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Employer Bulletin

All Employers
Vol. 16, No. 13
September 20, 1999

Medicare Data Match Project Forms Attached

In the past, the Department of Employe Trust Funds (ETF) has, through the Employer Bulletin, provided the Part II forms (included) of the Medicare Data Match Project to state agencies and local governments participating in the health insurance program. The enclosed forms pertain to group health insurance plans offered since January 1, 1997.

The Medicare Data Match Project is a federal program that requires employers and health care plans to provide information about specific former employes covered under the employer health plan. Medicare, administered by the Health Care Financing Administration (HCFA), may ask you questions regarding these employes.

If Medicare asks you for information, you'll find instructions on how to respond in the Medicare mailing.

Medicare may contact employers for specific dates of employment and health care plans selected by the employe. The data match enables Medicare to determine if former employes were eligible for the employer's group health plan as a primary carrier. In some cases, Medicare finds it has paid benefits as the primary carrier prior to payment by the employer's plan. By cross-checking dates of coverage and employment, Medicare may pursue recovering some of these benefits.

Following this Bulletin is a link to the completed Part II of the Data Match Form which provides a complete list of plans for employers to use in a Medicare inquiry. It is in a PDF format. You must have Adobe Acrobat to view these files. The completed Part II forms may be photocopied and submitted to Medicare along with other Parts completed by the employer.

Please note: Employers are required to list only the plans that identify employes for that plan. If a small number of employes and plans are involved, employers may wish to do their own list rather than use the ETF list. In addition, the self-insured plans listed on line 25 (Standard, Standard II and SMP) have different "Type of GHP" code letters. State employers are D and local employers are E.

ETF has no specific role in coordinating this effort. Direct your questions concerning the data match directly to Medicare. If you receive a Medicare Data Match inquiry and have questions, contact the Medicare Toll Match Project toll free at (800) 999-1118.

Completed Part II of the Data Match Form (updated 11/08/2002)


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