WAG 19-06-01-d: Code C

This code lists for categories 00, 01, 02, 03, 04, 06, 90, 91, 92, 93, 94, and 96, including Share, Premium and Rebate. Medical extension cases (i.e., coded X in Item 25) that are receiving SNAP and meet the C code criteria are selected for code C.

This code identifies a person who received earnings, as shown on the Illinois Department of Employment Security (IDES) files, while they were receiving Cash or SNAP. The case selects if no earnings were budgeted for the quarter. A case is not selected if earnings ended during the quarter and Item 80 Code 651 EE is present. In addition, any case in EZ REDE status (Item 36 coded R) for at least one month in the quarter is not selected.

NOTE: During the period 06/12 through implementation of IES Phase 2, SNAP approval periods were extended 6 months for SNAP only (category 08) and Family Health Plan (category 94/96) cases due for mail in rede.  Those cases coded with 801, 802, or 654 in Item 90 that have a SNAP benefit amount of $400 or higher were not extended. The cases with approval periods centrally extended were coded with a C, D, E, G, J, K, or L in Item 80 656 Total Cost field based on the time period for the extension. Codes C, D, E, G, J, L, or L in Item 80 656 Total Cost field are retained and displayed in ACID and on the Form 552.

For those converted cases coded with a R in Item 36 and a C, D, E, G,  J, K, or L in Total Cost field of Item 80 code 656 EZ RD, the system will select the case for any of the "match" months. Once the converted cases have matched for the appropriate months, the system will revert to the previous selection criteria so cases with an R in Item 36 will not be selected and will no longer appear on the PAL.

• See PM 01-01-04 regarding confidentiality of case information.
• See PM 02-07-03 regarding verification of eligibility factors.
• See PM 03-11-00 regarding SSN discrepancies.
• See PM 10-02-00, WAG 10-02-00, PM 10-04-00, and WAG 10-04-00 regarding budgeting of income.
• See WAG 15-04-00 regarding consideration of income for Medical.
• See PM 22-08-03 for a description of the AWVS inquiry system.
• See WAG 23 regarding overpayments and recoupment/recovery procedures.

Central C Code Project

Cases receiving SNAP with C codes in the following FCRCs are centrally referred to BOC if no earnings were budgeted for the earnings quarter:

• DuPage
• East St. Louis
• East Alton
• Granite City
• Humboldt Park
• Jackson
• Kankakee
• Logan
• Macon
• Mid-Illinois
• Mid-South
• Peoria
• Western
• Williamson
• Winnebago, and
• South Suburban

See WAG 19-06-05, for actions on cases referred to BOC.

See PM 19-08-00 for information about batch actions in IES.  In Phase 2, BOC workers will use IES to process and manage overpayments on active and legacy cases.  A chart that shows how PAL codes are handled in IES Phase 2 is contained in PM 19-06-00.

Casework Action

1. Verify that the IDES wage earner is the customer rather than someone else using the same last name and/or SSN. See WAG 03-11-01 for SSN discrepancy procedures if the SSN is incorrect. If the wage earner is not the customer, go to Step #12 for code removal.
2. If it is determined that the person(s) shown on the PAL is a child(ren), no further action is needed and the code may be cleared. Enter code 805 in Item 90 of Form 552 to prevent re-selection of the case if the child currently has earned income. See Step #12 for code removal.
3. If the matched person is a responsible relative (RR) who is not a member of the benefit unit and earnings were budgeted as a contribution, determine if the earnings were properly budgeted. If so, no further action is necessary.
4. If a C code was selected based on employment identified in a previous match, check to see if the C code was cleared appropriately before. If an overpayment was filed for the entire period of employment and all the appropriate procedures were followed in clearing the original C code, no further action is necessary. See Step #12 for code removal.
5. If earnings identified on the PAL were not budgeted correctly, determine whether it was a budgeting error by the FCRC. Even if the customer reported income correctly, if the FCRC budgeted it incorrectly determine the overpayment and initiate recoupment if appropriate (see PM 23-04-00).

   For Medical, determine the amount of nonexempt income available during the established period and adjust the spenddown status or amount if necessary (see WAG 15-08-00). No further action is necessary. See Step #12 for code removal. 

6. If it was not a budgeting error and there are "Gross Earnings Received" on the PAL that have not already been reconciled, send the customer Instructions to Recipient - Earnings Information (Form 1721C).

   If the discrepancy in earnings involves a member of the TANF unit and the customer does not respond within 10 days from the date Form 1721C is mailed, cancel the case for failure to cooperate with income verification. If it can be determined that the discrepancy in earnings involves only a SNAP component member(s) and the customer does not respond within 10 days from the date Form 1721C is mailed, cancel only the SNAP benefits.

   For cash and SNAP, divide the quarterly amount on the PAL by 3 to arrive at a monthly income amount. Use the monthly income amount to project income over the entire period up to the month of cancellation. Report the overpayment and notify the customer (see PM 23-04-00). 

7. If the customer cooperates and contacts the FCRC within the 10 days on Form 1721C, question the customer regarding employment. If the earnings information cannot be verified by the customer, send Request for Employment Verification (Form 266) to the employer(s) listed on the PAL. If they provide verification that employment with the matched employer has ended, attempt to determine if the customer has started work for a new employer.

   If current employment is discovered, follow procedures for the budgeting of income (see WAG 08-01-00 and WAG 15-04-02). If a regular Medical case becomes spenddown, send Form 2434 to the customer. Enter code 390 SPD in Item 80. If a REDE was also completed, submit the REDE first then resubmit Form 552 to code as spenddown. 

8. If the customer states they are unable to provide the wage verifications, wait up to 30 days for the return of Form 266 to calculate any overpayment. If the employer returns the wage verification within the 30-day period, use the information on Form 266 to calculate any overpayment (for cash and SNAP).

   If the employer does not respond within 30 days from the date of the Form 266, divide the quarterly amount on the PAL by 3 to arrive at a monthly income amount. Use this monthly income from the PAL to project income over the entire period up to the current month or the month the income ended, if it can be verified.

   Report the overpayment and notify the customer (see PM 23-05-00). For Medical, determine the amount of nonexempt income available during the established period using FamilyCare Assist/All Kids Computation Sheet (Form 2383A). If Form 266 indicates health insurance that has not already been reported, copy the reverse Health Insurance Report (Form 266/1442), enter PAL Code C, and submit to TPL. 

9. For cash and SNAP, if the employer later returns Form 266, recalculate the overpayment based on the additional information and send Change of Overpayment Information (Form 2404C) to the Bureau of Collections. If not already sent, copy the reverse Form 266/1442, enter PAL Code C, and submit to TPL.
10. If no earnings are currently being budgeted and no current employment was discovered, question the customer and run a Wage Verification File Inquiry (AWVS) to determine if UI benefits are being received. If the customer is not receiving UI benefits determine potential eligibility for UI and refer the customer to apply for UI benefits, if appropriate (see PM 09-03-01-g).

    For cash and SNAP, budget appropriately and determine any overpayment. Report the overpayment and notify the customer (see PM 23-04-00).

    For Medical, determine nonexempt income available during the established period using Form 2383A. If appropriate send Medical Assistance Enrollment Status Information/Changes During the Established Period (Form 2434) to advise the customer of the new spenddown amount. 

11. If participating, review SNAP eligibility to determine effect of any action taken on the TANF Case.
12. Enter the letter C in Item 52 to remove the case from the PAL.