Overdue REDEs on FHP Cases With SNAP-Special Mailing

Illinois Department of Healthcare and Family ServicesIllinois Department of Human Services

06/25/15

Action Memo

Summary:

  • On 5/21/15, a special mailing of medical REDE Form HFS 643 was generated to SNAP customers with overdue FHP REDEs; a second batch of HFS 643s will be generated to the remaining identified cases in late June 2015.
  • The HFS 643 forms that are being centrally generated are an older version and do not contain the MAGI tax filer questions.
  • When the 643 forms are returned, staff must review the record to determine whether Form 4765B (pdf)/4765BS (pdf) was returned with the most recent SNAP REDE.
    • Use Form 4765B to determine whether to use tax filer or relationship rules for the FHP REDE.
    • If the 4765B was not returned, or the tax filer questions were not answered, use relationship rules.
  • Additionally, the centrally generated 643 forms instruct the customer to provide only one pay stub as proof of income.
  • If proof of all income in the last 30 days is not provided by the customer, and you are unable to verify income electronically, send Form 1721 to request the required income verification.

  • A medical REDE should be completed the same time a SNAP REDE is completed on a case when:

    • the medical REDE is due or overdue, or
    • the medical REDE is not yet due and the children or pregnant women on the case continue to be eligible for the same medical benefits.
  • For more information, see the 4/22/15 policy memo, Processing a Medical Redetermination When SNAP is Due.

The Integrated Eligibility System (IES) is not programmed to allow medical cases with overdue REDE dates to be certified in its system. Because medical REDES were not always completed when SNAP benefits were recertified, there are thousands of overdue Family Health Plan (FHP) REDES statewide. To ensure program integrity we must catch up on overdue medical REDEs prior to IES Phase 2 conversion.

HFS 643 Special Mailing

On 5/21/15, a special mailing of medical REDE Form HFS 643 was generated to SNAP customers with overdue FHP REDEs. A second batch of HFS 643s will be generated to the remaining identified cases in late June 2015. Cases that receive this special mailing are identified in Mobius report #84504441.

These REDE forms are due back 14 calendar days after the notice date, or the next business day if the due date falls on a non-work day.

Determining Whether to Use Tax Filer or Relationship Rules for MAGI Budgeting

The centrally generated HFS 643 forms do not contain the MAGI tax filer questions. However, Form 4765B, Attachment to Application, would have been generated with the latest SNAP REDE form. Form 4765B contains the MAGI questions.

When the 643 forms are returned, staff must review the case to determine whether Form 4765B was returned with the most recent SNAP REDE.

  • Use Form 4765B to determine whether to use tax filer or relationship rules for the FHP REDE.
  • If the 4765B was not returned, or the tax filer questions were not answered, use relationship rules.

Verifying Income

The centrally generated HFS 643 tells the customer to provide only one pay stub from the most recent 30 days for each job. However, we must verify a full 30 days worth of income when electronic verification is unavailable. See the policy memo, Verifications for Medical Programs. 

If proof of all income in the last 30 days is not provided by the customer, attempt to verify income electronically before requesting additional proof. If unable to verify income electronically, send Form 1721 to request the required income verification.

Determine Eligibility for ACA Adult or AABD Program

For persons who are no longer eligible for a FHP, determine eligibility for other medical programs.

  • For children who have turned 19, use the REDE form to determine eligibility for the ACA Adult program.
  • If the youngest child has turned age 18, remove parents and determine eligibility for ACA Adult program.
  • Determine eligibility under AABD medical for anyone who no longer qualifies for FHP or ACA Adult and is age 65 or older or receiving Medicare. Send the 2378DR or VR. Use the rede and 2378DV/VR as the application for the AABD case.

[signed copy on file]

James T. Dimas

Secretary designate, Illinois Department of Human Services 

Felicia F. Norwood

Director, Illinois Department of Healthcare and Family Services

Forms referenced

  • Form HFS 643
  • Form 4765B
  • Form 1721