Medicare Advantage and Prescription Drug Plans December 28 ...

Plan Communications User Guide Appendices, Version 6.3
Code Type Title Short Definition Definition
117 A FBD Auto
Enrollment
Accepted
118 A LIS
Facilitated
Enrollment
Accepted
119 A Premium
Amount
Change
Accepted
FBD AUTO
ENROLL
LIS FAC ENROLL
PREM AMT CHG
This new enrollment transaction (Transaction Type 61) was the result of a Plan-submitted or CMSinitiated
auto-enrollment of a full-benefit dual-eligible beneficiary into a Part D Plan. The
enrollment was accepted. The effective date of the new enrollment is shown in the Effective Date
(field 18) of the TRR data record.
Other accompanying replies with different TRCs may give additional information about this new
enrollment.
Plan Action: Ensure the Plan’s system matches the information included in the TRR record. Take
the appropriate actions as per CMS enrollment guidance.
This new enrollment transaction (Transaction Type 61) was the result of a Plan-submitted or CMSinitiated
facilitated enrollment of a low income beneficiary into a Part D Plan. The effective date of
the new enrollment is shown in the Effective Date (field 18) of the TRR data record.
Other accompanying replies with different TRCs may give additional information about this new
enrollment.
Plan Action: Ensure the Plan’s system matches the information included in the TRR record. Take
the appropriate actions as per CMS enrollment guidance.
A Part C Premium Change transaction (Transaction Type 78) was accepted. The Part C premium
amount has been updated with the amount submitted on the transaction. The amount may have also
been updated by CMS.
The effective date of the new premium will be reported in TRR data record field 18. The amount of
the new Part C premium will be reported in field 19 of the TRR record.
Plan Action: Update the Plan’s records accordingly, ensuring that the beneficiary’s premium
amounts are implemented as of the effective date in field 18. Take the appropriate actions as per
CMS enrollment guidance.
December 28, 2012 I-29 Transaction Reply Codes (TRCs)