Medicare Managed Care Manual (Pub. 100-16), Ch. 17b § 350.2
A Nonconforming LGHP
350.2 - A Nonconforming LGHP
(Rev. 4, 10-01-01)
A nonconforming LGHP means that at any time during the calendar year, it is taken into
account that an active individual is eligible for or receives benefits based on disability,
for example, an LGHP fails to pay primary benefits for disabled individuals under age 65
for whom Medicare is secondary payer.
NOTE: Although the term “large group health plan” includes a plan for former
employees or persons formerly associated with the employer in a business
relationship or their families, these individuals are not included in the definition
of active individual, i.e., Medicare is not secondary for them. These individuals
are included within the definition of LGHP for tax purposes.