Rights to benefits under the Railroad Retirement Act also carry responsibilities for reporting events that may affect the payment of these benefits to the employee or to members of the employee’s family. If these events are not reported, benefit overpayments can occur that have to be repaid, sometimes with interest and penalties.
Events that can affect the payment of a Railroad Retirement annuity and result in overpayments if not promptly reported include:
entitlement to Social Security or certain other benefits, and changes in the amount of such benefit payments;
post-retirement work activity and the receipt of earnings by age and service annuitants;
post-retirement work activity, whether earnings are received or not, by disability annuitants;
the death of an annuitant;
a change in marital status;
a child leaving the care of a spouse or widow(er);
a student ceasing full-time school attendance.
The following questions and answers describe how these events affect Railroad Retirement benefits and what should be done to prevent overpayments.
How can the awarding of Social Security benefits result in a Railroad Retirement annuity overpayment?
The Tier I portion of a Railroad Retirement annuity is based on both the Railroad Retirement and Social Security credits acquired by an employee and figured under Social Security formulas. It approximates what Social Security would pay if railroad work were covered by Social Security. Tier I benefits are, therefore, reduced by the amount of any actual Social Security benefit paid on the basis of non-railroad employment, in order to prevent a duplication of benefits based on the same earnings.
The Tier I dual benefit reduction also applies to the annuity of an employee qualified for Social Security benefits on the earnings record of another person, such as a spouse. And, the Tier I portion of a spouse, divorced spouse or survivor annuity is reduced for any Social Security entitlement, even if the Social Security benefit is based on the spouse’s, divorced spouse’s or survivor’s own earnings. These reductions follow principles of Social Security law which limit payment to the higher of any two or more benefits payable to an individual at one time.
If a Railroad Retirement annuitant is also awarded a Social Security benefit, in most cases a combined monthly dual benefit payment will be issued by the Railroad Retirement Board (RRB). The Social Security Administration determines the amount of the Social Security benefit due, and the RRB determines the amount of the Railroad Retirement annuity due. (As stated above, the Tier I portion of a Railroad Eetirement annuity is reduced by the amount of the Social Security benefit due.)
A person should notify the RRB when he or she files for Social Security benefits. If the Social Security Administration begins paying benefits directly to a Railroad Retirement annuitant without the RRB’s knowledge, a Tier I overpayment will occur. This frequently happens when a railroad employee’s spouse or widow(er) is awarded Social Security benefits not based on the employee’s earnings.
Also, annuitants who are receiving their Social Security benefits directly from the Social Security Administration must notify the RRB if their Social Security benefits are subsequently increased for any reason other than annual cost-of-living increases, such as a recomputation to reflect post-retirement earnings. As such recomputations are usually retroactive, they can result in substantial Tier I overpayments.
While Social Security benefit information is provided to the RRB as a result of routine information exchanges between the RRB and the Social Security Administration, it will generally not be provided in time to avoid such a benefit overpayment.
What other types of benefit payments, besides Social Security benefits, require dual benefit reductions in a Railroad Retirement annuity?
For employees first eligible for a Railroad Retirement annuity and a federal, state or local government pension after 1985, there may be a reduction in Tier I for receipt of a public pension based, in part or in whole, on employment not covered by Social Security or Railroad Retirement after 1956. This may also apply to certain other payments not covered by Social Security, such as payments from a non-profit organization or from a foreign government or a foreign employer. However, it does not include military service pensions, payments by the Department of Veterans Affairs or certain benefits payable by a foreign government as a result of a totalization agreement between that government and the United States.
The Tier I portion of a spouse or widow(er)’s annuity may also be reduced for receipt of any federal, state or local government pension separately payable to the spouse or widow(er) based on her or his own earnings. The reduction generally does not apply if the employment on which the public pension is based was covered under the Social Security Act throughout the last 60 months of public employment. In addition, most military service pensions and payments from the Department of Veterans Affairs will not cause a reduction. Pensions paid by a foreign government or interstate instrumentality will also not cause a reduction.
If an employee is receiving a disability annuity, Tier I benefits for the employee and spouse may, under certain circumstances, be reduced for receipt of workers’ compensation or public disability benefits.
If annuitants become entitled to any of the above payments, they should promptly notify the RRB. If there is any question as to whether a payment requires a reduction in an annuity, an RRB field office should be contacted.
Can post-retirement work activity and earnings cause Railroad Retirement overpayments?
Unreported post-retirement work activity and earnings in non-railroad employment (including self-employment) are a major cause of overpayments in Railroad Retirement annuities. Like Social Security benefits, Railroad Retirement Tier I benefits paid to employees and spouses, plus Tier I and Tier II benefits paid to survivors, are subject to deductions if post-retirement earnings exceed certain exempt amounts, which increase annually. (For information on how post-retirement work activity and earnings affect disability annuitants, please see Question 4.)
These earnings deductions do not apply to those who have attained full Social Security retirement age. Under the Social Security Act, full retirement age for employees and spouses is age 66 for those born from 1943 through 1954 and gradually increases to age 67 for those born in 1960 or later. Full retirement age for survivor annuitants ranges from age 66 for those born from 1945 through 1956 to age 67 for those born in 1962 or later.
For those under full retirement age throughout 2019, the exempt earnings amount is $17,640. For beneficiaries attaining full retirement age in 2019, the exempt earnings amount is $46,920 for the months before the month full retirement age is attained. Prior to the calendar year in which full retirement age is attained, the earnings deduction is $1 in benefits for every $2 of earnings over the exempt amount. For those attaining full retirement age during a calendar year, the deduction is $1 for every $3 of earnings over the exempt amount in the months before the month full retirement age is attained.
Annuitants who work after retirement and expect that their earnings for a year will be more than the annual exempt amount must promptly notify the nearest RRB field office and furnish an estimate of their expected earnings. This way their annuities can be adjusted to take the excess earnings into consideration and prevent an overpayment. Annuitants whose original estimate changes significantly during the year, either upwards or downwards, should also notify the RRB.
Retired employees and spouses, regardless of age, who work for their last pre-retirement non-railroad employer are also subject to an earnings deduction in their Tier II and Railroad Retirement supplemental annuity benefits, if applicable, of $1 for every $2 in earnings up to a maximum reduction of the lesser of 50 percent of the earnings or Tier II and supplemental benefits combined. This earnings restriction does not change from year to year and does not allow for an exempt amount. Retired employees and spouses should therefore promptly notify the RRB if they return to employment for their last pre-retirement non-railroad employer or if the amount of their earnings from such employment changes.
A spouse benefit is subject to reductions not only for the spouse’s earnings, but also for the earnings of the employee, regardless of whether the earnings are from service for the last pre-retirement non-railroad employer or any other post-retirement employment. An annuity paid to a divorced spouse may continue despite the employee’s work activity. However, the employee’s non-railroad earnings over the annual earnings exempt amount may reduce a divorced spouse benefit.
How do post-retirement work activity and earnings affect disability annuities?
Any work performed by a disabled annuitant — whether for payment or not — may be considered an indication of recovery from disability and therefore must be reported promptly to avoid potential overpayments.
In addition, special restrictions limiting earnings to $950 per month in 2019, exclusive of disability-related work expenses, apply to disabled Railroad Retirement employee annuitants. These disability work restrictions apply until the disabled employee annuitant attains full retirement age which, as stated earlier, ranges from age 66 to age 67, depending on the year of birth. These work restrictions apply even if the annuitant has 30 years of railroad service. Also, a disabled employee annuitant who works for his or her last pre-retirement non-railroad employer would be subject to the additional earnings deduction that applies in these cases.
What effect does railroad work have on an annuity?
No Railroad Retirement annuity is payable for any month in which an employee, spouse or survivor annuitant performs compensated service for a railroad or railroad union. This includes local lodge compensation for more than $24.99 in a calendar month, and work by a local lodge or division secretary collecting insurance premiums, regardless of the amount of salary.
What should be done when a Railroad Retirement annuitant dies?
The RRB should be notified immediately upon the death of any retirement or survivor annuitant. Payment of a Railroad Retirement annuity stops upon an annuitant’s death and the annuity is not payable for any day in the month of death. This is true regardless of how late in the month death occurs and there is no provision for prorating such a payment. Any payments received after the annuitant’s death must be returned. The sooner the RRB is notified, the less chance there is of payments continuing and an overpayment accruing. The RRB would also determine whether any survivor benefits due are payable by the RRB or the Social Security Administration.
What are some other events that can affect payments to auxiliary beneficiaries, such as spouses, divorced spouses and widow(er)s?
A spouse or divorced spouse must immediately notify the RRB if the railroad employee upon whose service the annuity is based dies. A spouse must notify the RRB if her or his marriage to the railroad employee ends in divorce or annulment and a widow(er) or divorced spouse must notify the RRB if she or he remarries.
Also, benefits paid to spouses, widow(er)s and surviving divorced spouses that are based on the beneficiary caring for the employee’s unmarried child are normally terminated by the RRB when the child attains age 18 (age 16 for a surviving divorced spouse) or if a disabled child over age 18 (age 16 for a surviving divorced spouse) recovers from the disability. Therefore, the RRB must be notified if the child leaves the beneficiary’s care or marries.
Benefits are also payable to an unmarried child age 18 in full-time attendance at an elementary or secondary school or in approved home schooling until the student attains age 19 or the end of the school term in progress when the student attains age 19. (In most cases where a student attains age 19 during the school term, benefits are limited to the two months following the month age 19 is attained.) These benefits will be terminated earlier if the student marries, graduates or ceases full-time attendance. Therefore, the RRB must be notified promptly to prevent an overpayment.
Can an annuitant contest a decision that he or she has been overpaid?
Annuitants who believe a decision regarding a benefit overpayment is incorrect may ask for reconsideration and/or waiver of the overpayment. If not satisfied with the result of the initial review, the annuitant may appeal to the RRB’s Bureau of Hearings and Appeals. Further appeals can be carried to the three-member board itself and beyond the board to federal courts.
Annuitants are told about these appeal rights any time a decision is made regarding a benefit overpayment.
How can an annuitant find out if an event might affect his or her Railroad Retirement benefit payments?
Individuals should contact an RRB field office to determine if an event will affect their benefit payments. In any situation, the best rule is “If in doubt, report.” A Field Office Locator at RRB.gov provides easy access to every field office webpage where the street address and other service information is posted, as well as the option to email an office directly using the feature labeled Send a Secure Message. The agency’s toll-free number, 1-877-772-5772, is equipped with an automated menu offering a variety of service options, including being transferred to an office to speak with a representative, leave a message or find the address of a local field office. The agency also maintains a TTY number, 312-751-4701, to accommodate those with hearing or speech impairments. Most RRB offices are open to the public on weekdays from 9 a.m. to 3:30 p.m., except on Wednesdays when offices are open from 9 a.m. to noon. RRB offices are closed on federal holidays.
Disability Fund Shows Strong Improvement—Twenty Years
The Social Security Board of Trustees released its annual report on the long-term financial status of the Social Security trust funds. The combined asset reserves of the Old-Age and Survivors Insurance and Disability Insurance (OASI and DI) trust funds are projected to become depleted in 2035, one year later than projected last year, with 80% of benefits payable at that time.
The OASI trust fund is projected to become depleted in 2034, the same as last year’s estimate, with 77% of benefits payable at that time. The DI trust fund is estimated to become depleted in 2052, extended 20 years from last year’s estimate of 2032, with 91% of benefits still payable.
In the 2019 Annual Report to Congress, the trustees announced:
The asset reserves of the combined OASI and DI trust funds increased by $3 billion in 2018 to a total of $2.895 trillion.
The total annual cost of the program is projected to exceed total annual income, for the first time since 1982, in 2020 and remain higher throughout the 75-year projection period. As a result, asset reserves are expected to decline during 2020. Social Security’s cost has exceeded its non-interest income since 2010.
The year when the combined trust fund reserves are projected to become depleted, if Congress does not act before then, is 2035 – gaining one year from last year’s projection. At that time, there would be sufficient income coming in to pay 80% of scheduled benefits.
“The Trustees recommend that lawmakers address the projected trust fund shortfalls in a timely way in order to phase in necessary changes gradually and give workers and beneficiaries time to adjust to them,” said Nancy A. Berryhill, acting commissioner of Social Security. “The large change in the reserve depletion date for the DI fund is mainly due to continuing favorable trends in the disability program. Disability applications have been declining since 2010, and the number of disabled-worker beneficiaries receiving payments has been falling since 2014.”
Other highlights of the trustees’ report include:
Total income, including interest, to the combined OASI and DI trust funds amounted to just over $1 trillion in 2018. ($885 billion from net payroll tax contributions, $35 billion from taxation of benefits and $83 billion in interest)
Total expenditures from the combined OASI and DI trust funds amounted to $1 trillion in 2018.
Social Security paid benefits of nearly $989 billion in calendar year 2018. There were about 63 million beneficiaries at the end of the calendar year.
The projected actuarial deficit over the 75-year long-range period is 2.78% of taxable payroll – lower than the 2.84% projected in last year’s report.
During 2018, an estimated 176 million people had earnings covered by Social Security and paid payroll taxes.
The cost of $6.7 billion to administer the Social Security program in 2018 was a very low 0.7% of total expenditures.
The combined trust fund asset reserves earned interest at an effective annual rate of 2.9% in 2018.
The board of trustees usually comprises six members. Four serve by virtue of their positions with the federal government: Steven T. Mnuchin, secretary of the treasury and managing trustee; Nancy A. Berryhill, acting commissioner of Social Security; Alex M. Azar II, secretary of health and human services; and R. Alexander Acosta, secretary of labor. The two public trustee positions are currently vacant.
If you are thinking of retiring within the next five years, you may want to consider attending a pre-retirement seminar hosted by the Railroad Retirement Board (RRB).
Designed for railroad employees and spouses planning to retire, the pre-retirement seminars the RRB offers familiarize attendees with the retirement benefits available to them, and also guide them through the application process. Sponsored by the Office of the Labor Member, seminars are held at a number of locations annually.
RRB field service representatives conduct each pre-retirement seminar using a PowerPoint slide presentation covering the various benefits provided to retired rail workers and their families. Attendees receive a program booklet of this presentation with detailed side notes and fact sheets. In addition to the program booklet, seminar attendees receive a retirement kit full of informational handouts and other helpful materials. Online and downloadable versions of items included with seminar kits are available on the RRB’s educational materials webpage.
Registration is required to ensure accommodations and materials for all attendees.
Unless otherwise noted, pre-retirement seminars begin at 8:30 a.m. and are held over the course of four hours. (Doors open for attendees 30 minutes before the seminar start time.)
Security screening is required for seminars hosted inside any federal buildings. Bring a current, valid photo ID (issued by state or federal government); no weapons are permitted.
Parking fee for seminars marked with *.
Attendees are encouraged to bring original records (or certified copies) of documents required in order to file a Railroad Retirement application (such as proof of age, marriage or military service), along with an additional copy of each item to leave with field service staff.
Please inform the RRB if you sign up for a seminar and become unable to attend.
Can’t attend a seminar, but still interested in learning about the Railroad Retirement program and application process? Please contact the RRB via the Field Office Locator or by calling toll-free (1-877-772-5772) for pre-retirement information or to schedule an appointment for individual retirement counseling at your local RRB field office.
Here are the scheduled dates:
March 22, 2019: George H. Fallon Federal Building, 31 Hopkins Plaza, Room G-33 (ground level), Baltimore, Maryland*
March 22, 2019: West Covina Library, 1601 West Covina Parkway, West Covina, California* (9 a.m. start time)
March 29, 2019: Birmingham/Jefferson Convention Complex, 2100 Richard Arrington Jr. Boulevard North, East Meeting Rooms D/E, Birmingham, Alabama*
March 29, 2019: Maidu Community Center, 1550 Maidu Drive, Roseville, California
April 5, 2019: Country Inn & Suites, 4500 Circle 75 Parkway, Atlanta, Georgia
April 5, 2019: Hilton Garden Inn (Richmond Airport), 441 International Center Drive, Sandston, Virginia
April 12, 2019: Ronald V Dellums Federal Building, 1301 Clay Street – North Tower, 5th Floor (Room H), Oakland, California*
April 12, 2019: Drury Inn & Suites, St Louis Forest Park, 2111 Sulphur Avenue, St Louis, Missouri
In a recent decision (Wisconsin Central Ltd., et al v. United States), the U.S. Supreme Court ruled that non-qualified stock options granted to railroad employees are not considered compensation under the Railroad Retirement Tax Act of 1937, and are, therefore, not subject to taxation.
As a result, certain railroad employers and employees who previously paid railroad retirement taxes based on the exercise of such stock options may be eligible for tax refunds through the Internal Revenue Service (IRS).
Railroad employees and railroad retirement annuitants considering filing for such a tax refund should know that doing so may reduce the amount of their total creditable railroad compensation. Under the Railroad Retirement Act (RRA), creditable compensation is a factor in the computation of a railroad retirement annuity. A reduction in compensation could cause a reduction in an annuitant’s monthly benefit rate, and may result in an overpayment. For active employees, a change in creditable compensation may impact any estimated annuity amounts they were previously given by the Railroad Retirement Board (RRB).
At this time, the RRB is able to provide guidance to only a select group of individuals trying to determine if their total creditable railroad compensation will be reduced and/or if their annuity amounts will change as a result of claiming refunds of taxes paid on non-qualified stock options. That group is comprised of those individuals who have been identified by their railroad employers as employees whose regular earnings met the maximum compensation taxable caps without the inclusion of the stock option payment. In those cases, if the employees file claims for refunds of taxes paid on the stock option payment, payment of the refund will not impact their annuity rate computations. Employees who believe they are members of this group should review their consent letters to confirm whether they have been reported by their employers to be a “Medicare Tax Only” employee. If you are uncertain whether you are a “Medicare Tax Only” employee, please contact your railroad employer. Employees may also call the RRB’s toll-free number at 877-772-5772 if there are any other questions.
The RRB is currently unable to provide guidance to individuals not in the above group. The agency’s three-member board (appointed by the President with the advice and consent of the Senate, and representing rail labor, rail management and the public interest) has the authority to determine what effect, if any, the court’s decision will have on the RRB’s administration of the RRA. However, the position of chairman of the board is currently vacant, and the management member of the board must recuse himself from this issue as he previously worked for a railroad and received non-qualified stock options. The labor member of the board alone lacks statutory authority to make a decision, as a two-member quorum is required by law.
It is expected that in the first quarter of 2019, the agency will get a three-member board in place that will be able to make policy decisions related to this matter. The RRB is currently in discussions with the IRS to determine if it is possible to hold open the period for railroad employees and retirees to file claims for tax refunds until such time as the RRB gets a three-member board in place. The RRB would then be better able to provide information regarding the effect on RRB benefits to those needing assistance.
World War I – known at the time as “The Great War” – officially ended when the Treaty of Versailles was signed on June 28, 1919, in the Palace of Versailles outside the town of Versailles, France. However, fighting ceased seven months earlier when an armistice, or temporary cessation of hostilities, between the Allied nations and Germany went into effect on the eleventh hour of the eleventh day of the eleventh month. For that reason, November 11, 1918, is generally regarded as the end of “the war to end all wars.”
In November 1919, President Wilson proclaimed November 11 as the first commemoration of Armistice Day with the following words: “To us in America, the reflections of Armistice Day will be filled with solemn pride in the heroism of those who died in the country’s service and with gratitude for the victory, both because of the thing from which it has freed us and because of the opportunity it has given America to show her sympathy with peace and justice in the councils of the nations…”
The original concept for the celebration was for a day observed with parades and public meetings and a brief suspension of business beginning at 11:00 a.m.
The United States Congress officially recognized the end of World War I when it passed a concurrent resolution on June 4, 1926, with these words:
“Whereas the 11th of November 1918, marked the cessation of the most destructive, sanguinary, and far reaching war in human annals and the resumption by the people of the United States of peaceful relations with other nations, which we hope may never again be severed, and
“Whereas it is fitting that the recurring anniversary of this date should be commemorated with thanksgiving and prayer and exercises designed to perpetuate peace through good will and mutual understanding between nations; and
“Whereas the legislatures of twenty-seven of our States have already declared November 11 to be a legal holiday: Therefore be it Resolved by the Senate (the House of Representatives concurring), that the President of the United States is requested to issue a proclamation calling upon the officials to display the flag of the United States on all Government buildings on November 11 and inviting the people of the United States to observe the day in schools and churches, or other suitable places, with appropriate ceremonies of friendly relations with all other peoples.”
An Act (52 Stat. 351; 5 U. S. Code, Sec. 87a) approved May 13, 1938, made the 11th of November in each year a legal holiday—a day to be dedicated to the cause of world peace and to be thereafter celebrated and known as “Armistice Day.” Armistice Day was primarily a day set aside to honor veterans of World War I, but in 1954, after World War II had required the greatest mobilization of soldiers, sailors, Marines and airmen in the Nation’s history; after American forces had fought aggression in Korea, the 83rd Congress, at the urging of the veterans service organizations, amended the Act of 1938 by striking out the word “Armistice” and inserting in its place the word “Veterans.” With the approval of this legislation (Public Law 380) on June 1, 1954, November 11th became a day to honor American veterans of all wars.
Later that same year, on October 8th, President Dwight D. Eisenhower issued the first “Veterans Day Proclamation” which stated: “In order to insure proper and widespread observance of this anniversary, all veterans, all veterans’ organizations, and the entire citizenry will wish to join hands in the common purpose. Toward this end, I am designating the Administrator of Veterans’ Affairs as Chairman of a Veterans Day National Committee, which shall include such other persons as the Chairman may select, and which will coordinate at the national level necessary planning for the observance. I am also requesting the heads of all departments and agencies of the Executive branch of the Government to assist the National Committee in every way possible.”
In 1958, the White House advised VA’s General Counsel that the 1954 designation of the VA Administrator as Chairman of the Veterans Day National Committee applied to all subsequent VA Administrators. Since March 1989 when VA was elevated to a cabinet level department, the Secretary of Veterans Affairs has served as the committee’s chairman.
The Uniform Holiday Bill (Public Law 90-363 (82 Stat. 250)) was signed on June 28, 1968, and was intended to ensure three-day weekends for Federal employees by celebrating four national holidays on Mondays: Washington’s Birthday, Memorial Day, Veterans Day, and Columbus Day. It was thought that these extended weekends would encourage travel, recreational and cultural activities and stimulate greater industrial and commercial production. Many states did not agree with this decision and continued to celebrate the holidays on their original dates.
The first Veterans Day under the new law was observed with much confusion on October 25, 1971. It was quite apparent that the commemoration of this day was a matter of historic and patriotic significance to a great number of our citizens, and so on September 20th, 1975, President Gerald R. Ford signed Public Law 94-97 (89 Stat. 479), which returned the annual observance of Veterans Day to its original date of November 11, beginning in 1978. This action supported the desires of the overwhelming majority of state legislatures, all major veterans service organizations and the American people.
Veterans Day continues to be observed on November 11, regardless of what day of the week on which it falls. The restoration of the observance of Veterans Day to November 11 not only preserves the historical significance of the date, but helps focus attention on the important purpose of Veterans Day: A celebration to honor America’s veterans for their patriotism, love of country, and willingness to serve and sacrifice for the common good.
The following health and wellness resources are available to those impacted by Hurricane Michael.
United Behavioral Health/Optum: 1-866-342-6892 (toll-free) 24 hours a day, 7 days a week
An emotional support hotline is available, free of charge, regardless of behavioral health plan membership. It provides access to specially-trained mental health specialists.
Accredo and Express Scripts: 1-800-842-0070 (toll-free) 24 hours a day, 7 days a week, express-scripts.com
If you are affected by the hurricane and need your medicine, we can help. If you need an emergency fill, login to express-scripts.com and go to Find a Pharmacy to locate a nearby network pharmacy. Then, call the pharmacy to check if it is open. If your ID card is unavailable, call the number above for assistance, and to locate a nearby network pharmacy. Deliveries might be delayed into affected areas.
EyeMed: 1-866-652-0018 (toll-free) Mon-Sat 7:30 a.m.-11 p.m. ET; Sun 8 a.m.-8 p.m. ET
If you’ve lost, broken or damaged your eyewear, emergency (temporary) replacement glasses can be sent to you, at no cost, with overnight shipping (must call by 2:30 p.m. ET for same-day processing). Or, if you prefer to order permanent replacement glasses or contacts, expedited shipping is available.
Medical care and more:
Teladoc: 1-855-764-1727 (toll-free) 24 hours a day, 7 days a week, or for more information visit teladoc.com/michael/
Telemedicine services are available to any resident of an evacuation zone, regardless of health plan membership. Individuals can request a call from a doctor, free of charge, to handle non-emergency medical problems via specific contact information above.
Railroad HEALTHLINK: 1-866-735-5685 (toll-free) 24 hours a day, 7 days a week
Free telephone access to registered nurses is available 24 hours a day, 7 days a week regardless of health plan membership.
Aetna: 1-833-327-2386 (toll-free) 24 hours a day, 7 days a week
Help finding care, behavioral health support, and assistance with finding available shelters and government resources, and other services are available through Aetna’s Resources for Living, regardless of health plan membership to people in affected areas.
Highmark/Blue Cross Blue Shield: 1-866-267-3320 (toll free) Mon-Fri 8 a.m.-8 p.m. ET
For those who reside in areas where States of Emergency have been declared, waivers have been put in place for Medical Authorization Requirements, Claims Timely Filing, and Paying Out-of-Network Claims as In-Network.
UnitedHealthcare: 1-866-735-5685 (toll-free) 24 hours a day, 7 days a week
Free telephone access to registered nurses is available 24 hours a day, 7 days a week regardless of health plan membership. Help finding health care services is available through the toll-free phone number, and in-network rates will be available even if members are not able to see an in-network provider.
HealthAdvocate: 1-866-799-2690 (toll-free) 24 hours a day, 7 days a week
Experts are available to help: locate in-network providers in a new area, find facilities that will be able to provide temporary assistance, transfer medical records and prescriptions, get a short supply of medications if prescriptions have been lost, coordinate care between insurance company and medical providers, answer benefit and treatment questions and help with elderly parents.
Aetna Dental: 1-877-238-6200 (toll-free) Mon-Fri 8 a.m.-6 p.m. ET
Members affected by the hurricane who need care or other assistance can access Aetna.
The Centers for Medicare & Medicaid Services has announced that the standard monthly Part B premium will be $135.50 in 2019, a slight increase from $134.00 in 2018. However, some Medicare beneficiaries will pay slightly less than this amount. By law, Part B premiums for current enrollees cannot increase by more than the amount of the cost-of-living adjustment for social security (railroad retirement tier I) benefits.
Since that adjustment is 2.8 percent in 2019, about 2 million Medicare beneficiaries will see an increase in their Part B premiums but still pay less than $135.50. The standard premium amount will also apply to new enrollees in the program, and certain beneficiaries will continue to pay higher premiums based on their modified adjusted gross income.
The monthly premiums that include income-related adjustments for 2019 will range from $189.60 up to $460.50, depending on the extent to which an individual beneficiary’s modified adjusted gross income exceeds $85,000 (or $170,000 for a married couple). The highest rate applies to beneficiaries whose incomes exceed $500,000 (or $750,000 for a married couple). The Centers for Medicare & Medicaid Services estimates that about 5 percent of Medicare beneficiaries pay the larger income-adjusted premiums.
Beneficiaries in Medicare Part D prescription drug coverage plans pay premiums that vary from plan to plan. Part D beneficiaries whose modified adjusted gross income exceeds the same income thresholds that apply to Part B premiums also pay a monthly adjustment amount. In 2019, the adjustment amount ranges from $12.40 to $77.40.
The Railroad Retirement Board withholds Part B premiums from benefit payments it processes. The agency can also withhold Part C and D premiums from benefit payments if an individual submits a request to his or her Part C or D insurance plan.
The following tables show the income-related Part B premium adjustments for 2019. The Social Security Administration (SSA) is responsible for all income-related monthly adjustment amount determinations. To make the determinations, SSA uses the most recent tax return information available from the Internal Revenue Service. For 2019, that will usually be the beneficiary’s 2017 tax return information. If that information is not available, SSA will use information from the 2016 tax return.
Those railroad retirement and social security Medicare beneficiaries affected by the 2019 Part B and D income-related premiums will receive a notice from SSA by the end of the year. The notice will include an explanation of the circumstances where a beneficiary may request a new determination. Persons who have questions or would like to request a new determination should contact SSA after receiving their notice.
Additional information about Medicare coverage, including specific benefits and deductibles, can be found at www.medicare.gov.
2019 PART B PREMIUMS
Beneficiaries who file an individual tax return with income:
Beneficiaries who file a joint tax return with income:
Income-related monthly adjustment amount
Total monthly Part B premium amount
Less than or equal to $85,000
Less than or equal to $170,000
Greater than $85,000 and less than or equal to $107,000
Greater than $170,000 and less than or equal to $214,000
Greater than $107,000 and less than or equal to $133,500
Greater than $214,000 and less than or equal to $267,000
Greater than $133,500 and less than or equal to $160,000
Greater than $267,000 and less than or equal to $320,000
Greater than $160,000 and less than $500,000
Greater than $320,000 and less than $750,000
$500,000 and above
$750,000 and above
The monthly premium rates paid by beneficiaries who are married, but file a separate return from their spouses and who lived with their spouses at some time during the taxable year, are different. Those rates are as follows:
Beneficiaries who are married, but file a separate tax return, with income:
Most railroad retirement annuities, like social security benefits, will increase in January 2019 due to a rise in the Consumer Price Index (CPI) from the third quarter of 2017 to the corresponding period of the current year.
Cost-of-living increases are calculated in both the tier I and tier II benefits included in a railroad retirement annuity. Tier I benefits, like social security benefits, will increase by 2.8 percent, which is the percentage of the CPI rise. Tier II benefits will go up by 0.9 percent, which is 32.5 percent of the CPI increase. Vested dual benefit payments and supplemental annuities also paid by the Railroad Retirement Board (RRB) are not adjusted for the CPI change.
In January 2019, the average regular railroad retirement employee annuity will increase $60 a month to $2,808 and the average of combined benefits for an employee and spouse will increase $86 a month to $4,078. For those aged widow(er)s eligible for an increase, the average annuity will increase $34 a month to $1,398. However, widow(er)s whose annuities are being paid under the Railroad Retirement and Survivors’ Improvement Act of 2001 will not receive annual cost-of-living adjustments until their annuity amount is exceeded by the amount that would have been paid under prior law, counting all interim cost-of-living increases otherwise payable. Some 52 percent of the widow(er)s on the RRB’s rolls are being paid under the 2001 law.
If a railroad retirement or survivor annuitant also receives a social security or other government benefit, such as a public service pension, the increased tier I benefit is reduced by the increased government benefit. Tier II cost-of-living increases are not reduced by increases in other government benefits. If a widow(er) whose annuity is being paid under the 2001 law is also entitled to an increased government benefit, her or his railroad retirement survivor annuity may decrease.
However, the total amount of the combined railroad retirement widow(er)’s annuity and other government benefits will not be less than the total payable before the cost-of-living increase and any increase in Medicare premium deductions.
The cost-of-living increase follows a tier 1 increase of 2.0 percent in January 2018, which had been the largest in 6 years. The Centers for Medicare and Medicaid Services recently announced the Medicare Part B premiums for 2019, and this information is available at www.medicare.gov.
In late December the RRB will mail notices to all annuitants providing a breakdown of the annuity rates payable to them in January 2019.
Social Security and Supplemental Security Income (SSI) benefits for more than 67 million Americans will increase 2.8 percent in 2019, announced the Social Security Administration (SSA).
The 2.8 percent cost-of-living adjustment (COLA) will begin with benefits payable to more than 62 million Social Security beneficiaries in January 2019. Increased payments to more than 8 million SSI beneficiaries will begin on December 31, 2018. (Note: some people receive both Social Security and SSI benefits). The Social Security Act ties the annual COLA to the increase in the Consumer Price Index as determined by the Department of Labor’s Bureau of Labor Statistics.
Some other adjustments that take effect in January of each year are based on the increase in average wages. Based on that increase, the maximum amount of earnings subject to the Social Security tax (taxable maximum) will increase to $132,900 from $128,400.
Social Security and SSI beneficiaries are normally notified by mail in early December about their new benefit amount. This year, for the first time, most people who receive Social Security payments will be able to view their COLA notice online through their mySocial Security account. People may create or access their mySocial Security account online at www.socialsecurity.gov/myaccount.
Information about Medicare changes for 2019, when announced, will be available at www.medicare.gov. For Social Security beneficiaries receiving Medicare, Social Security will not be able to compute their new benefit amount until after the Medicare premium amounts for 2019 are announced. Final 2019 benefit amounts will be communicated to beneficiaries in December through the mailed COLA notice and mySocial SecurityMessage Center.
When a natural disaster, extreme weather or other emergency occurs that affects providers and the Medicare beneficiaries that they serve, special emergency-related policies and procedures may be implemented.
The process begins when a governor of an affected state requests assistance. This is done if the event is beyond the combined response abilities of the state and local governments. From this request, the President of the United States can declare a Public Health Emergency (PHE), using the Robert T. Stafford Disaster Relief and Emergency Assistance Act.
Under Section 1135 or 1812(f) of the Social Security Act, the Centers for Medicare & Medicaid Services (CMS) can issue ‘blanket waivers’ for providers and suppliers when it comes to services that are provided by skilled nursing facilities, home health agencies and critical access hospitals. Measures are in place to assist with durable medical equipment and supplies, as well as quality reporting, extending the appeals time limit, and getting replacement prescription refills.
As an example in an impacted area, when a waiver is granted for submitting appeal requests (which normally would need to be filed 120 days from the date of the claim denial notification), an appeal may be filed after the 120 days based on CMS guidance.
The following are the most recent hurricane-related PHE’s for which HHS has authorized waivers:
Hurricane Michael – Florida (at the time of writing this article)
Hurricane Florence – North Carolina, South Carolina and Virginia
Hurricane Maria – Puerto Rico and the U.S. Virgin Islands
Hurricane Nate – Louisiana and Mississippi
Hurricane Irma – Florida, Georgia and South Carolina
Hurricane Harvey – Texas and Louisiana
Medicare has a toll-free helpline you can use if you are in an impacted area. This Disaster Distress Helpline is available 24/7. The toll-free, multilingual and confidential crisis support service can be reached by calling 1-800-985-5990. You can also text TalkWithUs to 66746 (for Spanish, press 2 or text Hablanos to 66746) to connect with a trained crisis counselor.
Hurricanes don’t discriminate in terms of destruction, and there are times when a person only has the clothes on their back – but no wallet or Medicare card to get assistance. If you lose your Medicare card, you can call our Beneficiary Customer Service Center at 800-833-4455, Monday through Friday, 8:30 a.m. until 7 p.m. ET to order a new one. For the hearing impaired, call TTY/TDD at 877-566-3572. You may also call the Railroad Retirement Board at 877-772-5772.
Under the Railroad Retirement Act, a “current connection with the railroad industry” is one of the eligibility requirements for occupational disability annuities and is one of the factors that determines whether the Railroad Retirement Board (RRB) or the Social Security Administration has jurisdiction over the payment of monthly benefits to survivors of a railroad employee. It is also one of the eligibility requirements for supplemental annuities.
The following questions and answers describe the current connection requirement and the ways the requirement can be met.
1.How is a current connection determined under the Railroad Retirement Act?
To meet the current connection requirement, an employee must generally have been credited with railroad service in at least 12 months of the 30 months immediately preceding the month his or her railroad retirement annuity begins. If the employee died before retirement, railroad service in at least 12 months in the 30 months before the month of death will meet the current connection requirement for the purpose of paying survivor benefits.
However, if an employee does not qualify on this basis, but has 12 months of service in an earlier 30-month period, he or she may still meet the current connection requirement. This alternative generally applies if the employee did not have any regular employment outside the railroad industry after the end of the last 30-month period which included 12 months of railroad service, and before the month the annuity begins or the date of death.
Once a current connection is established at the time the railroad retirement annuity begins, an employee never loses it, no matter what kind of work is performed thereafter.
2.Can nonrailroad work before retirement break a former railroad employee’s current connection?
Yes. Full or part-time work for a nonrailroad employer in the interval between the end of the last
30-month period including 12 months of railroad service and the month an employee’s annuity begins, or the month of death if earlier, can break a current connection, even where the earnings are minimal.
Self-employment in an unincorporated business will not break a current connection. However, if the business is incorporated the individual is considered to be an employee of the corporation, and such self-employment can break a current connection.
Federal employment with the Department of Transportation, National Transportation Safety Board, Surface Transportation Board, National Mediation Board, Railroad Retirement Board or Transportation Security Administration will not break a current connection. State employment with the Alaska Railroad, as long as that railroad remains an entity of the State of Alaska, will not break a current connection. Also, railroad service in Canada for a Canadian railroad will neither break nor preserve a current connection.
3.Are there any exceptions to these normal procedures for determining a current connection?
A current connection can also be maintained, for purposes of survivor and supplemental annuities, but not for an occupational disability annuity, if the employee completed 25 years of railroad service, was involuntarily terminated without fault from his or her last job in the railroad industry, and did not thereafter decline an offer of employment in the same class or craft in the railroad industry regardless of the distance to the new position.
If all of these requirements are met, an employee’s current connection may not be broken, even if the employee works in regular nonrailroad employment after the 30-month period and before retirement or death. This exception to the normal current connection requirement became effective October 1, 1981, but only for employees still living on that date who left the rail industry on or after October 1, 1975, or who were on leave of absence, on furlough or absent due to injury on October 1, 1975.
4.Would the acceptance of a buy-out have any effect on determining whether an employee could maintain a current connection under this exception provision?
Generally, in cases where an employee has no option to remain in the service of his or her railroad employer, the termination of the employment is considered involuntary, regardless of whether the employee does or does not receive a buy-out.
However, if an employee has the choice of either accepting a position in the same class or craft in the railroad industry or termination with a buy-out, accepting the buy-out is a part of his or her voluntary termination, and the employee would not maintain a current connection under the exception provision.
5.An employee with 25 years of service is offered a buy-out with the option of either taking payment in a single lump sum or of receiving monthly payments until retirement age. Could the method of payment affect the employee’s current connection under the exception provision?
The employee must always relinquish job rights in order to accept the buy-out, regardless of whether it is paid in a lump sum or in monthly payments. Neither payment option would extend the 30-month period. The determining factor for the exception provision to apply when a buy-out is paid is not the payment option. It is whether or not the employee stopped working involuntarily.
An employee considering accepting a buy-out should also be aware that if he or she relinquishes job rights to accept the buy-out, the compensation cannot be used to credit additional service months beyond the month in which the employee severed his or her employment relation, regardless of whether payment is made in a lump sum or on a periodic basis.
6.What if the buy-out agreement allows the employee to retain job rights and receive monthly payments until retirement age?
The RRB considers the buy-out to be a dismissal allowance. When a monthly dismissal allowance is paid, the employee retains job rights, at least until the end of the period covered by the dismissal allowance. If the period covered by the dismissal allowance continues up to the beginning date of the railroad retirement annuity, railroad service months would be credited to those months. These railroad service months would provide at least 12 railroad service months in the 30 months immediately before the annuity beginning date and maintain a regular current connection. They will also increase the number of railroad service months used in the calculation of the railroad retirement annuity.
7.Could the exception provision apply in cases where an employee has 25 years of railroad retirement coverage and a company reorganization results in the employee’s job being placed under social security coverage?
The exception provision has been considered applicable by the RRB in cases where a 25-year employee’s last job in the railroad industry changed from railroad retirement coverage to social security coverage and the employee had, in effect, no choice available to remain in railroad-retirement-covered service. Such 25-year employees have been deemed to have a current connection for purposes of survivor and supplemental annuities.
8.Where can a person get more specific information on the current connection requirement?
More information is available by visiting the RRB’s website, RRB.gov,or by calling an RRB office toll-free at 1-877-772-5772. Persons can also find the address of the RRB office servicing their area by calling the toll-free number, or by clicking on the Field Office Locator tab at RRB.gov. Most RRB offices are open to the public on weekdays from 9:00 a.m. to 3:30 p.m., except on Wednesdays when offices are open from 9:00 a.m. to 12:00 p.m. RRB offices are closed on Federal holidays.
Medicare is always working to fight fraud and abuse. With that, a new type of claim review has recently begun: a process called Targeted Probe and Educate, or ‘TPE’ for short.
How TPE works:
Palmetto GBA/Railroad Medicare will conduct data analysis and find providers whose billing may be very different from their peers. Palmetto will also look at providers who have been identified as having a high error rate (having filed claims that should not be paid, due to medical necessity issues, billing or coding errors, or ones that do not have sufficient documentation to support the service was rendered as billed).
Once a provider is identified, Palmetto will request records for 20 to 40 services, depending on how much the provider has billed to Railroad Medicare.
After the claims are reviewed, one of Palmetto’s clinical staff members will contact the provider by letter and by phone to go over their results and offer education on how to bill and document their services correctly. If the provider has a high error rate in the review, then Palmetto will ask for records for an additional 20-40 claims submitted for payment and follow the process outlined above. If the provider fails to improve again, then a last round of TPE is conducted. If the provider’s error rate is still unacceptable, they will be referred to Palmetto’s Benefit Integrity Unit for investigation. The same is true for providers who refuse to respond to the records requests.
However, if the provider makes an appropriate improvement, they can be removed from the TPE process for a period of time, and then rechecked later to be sure they are still in compliance.
If your provider has questions:
Your provider may have questions about this review process. If they do, please ask them to call our Provider Contact Center at 888-355-9165 and select Option 5. Customer Service Representatives can assist them in understanding the TPE process. All Medicare contractors are using the TPE process to review claims.
If you have any questions about your Railroad Medicare coverage, please call Palmetto’s Beneficiary Contact Center at 800-833-4455, Monday through Friday, from 8:30 a.m. to 7 p.m. ET. For the hearing impaired, call TTY/TDD at 877-566-3572. This line is for the hearing impaired with the appropriate dial-up service and is available during the same hours customer service representatives are available.
Palmetto also invites you to join their listserv/email updates. Just select the ‘Listservs’ link at the top of their main webpage at www.PalmettoGBA.com/RR/Me.