Explanation of Non-substantive changes

SSA-44: Medicare Part B Income-Related Premium Life-Changing Event Form

OMB No. 0960-0735

Explanation of Non-Substantive Changes

Page 1

Changes:

First paragraph: SSA updated the tax years we use to determine income.

Third paragraph: We updated the threshold amounts, which change annually.

We updated tables to reflect the 2009 sliding scale ranges and the income-related premium amounts for 2009.

Justification:

These changes reflect new figures which we update annually.

NOTE: Please note that we have already started using these new figures, since 1) they do not require OMB approval, as they change annually and 2) a number of individuals and groups that use these needed to know the new figures as soon as possible.

Page 2

Change:

We changed the 6^th check block in Step 1 from “Loss of Income Due to Property Loss” to “Loss of Income from Income-Producing Property.”

Justification:

We made this language change to minimize user confusion and bring the language into conformity with the intent of regulation 20 CFR 418.1205 (definition and explanation of what constitutes a life-changing event).

Page 3

Change:

In the first two paragraphs of Step 5, we re-wrote the Signature explanatory language. We also divided the last paragraph into bullets.

Justification:

We changed the Signature language so it conforms with what we are now using on other forms. We divided the last paragraph because it makes it easier to read and understand.

Page 4

Change:

We revised the Privacy Act statement.

Justification:

This revised language reflects our new standard PA statement, which we adopted in response to litigation.

Page 5

Change:

We updated the tax years listed in Step 1, second paragraph.

Justification:

We made this change to reflect the new 2009 figures.

Change:

We re-worded the Life-Changing Event “Loss of Income Due to Property Loss” to “Loss of Income from Income-Producing Property.”

Justification:

We made this change to be consistent with the Page 2 wording change (described on the first page of this document).

Page 6

Change:

We updated the years listed under “Tax Year.”

Justification:

We made this change to reflect the updated 2009 data.

Page 7

Change:

We changed the years listed under “Tax Year.”

Justification:

We made this change to reflect the updated 2009 data.

Page 8

Change:

In the Life-Changing Event table, we changed Life-Changing Event “Loss of Income Due to Property Loss” to “Loss of Income from Income-Producing Property.”

Justification:

We made this change to be consistent with the Page 2 wording change (described on the first page of this document).

0960-0735 (SSA-44) non-substantive changes

12/10/2008

4