 not present.   
Representative Payee Name   44   25   ...    68   CHAR  
 
Beneficiarys First Name   12   69   ...    80   CHAR  
 
Beneficiarys Middle Name   1   81   ...    81   CHAR  
Beneficiarys  Last Name   28   82   ...    109   CHAR   Last name starts in position 83  
if a  middle initial is present.  
Last  names that exceed the 
length  will have the last 
characters dropped.   
Beneficiarys Address Line 1    40   110   ...    149   CHAR   Filled with  the Address   
Beneficiarys Address Line 2    40   150   ...    189   CHAR   Filled  with the  Address, if  
available.   
Beneficiarys Address Line 3    40   190   ...    229   CHAR   Filled  with the  Address, if  
available.   
Beneficiarys Address Line 4    40   230   ...    269   CHAR   Filled  with the  Address, if  
available.   
Beneficiarys Address Line 5    40   270   ...    309   CHAR   Filled  with the  Address, if  
available.   
Beneficiarys Address Line 6    40   310   ...    349   CHAR   Filled  with the  Address, if  
available.   
Beneficiarys City    26   350   ...    375   CHAR   Filled with  the City   
Filler    1   376   ...    376   CHAR   Spaces   
Beneficiarys State   2   377   ...    378   CHAR   Filled  with the State Code   
Filler    1   379   ...    379   CHAR   Spaces   
Beneficiarys  Zip Code   10   380   ...    389   CHAR   Filled  with the  Zip Code   
 
Beneficiarys Next Years   50   390   ...    439   CHAR  
Organization Marketing Name     
Beneficiarys Next Years Plan   50   440   ...    489   CHAR  
Name   
  CMCS Informational Bulletin Page 5  
 
Data Field    Length   Position   Format   Valid Values   
 
Beneficiarys Next Years Plan   18   490   ...    507   CHAR  
Member Services Toll-Free Number     
Beneficiarys Next Years Plan Web   50   508   ...    557   CHAR  
Address  
Beneficiarys LIS  Subsidy Co- 1   558   ...    558   CHAR   1 - high co-pay  
Payment Category    2 - low co-pay  
3 - no co-pay  
4 - 15%  
Beneficiarys Next Years  Assign   8   559   ...    566   NUMERIC   CCYYMMDD  
Effective Date   
Beneficiarys Part D Premium   3   567   ...    569   CHAR   100, 075, 050, or 025   
Subsidy Percentage    
Beneficiarys PDP Region ID  Code   2   570   ...    571   NUMERIC  
 
Beneficiarys Current Years   50   572   ...    621   CHAR  
Organization Name     
Beneficiarys Current Years  Plan   50   622   ...    671   CHAR  
Name     
Beneficiarys Current Years  Plan   18   672   ...    689   CHAR  
Member Services Toll-Free Number     
Beneficiarys Current Years  Plan   6   690   ...    695   DECIMAL   
Premium Liability   
Filler    8   696   ...    703   NUMERIC   Zero   
 
Beneficiarys Next Years Contract   5   704   ...    708   CHAR  
Number     
Beneficiarys Next Years PBP   3   709   ...    711   CHAR  
Number     
Beneficiarys Current Years   5   712   ...    716   CHAR  
Contract Number     
Beneficiarys Current Years  PBP   3   717   ...    719   CHAR  
Number   
Beneficiarys Next Years Plan   6   720   ...    725   DECIMAL    Used  when the premium is  
Premium Liability    increasing, decreasing, or  
remaining the same amount that  
is above the benchmark  for the 
following year.   
 
Contains next years  premium  
for the current plan.  
Filler    75   726   ...    800   CHAR   Spaces   
 
   
  CMCS Informational Bulletin Page 6  
 
 
Reassignment State  Response Files - Trailer Record  
Data Field    Length   Position    Format   Valid Values   
Trailer Code   8   1   ...    8   CHAR   TRL for re-assign state  
notification file.   
Sending Entity   8   9   ...    16   CHAR   CMS   
(CMS + 5 spaces)   
File Creation Date    8   17   ...    24   CHAR   CCYYMMDD  
Date file was created.   
File Control Number    9   25   ...    33   CHAR   Spaces   
Record Count    9   34   ...    42   NUMERIC   Right justified.   
 
Count = Number of detail  
records.   
Filler    758   43   ...    800   CHAR   Spaces