LEP Refresher

When will the penalty be applied?

• A follow up letter will advise you of the amount and when the amount will be applied. Read the letter carefully as you will be given reconsideration information if something doesn't look quite right.

• Do not provide any information to the member.

How long will it take to process the member’s LEP attestation?

• It will take 10-13 calendar days if the attestation is complete.

• In most cases it will take 14 calendar days if the attestation is complete.

What if the member wants to just send in the letter? What is the preferred method?

• Obtain a verbal attestation

• Return the letter they received.

• Send letter via email.

If the member has completed an LEP attestation either by mail or over the phone and have 0 uncovered months, will they receive a letter confirming that?

• Yes, they will receive a letter confirming that they have 0 uncovered months.

• No, they will not receive a letter confirming they have no uncovered months. However, they will receive a Billing Statement showing the LEP was not charged to them.

Will I receive new billing information?

• No, You will be getting an email confirmation.

• Yes, Once we receive the penalty information we will be following up with a Letter Confirming LEP Adjustment advising you of the change.

Is there going to be follow up notification to notify me whether or NOT the LEP is going to be applied?

• Yes, you will receive a letter with the amount that will be applied.

• No, you will receive a letter confirming that you have Penalty to pay.

This letter says my Late Enrollment Penalty (LEP) has increased. Why did my LEP change?

• Medicare decides the amount of your LEP. It is based on the National Base Beneficiary Premium and can change every year.

• Medicare uses the current coverage year's base beneficiary premium to calculate the penalty amount.

What if the member does not know all of the insurance names of their creditable coverage, but knows the employer's name?

• If the insurance company name is not known, we can’t file an attestation.

• The plan can accept either the employer's name or insurance name(s) for the Late Enrollment Penalty attestation.

If someone didn't enroll in a plan until one month after they were first eligible to join, will they have a penalty?

• No. A person must be without creditable prescription drug coverage for 63 days or longer.

• Yes, they will have a penalty.

Who receives the money for the late enrollment penalty when the member pays it?

• CMS receives the money collected for the LEP.
  

• UnitedHealthcare receives the money collected for the LEP.