American Bar Association TIPS: Medicare Set-Asides Online Registration Form

American Bar Association TIPS: Medicare Set-Asides Online Registration Form

Here is an ABA 90 minute teleconference regarding MSAs. You might find it informative. The date is May, 9th at 1:00 (EST). The cost is variable.

Rated Ages

Rated-ages are used in the life insurance industry to determine if someones health has had a detrimental affect on his/her life expectancy. A rated age is usually obtained by submitting relevant medical records to an insurance broker. The broker then has the records reviewed by someone in the industry. I am not sure how the process works exactly. All I know is that I receive a piece of paper that states the person's rated age (a "standard" rating means no change). Most of the time the person's rated age is a bit higher (2 to 5 years) than his actual age because he has some minor health problems. In some instances the rated age comes back significantly higher (10-12 years).

We then use the rated age to calculate the person's life expectancy. The higher the rated age, the lower the life expectancy and thus a lower MSA proposal.

Although there is some documentation to suggest CMS requires the average of 3 rated ages to be submitted with an MSA proposal to prove the rated age, we have been getting away with just submitting one. We have a rated age done with every MSA to make sure we get the lowest MSA possible.

Update: Draconian rules about contact with CMS

Based on the last post I have created a newsletter concerning the benefits to being the submitter of the MSA proposal. Check it out here (pdf format).

Draconian rules about contact with CMS

The MSA submission process in convoluted enough without CMS imposing draconian rules about which party can contact CMS about an MSA proposal. Here is my understanding of the system: The first party to file the MSA proposal is designated as the "submitter" and CMS will only discuss the MSA proposal with the submitter.

This appears to be true even if the employer makes the submission. If this happens CMS won't even speak with the actual Medicare recipient about the proposal. This does not seem to make any sense.

In a case I was working on, CMS erroneously designated the claimant's attorney as the submitter although I clearly represented the employer and my name appeared on the submission letter. CMS would not speak with me about the MSA proposal even though the representative acknowledged my name appeared on the submission letter. Here is the best part, CMS had no way to correct this situation. I had to go through the CMS Regional Office to get it resolved.

So here is the lesson, if you need to be in control of the MSA submission process (for any reason) make sure you file your submission letter first.