PM 06-08-09-d: Cases in Enrolled Status

WAG 06-08-09-d.

A case in enrolled status is similar to an unmet spenddown case. The case does not actually receive benefits but appears as enrolled on the Client Database. When a case is enrolled, no notice of decision is sent. Do not send a locally generated notice of decision.

  • If the family pays the required premiums within 30 days of the day the system enrolls the case, the system changes the case status to active for the current processing month. It does this on the day the premiums are paid. An approval notice is centrally generated. The original 12-month eligibility period stays the same.
  • If the family does not pay the required premiums within 30 days, the system cancels the enrolled case and generates a denial notice.