To continue benefits at the previous month's level after terminal cut-off for the effective month of the change, provide Mercury benefits by completing a blank Form 552 as follows:
|Item 1 -
|Item 2 -
||Enter the month and year (for canceled cases, enter month and year of the cancellation).|
|Item 3 -
|Item 4 -
|Items 5, 6, 8 -
|Items 9-10 -
||Complete if the unit's address has changed.|
|Item 23 -
|Item 33 -
||For canceled cases, enter TAR 08. For active cases, enter TAR 11.|
|Item 38 -
For canceled cases, enter the amount of the previous month's benefit. A different amount can be entered if a change occurred, a timely notice has been sent, and that change is not the issue under appeal.
For active cases, enter the difference between the previous month's benefit and the reduced payment.