Phase 1 Training RAQ

RAQ Instructions
Phase 1 Training
BCPH Program Overview
BCPH Non-Financial
BCPH Financial
BCPH Program Admin
BCPH Program Coverage
BCPH Tables
Phase 2 Training
Miscellaneous

Instructions

Welcome to the BadgerCare + / Eligibility on CWW 3.0 / Notice Re-Engineering Training RAQ.

Questions and Answers related to the BadgerCare +, CWW Eligibility and Notice Re-Engineering training will be posted on this page. Updates will be posted weekly (at a minimum). RAQ's will be posted chronologically, with the most recent Questions appearing first (at the top of each section).

The RAQ contains sections for different types of questions; issues related to the Phase 1 training materials, each section of the BadgerCare + Handbook (BCPH), questions specific to Phase 2 training and a section for other, miscellaneous questions.

Use the tabs on the left of the page to select the RAQ section you would like to view. Clicking the desired tab will display the contents of that section of the RAQ.

Please contact the DHFS IM Training Call Center if you have questions about the RAQ or have additional questions related to the training materials:

Phone: (608) 267-6378 (option 2)

Email: IMTraining@dhfs.state.wi.us

Phase 1 Training Questions:

12/17/07

Q: What should I use to train/inform staff on BC+ if they do not do eligibility (e.g. clerical staff)?
A: Since this type of staff does not need to have all the details of BC+ policy, the Phase One Powerpoint and Handbook activity will provide introductory level information.

11/12/2007

Q: Do EBD type workers need to take all of Phase One?
A: EBD type workers (those who will be attending the WLW session) should review the ppt, the handbook webpage, and the handbook activity. Key parts of the draft handbook should be read in more detail, such as premiums, deductibles, and health choice.

11/05/2007

Q: How long will it take to complete the Phase 1 Training?
A: The estimated time to complete the Phase 1 Training is between 3 to 4 hours. Times will vary based on presentation methods; group or self-study, and follow-up on questions or technical issues, if needed.

Q: Why can't I see the entire training resource material when I open it using the link from the Instructional Resources page?
A: You may need to maximize the Internet browser window you are using to view the resource. To do this, using your mouse, left click once on the "Maximize" square located at the top right border of Internet browser window you are using to view the material.

Q: Why don't the links for the materials in the Instructional Resource Center work?
A: Make sure that any "pop-up" blockers that are installed are tunred off or set to allow "pop-up's" from the DHFS IM Learning Center site. Consult your local IT department for assistance.

Q: Why won't the Phase 1 Winter 2007/2008 Training Presentation play?
A: The latest version of the Flash Player needs to be installed on the computer you are using to view the presentation. The current Flash Player can be installed by visiting: http://www.adobe.com/go/getflashplayer

Program Overview (Chapter 1)

12/17/07

Q: How will the system know when there is a Health Care Choice? BC+ does not require asset information and EBD Medicaid does.
A: If there is a potential EBD member in the household CARES will schedule the asset pages. If the entered assets are greater than the EBD asset limit, the individual would be put into BC+ without a health care choice.

12/05/07

Q: When the client chooses to change their choice from EBD to BC+ or vise a versa, does a review need to be done or other factors of eligibility be looked at?
A: A review does not have to be completed when a member opts to change the program choice. However, all information necessary to process eligibility for that other program must be collected. For example, if the member chooses to change from BC+ to EBD Medicaid, the worker should make sure the asset information is current. If the member chooses to change from EBD Medicaid to BC+, the worker should make sure the insurance access information is current.

11/30/07

Chapter 1.1.2 Health Care Choice

Q: Why isn’t the Health Care Choice automated in CWW so that the member can receive notices/letters explaining the choice and giving the amount of the premium or deductible amount for each choice?
A: For the most part the health care choice is automated. In the majority of cases, CARES will automatically choose the best program (EBD Medicaid or BC+) for the individual based on the benefit plan and cost share amounts. When CARES makes the choice, the notice of decision will explain the two choices and let the member know s/he can change their plan by contacting the worker. The member may decide to choose the other plan because of HMO enrollment requirements or because s/he has old medical bills that could be used to meet a deductible. In the situations where CARES is unable to make the decision, the applicant will have to contact the worker. Which plan is best for that individual is determined not only by the amount of the cost share but also on preference for HMO enrollment and whether or not the individual has medical bills that could be used to meet the deductible. Because of this, a comparison of premium amount and deductible amount is not always the only information the applicant needs to make a choice, even though it will usually be the first thing the applicant will want to know. We will send the suggestion to have the cost share amounts displayed on the verification request Remember, these types of suggestions can be sent by using the link for ‘CWW Suggestions’ on the navigation menu in CWW.

Non-Financial Requirements (Chapters 2 - 15)

01/14/08

Chapter 2

Q: If one non-marital co-parent has income over 200% FPL, can that parent choose to not request BC+ so the other NMCP can become eligible?
A: Anyone can choose to not request BC+. However, the NMCP that is not requesting would still be pulled into the BC+ test group and be a counted adult in the assistance groups for the other NMCP and the child or children so the income would still be counted.

Chapter 7

Q: If a person is offered COBRA and they don’t sign up, are they eligible for BC+?
A: With the exception of pregnant women with income over 200% FPL and pregnant women covered under the BC+ Prenatal Program, the only insurance that will affect eligibility for BC+ members is employer sponsored insurance through a current employer of a household member where the employer pays 80% of the premium.

Q: If an employer pays 80% of the health insurance premium but the employee has to meet a very high deductible before coverage begins, would the employee be eligible for BC+?
A: If the income of the employee is over 150% FPL and s/he does not meet any of the other exceptions listed in Chapter 7.1 of the BC+ Handbook, we would consider the employee to have access to insurance and s/he would not be able to enroll in BC+.

Q: If there is no data available on the EVHI database and BC+ is opened based on the fact that no insurance access information was available, will the worker get an alert if the data base is updated at a later date?
A: The worker will get an alert if the database is updated within 60 days of the end of the application processing time limit. Since verification of insurance access is not required of the applicant or member, there is no overpayment if s/he has been made eligible due to the unavailability of the information in the database.

Q: How often will the employer’s information be updated in the database?
A: The employers will be surveyed annually. A future enhancement is planned for the database to allow employers to update their information as changes occur.

Chapter 9

Q: De we still have to verify the income for the backdated months for pregnant women?
A: Yes, all income for BC+ must be verified. In order to determine if the pregnant woman is eligible for the backdated months, the income must be verified.

Chapter 10

Q: If a child that has been removed from the Child Welfare Parent’s home and put with a relative receiving Kinship Care is included on the CWP’s case, won’t the Kinship Care payment be included in the CWP’s determination since it’s entered as the child’s income?
A: Kinship Care payments are disregarded or ‘not counted’ income so the payment won’t affect the CWP’s eligibility determination.

12/18/07

Chapter 10

Q: If a change is reported to the Child Welfare Agency in a CWP case but not reported to the IM worker we do consider this a client error if the benefit is not correct because the change wasn’t reported to the IM worker?
A: Yes. This would be a client error. Changes must be reported to the IM agency.

12/17/07

Chapter 2

Q: On Child Welfare Parent cases we count the child in both the CWP’s case and the caretaker’s case. If the child support income is being paid to the caretaker relative and not the parent would we count the income in both cases?
A: The child support income belongs to the child and is entered in CWW as the child’s income, so the income would be counted in both cases. If the CWP is the one paying the child support you would also allow the obligated amount as a deduction on that case.

Q:Does the caretaker relative (NLRR) have to verify their income when applying for BC+ for the NLRR child?
A: If the caretaker relative is not requesting BC+ for anyone other than the NLRR child, the caretaker’s income is not used in the child’s eligibility determination so would not have to be verified.

Q: In NLRR cases can both grandparents or both the aunt and uncle, etc now be eligible for BC+?
A: Yes. The spouse of the caretaker relative can now be eligible for BC+.

Q: Are both parents in a joint custody situation able to be eligible for BC+?
A: If both parents apply for BC+ and claim the child is residing with them, only one parent can be determined eligible at a time unless the child is residing with each parent at least 40% of the time during a month. If the child is residing with each parent at least 40% of the time, the child will be included in the group size for both cases and the child’s income will be counted in both cases. However, the child can be only be eligible in one of the cases.

Q: In joint custody cases where the parents each have the child at least 40% of the time, can both parents be eligible with income above 100% of the FPL?
A: Yes.

Q: What will happen with cases with step-parents who are not currently counted in the Medicaid, Healthy Start or BC test group when they are counted in the BC+ test group and we are counting their income? Will the children go to Transitional Grandfathering?
A: Children have no income limit under BC+ so the children will not be placed in a Transitional Grandfathered AG. If an adult loses eligibility when we move to BC+ because of excess income, the adult will be placed in a Transitional Grandfathered AG.

Chapter 7

Q: If a pregnant woman with income of 185% of the FPL drops her insurance coverage is there a penalty period?
A: No, the policy that requires pregnant women to keep their insurance coverage once they’ve been enrolled in BC+ only applies to pregnant women with income above 200% of the FPL.

Q: Will the EVHI system indicate who in the household the employer will pay 80% of the premium for? For example: the employer pays 80% of the premium for the employee but only 50% of the premium for the rest of the family.
A: The EVHI will contain information on how much of the premium the employer pays for employees and the rest of the family members if the amounts are different.

Q: If a family’s income is below 150% FPL the first month of the application but the income will exceed 150% FPL in the second and third month and the family has access to employer sponsored HI where the employer pays 80% of the premium, will the family be eligible in the first month?
A: Yes, the family meets the eligibility criteria for the first month but will fail for month 2 and 3 for access to health insurance.

Q: It an employer changes their policy from paying 80% of the premium to less than 80% of the premium, does the member have good cause for dropping HI and then become eligible for BC+?
A: Once the employer stops paying 80% or more of the premium we would not look at the insurance coverage or access. The family could drop the insurance or could keep the coverage and still be eligible for BC+. You would not need to determine if there was good cause if they drop the insurance since the employer is paying less than 80% of the premium.

Q: If someone drops employer sponsored health insurance where the employer pays 80% or more of the premium and then applies after the 3 month penalty period, would the person still be ineligible due to current or past access if they still have the same employer and the employer offers the same insurance?
A: If the individual can sign up for the employers insurance and be covered within the month of application or the next three months, s/he would not be eligible due to current access.

Chapter 9

Q: With the change to BC+ that requires income verification, will an NV code entered for income close BC+?
A: Yes. Since income is a mandatory verification, an NV will fail BC+.

Chapter 10

Q: What is the difference between court-ordered kinship care and permanent legal guardianship when we are looking at a Child Welfare parent?
A: To determine if the parent of the child is eligible as a CWP when the child is placed with someone under a permanent guardianship you would have to look to see if there is a reunification plan or permanency plan in place with the goal of reuniting the parent and the child. The Child Welfare Agency would be the best resource for this information.

Q: What constitutes verification of the reunification plan?
A: The Child Welfare agency that placed the child will be able to verify the reunification plan. The State is working with that agency to develop forms to be used to communicate information between the IM agency and the Child Welfare agency.

Q: What happens to a Child Welfare parent when the child who has been removed from the home turns 18, ages out of Foster Care and doesn’t return to the parent’s home.
A: At that point the reunification plan would no longer be in place. Once the reunification plan is no longer in place, the CWP would have to have another child under his/her care to remain enrolled in BC+.

Chapter 11

Q: Will there be coverage for YEOHCs that are still within the age guidelines but exited out of home care prior to the implementation of BC+?
A: Only Youths that turned 18 on or after January 1st, 2008 and were placed in out of home care at the time they turned 18 will be eligible as YEOHCs.

Q: If a YEOHC becomes incarcerated, would s/he still be eligible as a YEOHC?
A: No, once s/he becomes incarcerated s/he would not longer be eligible for BC+. The living arrangement would have to be changed to indicate s/he is now incarcerated.

Q: Can a YEOHC go back into BC+ once no longer incarcerated if they still meet the guidelines?
A: Yes, as long as s/he is still under the age of 21.

Q: May a child in county custody, but living independently, at the time s/he turns 18 be eligible as a YEOHC?
A: The 18 year old must have been placed in Foster Care, Kinship Care or subsidized guardianship at the time s/he turned 18 to qualify as a YEOHC.

12/06/07

Chapter 7

Q: Mom failed to report health insurance from absent parent at app. MA pays and she also submits bills to HI and receives money back to pay bills but just pockets this money. Is this no longer considered fraud with BC+ as you are just looking at health ins from household only?
A: The insurance provided through the absent parent would not affect the BC+ eligibility but we would still record any other Health Insurance coverage for billing purposes. BC+ is still the payer of last resort when there is other insurance coverage.

12/05/07

Chapter 2

Q: Is a pregnant woman who is also caring for born children BCPA or BCPP? If her income is under 150% FPL and drops coverage it would affect BCPP but not BCPA?
A: She would be covered under BCPP even if she is caring for born children. Unless she is eligible for BC+ Prenatal Program, if her income is under 150% FPL dropping coverage would not affect her eligibility under either BCPP or BCPA.

Q: Mom and dad have joint custody, child is removed from Mom’s home and placed with an aunt, could the 3 be eligible for BC+?
A: It is possible that all three caretakers could be BC+ eligible. If dad maintains joint custody (40-60%) he could remain BC+ eligible. If mom meets the criteria to be tested as a CWP, she could also remain eligible. As an NLRR caretaker, the aunt could also be eligible.

Chapter 7

Q: We have an employer in our county that pays 80% of premiums for their Employees. Many of these families do not have income that exceeds 150% of FPL. Can these families be eligible for BC+? If the above is correct, if they report an increase in income that exceeds the 150% of FPL, we would then end the BC+ with timely notice & they would have to enroll in their health insurance plan? Am I correct in interpreting that they could also drop their health insurance without a 3 month waiting period as their income is below 150% of FPL?
A: If the family’s income does not exceed 150% FPL the family can be eligible even if they are covered under or have access to an employer sponsored health insurance plan where the employer pays 80% of the premium. If their income goes over 150% FPL, they would be subject to the health insurance access/coverage rule and the eligibility would end following adverse action notice. If the family income is at or below 150% FPL, dropping insurance would not affect their eligibility.

Q: Once a case has pended for 30 days for HI information and no response comes from the employer, we understand that we run, pass the case and confirm eligibility, but what if the information comes in a month later and we find that the individual did have access or coverage what do we do than? Will we get an alert if information comes in later?
A: If the employer responds anytime within 60 days past the due date, the information will be automatically updated in CWW and an alert will be generated to let the worker know to run eligibility.

Q: Is the 30 days to pend the case from application filing date or process date?
A: The 30 days is the same processing time frame for the application. The 30 days begins with the filing date. However, remember that the applicant must be given 10 days to provide verification so the verification due date may go beyond the 30 day processing time frame if the application is not processed until after day 20.

Q: What if there is a discrepancy between the EVHI system and what the employee says? For example the EVHI say 80% and the employee says no they pay 70%, we contact the employer and verify that they only pay 70%, who do we report this to? Who is the contact for reporting these discrepancies?
A: The worker can override the information on the employment page if s/he receives verification that the information from the EVHI is not correct. Workers should report these discrepancies to the Call Center.

Q: How long would a pregnant woman with income over 200% of the FPL be ineligible if she dropped coverage?
A: If she did not have good cause for dropping the insurance she would be ineligible for 3 calendar months.

Q: Will an RRP based on non payment of premium follow (an individual) to a different case?
A: No.

Q: If there are two separate RRP’s occurring in a case because of non payment of premium, when first RRP is over, do arrears for both RRPs have to be paid for the first RRP group to be found eligible?
A: No. When RRP's occur in separate months for different AG's, the system will track the arrearage for each affected AG and allow those AG's to reopen by payment of their own separate arrearage amount.

Chapter 10

Q: What is a “valid” request for a deductible for a child? Will a phone call suffice?
A: If the case is open for other BC+ AGs or other programs of assistance a telephone call to request the deductible would be a valid request.

11/30/07

Chapter 2, BC+ Groups

Q: When there are many HH members, related and non related, and citizen children of undocumented immigrants, will income be deemed and how are they related if not eligible.
A: Building the BC+ test group is much easier than in the old Family Medicaid programs. All household members who have a qualifying relation ship or legal responsibility to or from the primary person (or to anyone already pulled into the test group) are included so there is no need to deem income. When a parent is ineligible because of citizenship, s/he is still a member of the test group and his or her income is counted in the eligibility determination for other test group members. The non qualifying immigrant would be a counted adult in the BC+ AGs built for the other eligible members of the test group. If a person living in the household had no qualifying relationship to or legal responsibility tie to someone in the BC+ test group we would not be looking at that person’s income

Chapter 7 Health Insurance Access/Coverage

Q: Client with income over 150% of the FPL has current employer access or coverage at 80% or more but the insurance doesn’t cover pre-existing conditions, is this a good cause?
A: Other than the exception for pregnant women, non coverage is not an automatic good cause reason for not taking the insurance or for dropping the insurance. However, good cause for other reasons can be determined on a case by case basis through the Call Center.

Financial Requirements (Chapters 16 - 24)

01/14/08

Chapter 17

Q: If an applicant must make a choice between an EBD Medicaid deductible and BC+ with a premium and they do not make the choice by the time the application processing time limit has passed, we have been instructed to enroll them in BC+. If they don’t pay the BC+ premium would they still be able to enroll in EBD Medicaid even if they are in a BC+ Restrictive Re-enrollment Period?
A: Yes. The BC+ RRP would not affect the person’s eligibility for EBD Medicaid.

Q: In the same situation as above, if we enrolled the person in BC+ with a premium because they did not respond to the request to make a choice between BC+ with a premium and an EBD Medicaid deductible, can the member later ask for the EBD Medicaid deductible with a backdate?
A: Yes, if the member has not been enrolled in BC+ you can still set up a 6 month deductible period beginning with the backdated months. If the member has been enrolled in BC+ and paid the premium for any of the months that would be included in the 6 month deductible period you would not be able to set up a deductible.

Q: We receive quite a few applications from Marshfield Clinic for children that have been hospitalized. If the parent knows at the time of application that the children will not be BC+ eligible due to insurance access/coverage, can a deductible be requested along with the initial application so the deductible could start as of the file date? If not, we may have cases where we can’t start the deductible in time to pay for the hospital bills not covered by the insurance.
A: Yes, the parent can request the deductible up front if s/he knows the child or children will not be eligible due to insurance access/coverage.

Chapter 19

Q: If there are four children in the household and each child has a $10 premium, will there be four separate premium budget pages?
A: The group premium, which is the total of the individual premiums, will be displayed on the BC+ budget page. You can see the individual premiums by using the ‘expand all’ function. The notice will only display the group premium amount.

12/17/07

Chapter 16

Q: Scenario: An adult with 2 children who receive Adoption Assistance applies for BC+. The adult becomes eligible for SSI and starts receiving CTS. If the AA income put the children over 150% of the FPL, would they be eligible under BCPC or BCPD?
A: The children are already automatically eligible for Medicaid through Adoption Assistance. They would not be BC+ eligible. If they weren’t receiving AA they would be eligible as BCPC unless their income was over 150% of the FPL and they had access to health insurance.

Q: Will work related child care expenses be allowed?
A: The only income deduction allowed is for court ordered child support.

Chapter 17

Q: When there is a family with one child who has a premium and another child that has to meet a deductible, both are included in the BCPD once the deductible is met. If the child with the deductible moves out does the other child remain in the BCPD with no premium until the end of the deductible period?
A: Yes.

Q: With an application in January, the children who do not have to meet a deductible would have a review date of December. If a child in the household meets a deductible in March, the review date for the BCPD would be August. At the end of the deductible period is the review due for all the children?
A: A review would have to be done for all children once the deductible period ends.

Q: If an application is made on the last day of the month and the parent requests the deductible on the second day of the next month, when can the deductible start?
A: The deductible would start in the month it was requested.

Chapter 18

Q: If BC+ closes due to excess income and access to health insurance will an extension be built?
A: If the family was eligible for BC+ with income at or below 100% of the FPL for 3 of the past 6 months prior to the time their income increased above 100% they would be eligible for an extension even if they also have access to or coverage under employer sponsored health insurance through an employed member of the household.

Chapter 19

Q: In the BC+ Handbook, 19.1, #3 under the heading of who must pay a BC+ premium lists “Self-employed parents, stepparents and caretaker relatives with income over 200% of the FPL.” Aren’t parents and caretakers with income over 200% ineligible?
A: This refers only to self employed parents and caretakers whose income without adding depreciation in is under 200% but over 200% when we add the depreciation back in. This is the group that can be eligible under the second test.

Q: If a member is on an RRP and their income goes below 150% of the FPL do they become eligible? What happens if their income again goes over 150%?
A: They would become eligible if their income goes below 150%. They would not have to pay the arrears as long as their income stayed below 150%. Once their income goes over 150% again, they would again be subject to the RRP if it had not expired and would have to pay any arrears to remain eligible.

12/06/07

Chapter 16

Q: If the non custodial parent who has a court ordered Child Support obligation is living with the custodial parent that would receive the payment do we still allow the expense and count the income? A: This policy has not changed for BC+. If one parent still has a court ordered obligation you would allow that amount as the expense. You would also count any payments actually made to the custodial parent as income for the household. Remember you allow the obligated amount as an expense but only count any amount actually paid as income.

Chapter 19

Q: If there are arrears will it appear on the Intake and Arrears Premium Information page?
A: Yes

12/05/07

Chapter 19

Q: Why would self employed members only have to pay a premium if their income is over 200% shouldn’t it be over 150%?
A: If the self-employment income is below 200% but over 150% in the first test when the depreciation is added back in, there would be a premium for the adults. If the income was over
200% FPL when the first test with the depreciation added back in, the second test is done to see if the income is below 200% without adding the depreciation back in. If so, the family is eligible but the premium would be calculated using the income with the depreciation added back in.

Chapter 17

Q: If everyone on the case is denied due to access to HI do we follow the same rules for requesting a deductible as we do for reapplying after a denial?
A: If the request is within 30 days of the denial the applicant just has to re-sign the application and set a new file date and if it is more than 30 days after the denial they would have to submit a new application (This is assuming no other programs are open).

Q: Since the deductible choice for children is not automatic and a request has to be made, how long after an application is denied does the client have to make a request? For example, the entire case is denied. Client calls after the case has been denied more than 30 days, do we need a new application at this point? If it is less than 30 days, do we than just reactivate the case and process the deductible request, without collecting any further information?
A: Follow the policy outlined in the BC+ Handbook 25.9. If the request is less than 30 days from the denial, the applicant would just have to re-sign the application and set a new filing date. If the request is more than 30 days after the denial, a new application must be submitted. If the case is open for any other program of assistance neither a new signature or a new application is required.

Q: Will the notice explain what a deductible is to the client so they know whether they would want it or not? Will the amount of the deductible be given to them?
A: The notice will tell anyone that has been denied due to access to health insurance that a child under 19 can be eligible by meeting a deductible. Because the deductible AG has not been processed in CARES at the time the notice is generated, the deductible amount will not be displayed on the notice. 11/30/07 Chapter 17 Deductibles

Q: Since deductible only begin from month they call to request after denied, can they sign a request for the deductible right away with the application? If so, can the deductible begin from month of application?
A: The deductible period begins with the month the request is made. If the request is made at the same time as the application, the deductible begin month would be the month of application.

Chapter 19, Premiums

Q: From the BC+ Handbook, premiums will be $10-$275. Premiums are calculated for individuals but all must be paid for anyone with a premium to be covered, so there could be premiums in excess of $275?
A: Yes. The premium range of $10-$275 is the range for individuals, not groups. The group premium amount is the total of the individual premiums so the group premium amount could be in excess of $275.

Q: Will the old premiums that weren’t paid for BC be erased with BC+?
A: All past unpaid premiums for BC will be forgiven when BC+ is implemented.

Program Administration (Chapters 25 - 37)

12/17/07

Chapter 25

Q: Can a backdate be requested at any time? Currently a person may apply in April and not request a backdate at application. They can come in after eligibility has been determined and request the backdate and be tested following the rules for backdating for those months. .Will this be the same for BC+?
A: Yes.

Q: Do we need a new application for people previously closed or denied and now could be eligible under the new rules?
A: If the case is open for other household members you do not need a new application. Most individuals will be tested for BC+ during the automated eligibility determination on January 11th.

Q: Will the Mail In Application forms be updated to ask the new questions for BC+?
A: Yes.

Chapter 27

Q: If we have an ongoing BC+ case that has verified income at application and later applies for FS we will ask for the past 30 day’s income for the FS application. If the household does not return the verification for the income the FS will fail. Would we also fail the BC+?
A: Income must be verified for BC+ at application, review, person add or delete and anytime there is a change in income that exceeds the next FPL level that required the income be reported. If the income didn’t change to exceed the reporting limit and there was not a person add or delete, the BC+ should not fail due to lack of income verification.

12/06/07

Chapter 27

Q: If we have an ongoing BC+ case with no other programs of assistance open or requested, and the Notice of Decision has informed the member what the limits are for reporting changes in income, does the member have to report when they sign up for several temp agencies if the total income doesn’t exceed the reporting limit?
A: BC+ members are only required to report changes in income that exceed the reporting limit.

12/05/07

Chapter 32

Q: Will income be verified at express enrollment?
A: No, income is not required to be verified when a child or pregnant woman is temporarily enrolled through Express Enrollment.

11/30/07

Chapter 25, Reviews

Q: Are mail in reviews still allowed? Will everyone who was transitioned to BC+ at January 11 have a review in February 2009 or will they retain their previous schedule for review dates?
A. The choice of review methods have not changed. The member can choose to complete the review using the mail in form, a face to face interview or a telephone interview. An Ops Memo describing the BC+ automated eligibility determination will be issued within the next week or so and will describe the process used to transition cases from Family Medicaid, Healthy Start and BC to BC+. Review dates from the previous program will be retained. If there were multiple AG’s open we will try to align as many review dates as possible.

Q: Are the paper application going to be out on time for BC+? Can the application be out earlier for mailing out to reviews due in February?
A: The applications should be available in time to mail out for February reviews.

Program Coverage (Chapters 38 - 48)

01/14/08

Chapter 39

Q: Are all self-employed families covered under the benchmark plan?
A: No. A self-employed family with income below 200% of the FPL when we add depreciation back in would not be covered under the benchmark plan.

12/18/07

Chapter 38

Q: If a member is enrolled in the Benchmark plan and their income decreases enough to put them in the Standard plan, is the change effective the month they report the change or do we have to give Adverse Action notice to make the change?
A: The change is effective the month the decrease is reported. You would have to run with dates for any months prior to the recurring month in order to let EDS know the member is now eligible to be enrolled under the Standard Plan.

Chapter 40

Q: Does FPS income need to be verified at application and after certification has been done. If we get a new job alert for a FPS only individual do we need to verify the new income?
A: The income would have to be verified at application but once the member is enrolled in FPS, income changes are not required to be reported or verified until recertification. If an income change is reported and the change would result in ineligibility, the income change is not effective until the end of the 12 month certification period. The enrollment will be put into an extension phase until the end of the 12-month certification period or until she reports an income decrease that is again below the FPS income limit.

If the reported change in income causes the member to become eligible for BC+, the income would have to be verified before certifying for BC+.

12/17/07

Chapter 38

Q: Will EDS/MMIS indicate enrollment in the Benchmark or Standard Plan?
A: The BC+ budget screens on CWW will indicate which plan the group is enrolled in.

Q: Will members enrolled in an HMO also have a co-pay?
A: Yes.

12/05/07

Chapter 39 Emergency Services

Q: What income limit do we use for emergency assistance for those who are not pregnant?
A: Use the same income limits as you would if the immigrant was applying for BC+. The income limit will depend on whether the immigrant is a child or a parent or caretaker.

Q: Can you backdate emergency services for undocumented immigrants if the income is below 150%?
A: Yes.

11/30/07

Chapter 39 Emergency Services

Q: What about Emergency Medicaid for non qualifying immigrants?
A: Non qualifying immigrants can be eligible for emergency services. Chapter 39 of the BC+ Handbook outlines the policies and procedures for this population.

Tables

Questions and Answers for this section of the RAQ will be added as they are received.

Phase 2 Training Questions

12/04/07

Q: What do I need to do before I attend the phase 2 full or 1/2 day classroom training ?
A: You need to take phase 1 of the training course. This is a distance learning course that can be accessed via the IM Instructional Resources page on the DHFS Learning Center.

Q; Who should attend the Phase 2 training sessions?
A; IM workers who use CARES/CWW to determine eligibility for IM programs.

Q: Who should NOT attend the phase 2 sessions?
A: W2 and/or child care workers who are not also IM workers - training for these workers will be announced separately. Workers who do not process eligibility - for example those with query only access to CARES or CWW.

Q: For phase 2, should I attend the full day classroom session or the 1/2 day virtual classroom Wisline Web session, or both?
A: - IM workers who work with family Medicaid should take the full day class.
- IM workers who do not work with family Medicaid, e.g. LTC workers, should take the 1/2 day class.
- No one should take both classes.

Q: I attended a phase 2 training session and I did not get a training packet. Where is it?
A: Because all of the materials referenced and/or displayed in the phase 2 training sessions - both 1/2 and full day - are available in either the BC+ handbook or the recently released process help chapter 83 a separate training packet was not developed. The handbook and process help should be the reference materials workers use for BC+ policy and process.

Q: Where can I get hands-on training for BC+/Eligibility in CWW/Notices?
A: In spring of 2008 we will again be offering the CWW Labs statewide. These offerings will focus on the changes implemented in January 2008, including BadgerCare Plus, Eligibility in CWW, and Notice Re-engineering.

Q: Where can I go to see answers to the questions asked during the full or 1/2 day training?
A: Questions are recorded and submitted to the CARES Call Center. Answers to all questions asked in training are compiled and are issued as an RAQ which is posted in the DHFS IM Learning Center under Instructional Resources.

11/12/2007

Q: What is the technology used to deliver the 2.5 hour Phase 2 class?
A: We are using WislineWeb, which requires the participant to have an internet connection and a telephone.

Q: Do I need to set up anything with IT to make sure this works?
A: In the confirmation letter that the participant will get a couple of weeks before the training, it will provide a test link that you can use to make sure the class will run through your browser. If there are troubles with that test, work with your local IT department to resolve the issue prior to the start of class. Agencies should check the test link when the confirmation letter is received, not just prior to the start of class.

Q: Should everyone sign up for the WLW sessions individually?
A: Yes, we would like to have each participant in this training have their own computer and phone line. This allows for more involvement in the interactive pieces of this class which will help with the learning process.