Specifications include, but are not limited to: Respondents may submit proposals for some or all of the services requested below. 1. Social Security Disability Insurance (SSDI) Advocacy Assistance a) Track all disability retirees to ensure that they comply with requirement to apply for SSDI benefits within 2 years from date of disability retirement. b) Contact such individuals to confirm potential eligibility for SSDI. c) Conduct interviews to determine their suitability for the advocacy process. If Contractor(s) determines that client referred is not SSDI eligible, Contractor(s) shall immediately close the referral and notify OSC. d) Meet with clients to prepare all supporting paperwork. e) Collect all necessary medical records and names and addresses of providers. f) File a timely Request for Reconsideration when a client’s initial application is denied by the Social Security Administration. g) File a timely Administrative Law Judge (ALJ) Hearing when client is denied at the reconsideration stage. Also, provide Social Security Administration with updated records and supporting documentation. h) In consultation with OSC’s Retirement Division, determine whether an appeal following denial of benefits is warranted, and, if so, assist such individual in appealing such denial. i) Ensure that any individual who receives SSDI benefits also enrolls in Medicare Parts A and B when first eligible to do so. 2. Compile Current Medicare premium data for all Medicare-covered members of – retiree health plan a) Obtain current Medicare status and premium information for all enrollees in the State of CT Retiree Health Plan based on eligibility files provided by the Comptroller’s Office. b) Prepare a dataset to be used by the State of CT for reimbursing Medicare B and D premiums, including IRMAA, paid by retiree health plan members. The required fields should be as follows for each enrollee’s Medicare status, including but not limited to: • Medicare Parts A and B eligibility, enrollment, and effective coverage dates • Part B premium, including any associated Income Related Monthly Adjustment Amount (IRMAA) • Part D, including any IRMAA premium • Medicare Beneficiary ID (MBI) and/or Health Insurance Claim Number (HICN) • End Stage Renal Disease (ESRD) status and determination period. c) At least monthly share Medicare status files with Comptroller’s Office to facilitate payment of Medicare premium reimbursements to members. 3. Identify retirees, spouses and dependents enrolled in the under-65 retiree plan who are eligible for but not enrolled in Medicare A and B coverage. Utilize eligibility files to identify enrollees in the under-age 65 retiree plan to identify individuals who are eligible for but not enrolled in Medicare and assist those individuals to enroll in Medicare Parts A and B.
