11/04/13
Summary
- All Kids Rebate is ending 12/31/13 due to a state law change.
- A client notice will be sent to Rebate families to notify them of the change.
- Procedures are in place to move children into Share/Premium coverage or cancel the case depending on the family's preference.
To pave the way for new medical coverage options through the Affordable Care Act (ACA), P.A. 98-0104 eliminates All Kids Rebate as of 12/31/13.
Children whose families choose not to move them into direct medical coverage under Share or Premium will lose the remaining months of their current 12 month enrollment period after 12/31/13.
Option to Switch to Share/Premium
Families have the option of moving their children from All Kids Rebate to Share or Premium Level 1. A Client Notice 13.27 (pdf) Important News about All Kids Rebate explaining this option will be mailed to all active Rebate cases in October. Families may request Share/Premium coverage for the children who are currently enrolled in Rebate. If they request medical coverage by 11/15/13, authorize the change effective 01/14 so there is no break in eligibility.
For Rebate cases that are still active in the Family Community Resource Centers (FCRCs), refer the family to the All Kids unit at 1-877-805-5312. The All Kids unit will handle the change in benefit and cancel the Rebate case.
Cancel the Rebate cases effective 01/01/14 for families who fail to respond to CN 13.27 (pdf) or indicate that they are not interested in receiving Share/Premium coverage for their children.
Applications for Rebate
Process any All Kids Rebate applications received prior to 10/01/13. It's important to process them as soon as possible because Rebate is approved prospectively. Do not approve Rebate effective any month after December 2013.
For All Kids Rebate applications received 10/01/13 and later, contact the applicant to explain that All Kids Rebate is no longer available due to a state law change and ask if they are interested in All Kids Share or All Kids Premium. If they are not interested in direct medical coverage, deny the application.
Send a manual Form 360KC Notice of Decision with the following reason:
"Your children are not eligible for All Kids Rebate because the All Kids Rebate program is ending due to a state law change. Public Act 98-104"
"Sus niños no son elegibles para All Kids Reembolso porque el programa de All Kids Reembolso está terminando debido a un cambio a la ley estatal. Acta Pública 98-104"
Renewals for Rebate
The last month form 643KC/S was sent was in September 2013 for December. Do not process any renewals for Rebate effective January 2014 or later.
Cancelations
Beginning with the processing month for January 2014, cancel active Rebate cases using Type Action Reason (TAR) K3. Send a manual notice Form 157R/S Notice of Change. Form 157R/S provides the reason for the cancelation and information about the Health Insurance Marketplace should the family have a need for insurance in the future.
Appeals
Appeal rights do not apply if the reason for the appeal is that the client disagrees with the law change. However, the client has the right to appeal and be given a fair hearing if they believe that they remain eligible for medical benefits due to an error in the eligibility determination regarding their income or family size, or that they are eligible due to having a disability. In those situations, follow policy contained in PM 01-07.
[Signed]
Michelle R. B. Saddler, Secretary
Illinois Department of Human Services
Julie Hamos, Director
Illinois Department of Healthcare and Family Services
Forms Referenced:
- CN/S 13.27
- 157R/S
- 360KC
- 643KC/S