PM 18-04-14.

(FCRC) Complete Form 552 to change a component FS member to an active Cash or Medical benefit client on the same Form 552:

  • Item 2 - Complete.
  • Item 3 -Enter TA 34.
  • Item 4 -Enter 1.
  • Item 15 -Enter 1 if currently coded 2.
  • Item 23 -Reenter number of eligible FS members.
  • Item 24 -Reenter FS approval expiration date.
  • Item 33 -Enter TAR 00.
  • ASSISTANCE UNIT-To include the member in the cash or medical benefit case, line out the person being changed and reenter them.
  • Items 60-74 -Complete.
  • Items 77-79 -Complete.
  • Item 80 -Enter any FS Needs Codes that require change or correction.

Complete other items as needed.

(System) Reassigns the changed person to the proper place in the benefit unit section on the turnaround Form 552.

See WAG 17-02-06 to authorize benefits as a Cash or Medical FS unit.