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eligible individual’s request, the MAO may restore the person to the MA-only plan retroactive to the auto-enrollment effective date. This is accomplished by submitting a TC 61 with the same effective date and setting the opt-out flag. If a TC 61 has already been submitted to move the person to the MA-PD plan, the MAO sends another TC 61 (to move the person back to the MA- only plan), setting the Part D opt-out flag to Y (opt-out of auto-enrollment). If it has not, submit just the opt-out indicator on a TC 79.

40.1.9 – Reassignment of Certain LIS Beneficiaries 42 CFR § 423.34(c)(1)

CMS conducts reassignments in the fall of each year (Late October) for LIS beneficiaries in the following situations:

Part C Reassignment: CMS will reassign all affected LIS eligible individuals in terminating MA plans. This includes non-renewing MA-only plans, as well as MA-PD plans and MA PFFS plans. In the case of an MA-only or MA-PD plan with a Service Area Reduction (SAR), reassignment will only be performed for counties that will no longer be served by the plan in the following year.

Beneficiaries who have LIS for the current calendar year and will continue to do so for the following calendar year will be included in this reassignment process.

Exception: LIS beneficiaries will not be reassigned if they have Part D coverage the following year. LIS beneficiaries will also not be reassigned if they (1) reside in the U.S. Territories, even if their MA-only or MA-PD plan is non-renewing, or (2) are enrolled in an employer-sponsored MA-only or MA-PD plan, unless the MA-only or MA-PD plan is non-renewing.

PDP Reassignment: CMS will reassign affected LIS eligible individuals in the following circumstances:

Individuals enrolled in PDPs that will have a premium in the following year that will be above the benchmark amount (unless the amount above the benchmark is de minimis and plan volunteers to waive such amount) if they meet ALL the following criteria:

• Individuals that continue to be eligible for 100 percent premium subsidy LIS in the following year. • Individuals were enrolled by CMS into their current PDP (i.e., through auto- and facilitated enrollment, reassignment). • Individuals do not live in a U.S. territory.

In the case of PDPs that are non-renewing (terminating):

• All current LIS enrollees who continue to have LIS in the following year, regardless of premium subsidy amount, and regardless of whether the individual was assigned to or voluntarily enrolled in a plan.