PM 19-08-00

  1. Triggers that Rerun Eligibility Based on Case Information
  2. Triggers that Rerun Eligibility Based on Interface Data
  3. Triggers that Generate a Task
  4. Triggers that Generate a Notice or Redetermination

Triggers that Rerun Eligibility Based on Case Information

Under certain circumstances, when a batch trigger is applied to a case, eligibility is run and the result is systematically certified. No worker action is necessary. 

Most batch actions will be run monthly (at or around schedule cut-off) by the eligibility batch process, unless otherwise stated.

The 'Last Mass Update Date' field on the 'Case Search/Summary' page shows when the last mass change occurred on a case. Staff may also go to the Eligibility Search page and search for a date range to see eligibility results after a mass change is applied to a case.

Programs Description IES Action = Rerun Eligibility
deleted text
TANF and Medical

Batch Action 19 Year Old

Case has a child turning 19

(Replaces PAL Code A)

TANF - removes 19 year old from TANF EDG, may close TANF EDG if last child.

Medical - determines eligibility under ACA Adult or other medical EDG, or cancels.

Runs the day after cut-off the month before 19th birthday, effective for month after 19th birthday.

TANF

Batch Action TANF 18 Year Old

Case has a child turning 18 and not a full time student

(Replaces PAL Code B) 

Removes 18 year old from TANF EDG if not a full time student, may close TANF EDG if last child.

Runs 2 days prior to cut-off for month after 18th birthday.

Medical

Batch Action Medical 18 Year Old

Last child turning 18

Note: This affects the caretaker relative's eligibility group; the 18 year old remains eligible as a child until age 19.

Moves parents/caretaker relatives from FamilyCare to ACA Adult if last child.

Runs 2 days prior to cut-off for month after 18th birthday.

SNAP

Batch Action ABAWD Time Limit

Able Bodied Adults Without Dependents (ABAWD) person reaching the time limit based on program rules.

Currently the State is exempt from the time limit for ABAWDS per PM 03-25-00.

Closure of the SNAP EDG

Runs 2 days prior to cut-off during the month when the individual will reach their time limit.

Refugee cash

Batch Action Refugee Time Limit

Refugee cash recipient reaching end of eligibility period

Closure of the Refugee Cash EDG

Runs at cut-off for the month after the certification end date.

TANF

Batch Action TANF Clock Limit

Reaching (or passed) the maximum 60 month TANF Clock Limit and no exception was/is granted.

Closure of the TANF Cash EDG

Runs at cut-off for the 61st (or next) month.

Medical

Batch Action 60 Day Post Partum

Pregnant woman's 60 day post partum period is going to end.

(Replaces PAL code P)

Closes pregnant woman EDG, determines eligibility for other medical EDG, or cancels if criteria not met.

Runs 2 days prior to cut-off for month after post partum period ends.

SNAP & cash

Batch Action MPR

Mid Point Report (MPR) not received - 6 months (due date passed)

Closure

Runs at cut-off for the 7th month.

SNAP

Batch Action TSNAP

Transitional SNAP (TSNAP) reached 5 months

Closure

Runs at cut-off for the 6th month.

Medical

Batch Action Unmet Spenddown

Spenddown not met in at least one of the last 3 months, after being in spenddown for at least 6 months

Closure

EDG is closed unless it meets one of the exceptions in PM 19-02-02-c or 19-02-03-c

Runs at cut-off.

Medical

Batch Action LPR Reaches 5 Years

Legal permanent resident (LPR) child (or pregnant woman) reaches 5 years in this status

Sends updated immigration status code to MMIS for federal funding purposes; does not affect eligibility.

Runs 2 days prior to cut-off for month individual reaches 5 years in status.

Medical

Batch Action HBWD Age 65

HBWD recipient turning 65

Determines eligibility under AABD Community program.

Runs 2 days prior to cut-off for month individual reaches age 65.

Triggers that Rerun Eligibility Based on Interface Data

Programs Description IES Action = Rerun Eligibility
Medical

Bendex Update Medicare

AABD recipient receives Part A Medicare (MSP / ACA)

Determines eligibility for Medicare Savings Plan (MSP)
Medical

Bendex Update Widow(er)

Eligible as a Widow(er)

Bendex update file contains a record of an individual receiving widow(er) benefits; provides Widow(er) benefits (PM 06-07-00)
All Programs

Bendex Update SSI

Recipient receives SSI

Bendex update file contains a record of an individual receiving SSI. This will trigger a mass change if that individual is eligible in a TANF or SNAP EDG
  • TANF - closure or deletion
  • SNAP - budget the SSI
  • Medical (ACA Adult)- updates code sent to MMIS for federal funding purposes
All Programs

Bendex Update SSA

Update to SSA-RSDI Income or Medicare Premium Expenses

Updated income is budgeted.
All Programs

Consolidated Death Match

Death Match- Public Health, Bendex, other certified death match

Enters date of death in Individual Information screen, closes case if single person case, or removes from certified group if case has multiple persons.

If person is included in the tax filer unit of another person's FHP or ACA Adult EDG size, he will remain in the EDG size until end of tax year.

revised textA task "Client Presumed Deceased" will be created when IES is unable to auto-process the match in situations where an exact match cannot be confirmed.

All Programs

IDES UIB

Unemployment Insurance Benefits income discrepancy (Replaces PAL code U)

(Replaces PAL code U)
IDES file updates IES with new or updated unemployment insurance income.

Triggers that Generate a Task

The following triggers create tasks in the Changes/Misc EDM queue in the EDM Inbox for each case an individual is on. Tasks also appear on the case. If a task is connected to a person who is on more than one case, both cases need to be reviewed and certified separately.

  • Example: Mr. T is a component SNAP member on his parents' SNAP case, and receives ACA Adult medical benefits on a separate IES case. An IDES Wage Mismatch task is received indicating that he had unbudgeted earned income. The worker discovers that he is currently employed and enters his income information on the SNAP case. Since income is stored in IES at the individual level, his income is updated on the medical only case as well. The worker runs eligibility and certifies the results on the SNAP case, and must run eligibility and certify the results on the Medical only case as well.

Tasks in IES are closed when updates are made, the worker runs eligibility and the case is certified.

Programs Description IES Action = Task CW Action
All Programs

IDES Wages

Wage discrepancy between IES and IDES file; income is not being budgeted

(Replaces PAL code C)

Task is 'IDES Wage Mismatch'.

Wage discrepancy information, runs quarterly and appears on a quarterly report IL-18100502-QTL Priority Action List, generated in February, May, August and November.

CW actions listed in WAG 19-06-01-d

Manually generate Form 1721C if appropriate.

Document in case notes how discrepancy was resolved.

All Programs

IDES New Hires

State New Hire Report

(runs weekly)

Task is 'IDES New Hire Match'

Hew Hire information appears on a weekly report IL-50470321-WLY-State New Hire No EI Budgeted, and a notice is sent to client (Instructions to Client New Hire)

CW actions listed in WAG 22-14-02

Document in case notes how discrepancy was resolved.

AABD Medical, TANF

CAU Review

CAU Disability Determination Review

(Replaces PAL code X)

Task is 'CAU Disability Determination Review' Identifies clients who are due for a review of their CAU determination.

  • AABD medical - for disability determination
  • TANF - for W&T exemption (Medical Barrier)

Runs the day after cut-off the month before CAU review due date.~

CW actions listed in WAG 19-06-01-l

Update CAU questions in IES 'Disability' screen; this will create a task for CAU staff.

Triggers that Generate a Notice or Redetermination

Redeterminations may go through several batch actions. For medical EDGs, an interface action occurs prior to generating the REDE notice. The interface runs clearances to determine whether a medical EDG qualifies for an auto-REDE (Process A) or a manual REDE (Process B).

After IES determines if the Medical EDG qualifies for auto-REDE, IES sends the appropriate correspondence to the customer.

A third batch action occurs at cut-off in the last month of the certification period when a medical EDG may be automatically recertified under Process A; or a SNAP, cash or medical EDG may be canceled due to not responding to a REDE notice as required.

Programs Description IES Actions = Notice/REDE CW Action
TANF

TANF Newborn

Newborn turns 1 year old

Schedules and sends appointment notice; generated when any child turns 1 year old (not just deemed newborn).

Also creates task in the WVS Inbox (rather than EDM Inbox).

Batch runs the day after cut-off in the month before 1st birthday.

Update the RSP
TANF & SNAP

Child Age 6

Youngest child turned 6 years old

Schedules and sends appointment notice; generated when the youngest child in the SNAP EDG turns 6 years old and the EDG contains an individual that is exempt from Work Participation for having a child under 6 years.

Also creates task in the WVS Inbox (rather than EDM Inbox).

Runs the day after cutoff in the one month before 6th birthday.

Update the RSP

Update work deferral

TANF TANF 57 Month trigger

Notice to inform them about the process for requesting exemption, and the request form is generated to TANF clients.

The batch runs after cut-off of the 56th month.

Respond to exemption request if received
TANF TANF 54 Month trigger

Notice generated to notify client of their TANF Counter and time limit (Form 4634).

The batch runs after cut-off of the 53th month.

Respond to exemption request if received
TANF TANF 48 Month trigger

Notifies the client of their TANF Counter and time limits (Form 4634).

The batch runs after cut-off of the 47th month.

Respond to exemption request if received
Medical

REDE Clearances

Runs AWVS, The Work Number (TWN) and Secretary of State clearances for Medical EDGs due for REDE

Determines whether medical EDGs that qualify can be auto-REDE'd or not, based on income & Illinois residence data.

Runs after cutoff 2 months before the last month in the certification period.

No action
All Programs

REDE Notices

REDE Notices generated

Medical

  • Process A - notifies client about continued medical eligibility.
  • Process B - client must respond to REDE to determine continued medical eligibility.

Cash & SNAP - Client must always respond to REDE.

Notices mailed about 60 days before last day of certification period.

A REDE task is created when a client response to the REDE notice is received and entered into IES.

Process A and no response received - No action.

Client Responds to REDE - process REDE and certify results.

All Programs

REDE Auto Actions

REDE is certified and new certification period assigned, or benefits canceled by system

Runs all REDEs for which a response has not been received and entered into IES.

  • Recertifies medical benefits for EDGs eligible under Process A
  • Cancels benefits for EDGs that did not respond to cash or SNAP REDE, or to medical REDE for EDGs subject to Process B

Runs on cut-off in the last month of the certification period.

No action unless client responds within allowable time limits.

(see PM 19-04-02)

new textMedical

REDE Deemed Newborn

Deemed newborn turns 1 year old.

Child must now meet income and SSN (or application for SSN) criteria; written request to add child required if not yet on file.

Generates REDE to determine continued eligibility under another medical program.

A REDE task is created when a client response to the REDE notice is received and entered into IES.

Process A and no response received - No action.

Client Responds to REDE - process REDE and certify results.

Medical

REDE AGE 65

ACA Adult, BCC, Widow(er) or VC recipient turning 65

Generates REDE to determine continued eligibility under another medical program.

A REDE task is created when a client response to the REDE notice is received and entered into IES.

Process A and no response received - No action.

Client Responds to REDE - process REDE and certify results.

Medical

Medicare VCL

ACA Adult or FHP recipient receives Part A Medicare (MSP / ACA) - Bendex Update

  • ACA Adults - Generates VCL to request resource information to determine AABD and MSP eligibility.
  • FHP - Generates VCL to request resource information to determine MSP eligibility.

ACA - remove from ACA Adult and determine AABD and MSP eligibility.

FHP - determine MSP eligibility.

Medical

REDE FFC

Former Foster Care (FFC) recipient tuning age 26

Generates REDE to determine eligibility for another medical program.

REDE task is created when a client response to the REDE notice is received and entered into IES.

Process A and no response received - No action.

Client Responds to REDE - process REDE and certify results.

Medical

REDE AATV

Asylum Applicant or Torture Victim (AATV) recipient reaching maximum 36 month limit.

Generates REDE to determine eligibility for another medical program.

REDE task is created when a client response to the REDE notice is received and entered into IES.

Client Responds to REDE - process REDE and certify results