When processing a new application, AIS is programmed to make the appropriate determination, based on the answers to the questions on Screens K2 and K3.
(FCRC/All Kids Unit) Review the automated ACID clearances in AIS to see if the child or caretaker relative previously received All Kids Premium. If so, determine if code 178 appears in Item 80 on the previous case. Code 178 means that when the case was canceled, the case had unpaid premiums. Indicator 1 means that the past due premiums are unpaid. Indicator 2 means that the past due premiums have been paid.
If code 178 appears in Item 80:
- On Screen K2, enter Y to question 1., "Has anyone been canceled for All Kids Share/Premium/Rebate?" following the name of the child(ren) in the case at the time of cancellation.
- On Screen K3, enter MM/YYYY under "Eff. Date of Cancel", Y under "Code 178 in Item 80? (Y/N)", and 1 or 2, as appropriate under "If yes, Indicator (1 or 2)".
Based on this information, AIS determines the appropriate action.
Example 1: The D family's All Kids Premium case is canceled effective 9/11 for nonpayment of premium. They reapply on 9/13/11. Eligibility is being determined for Rebate. Item 80 contains code 178 with an indicator of 1. Deny the application.
Example 2: The E family's All Kids Premium case is canceled effective 12/11 due to nonpayment of premium. They reapply on 1/01/12. Eligibility is determined on 1/20/12 for All Kids Premium (current processing month of 03/12). Item 80 contains code 178 with an indicator of 2. Screen K3 was completed as follows
Eff. Date of Cancel (MM/YYYY) 12/2011
Code 178 in Item 80? (Y/N) Y
If yes,Indicator (1 or 2) 2
The application is approved and the case is placed in 'enrolled' status effective 03/12.