Medicare Advantage and Prescription Drug Plans December 28 ...

Plan Communications User Guide Appendices, Version 6.3
Code Type Title Short Definition Definition
106 R Rejected,
Another
Trans Rcvd
with Later
App Date
107 R Rejected,
Invalid or
Missing PBP
Number
108 R Rejected,
Election
Limits
Exceeded
LATER APPLIC
BAD PBP
NUMBER
NO MORE
ELECTS
An enrollment transaction (Transaction Type 61) was rejected because a transaction with a more
recent application date or same date as another application date was received for the same effective
date. The submitted enrollment has been overridden by an enrollment in another contract/PBP.
When multiple transactions are received for the same beneficiary with the same effective date but
with different contract/PBP #s, the application date is used to determine which enrollment to accept.
If the application dates are different, the system will accept the election containing the most recent
date. .
Plan Action: The beneficiary is not enrolled in the Plan. Update the Plan records.
An enrollment or Record Update transaction (Transaction Types 61, 72, 73, 74, 75, 77, 78, 79, 80)
was rejected because the PBP # was missing or invalid. The PBP # must be of the correct format
and be valid for the contract on the transaction.
Note: PBP # is not required on Disenrollment, Residence Address, and Disenrollment Cancellation
transactions, (Transaction Types 51, 76, 81) but when submitted it must be valid for the contract
number on the transaction.
Plan Action: Correct the PBP # and resubmit the transaction if appropriate.
A transaction for which an election type is required (Transaction Types 51, 61) was rejected because
the transaction will exceed the beneficiary’s election limits for the submitted election type.
The valid Election Type values which have limits are:
A - Annual Election Period (AEP)
1 per calendar year
E - Initial Enrollment Period for Part D (IEP)
1 per lifetime
F - Initial Enrollment Period for Part D (IEP2)
1 per lifetime
I - Initial Coverage Election Period (ICEP)
1 per lifetime
Plan Action: Review the discussion of election type requirements in Chapter 2 of the MMCMor the
PDP Guidance on Eligibility, Enrollment and Disenrollment. Correct the election type and resubmit
the transaction if appropriate.
December 28, 2012 I-26 Transaction Reply Codes (TRCs)