DATE:             February 25, 2004




                        Regional Administrator

SUBJECT:       State Partners Update – Eligibility Quality Assurance

1.  Purpose.  This notice is directed to all State Workforce Agencies (SWA) to outline the end-of-month file transmission procedure for the month of February.   The Health Coverage Tax Credit (HCTC) team is requesting your support in ensuring that all eligibility files are transmitted in a timely manner. 

2.  Background .  The HCTC Program requires states to submit eligibility files as soon as possible; it is especially important that all files known to be eligible as of the last day of the month be sent at such time.  These records are then used to verify eligibility for the following month.  At the end of September, the HCTC Program noticed that a significant number of individuals were dropped from SWA eligibility lists.  This prompted the HCTC Program to develop a process to enable our state partners to review and provide feedback on their file transmissions for the last three months in 2003 and January 2004.  This special eligibility quality assurance procedure is also going to occur in February. 

The purpose of the end-of-month quality assurance exercise is to prevent individuals from being erroneously terminated from the HCTC program, and possibly losing their health care coverage.  Since the HCTC Program is new, the HCTC Program Office wants to confirm terminations on a short-term basis until a baseline for normal termination volume is determined.  Many of the HCTC Program participants have enrolled in qualified health plans they could not have otherwise afforded because of the 65% credit.  If the SWA does not send their name on the file, they in turn may lose their health coverage. 

3. Trade.  On February 25, 2004 the HCTC Program will run an end-of-month eligibility query to identify individuals who are active in the HCTC Program (in registration process or receiving benefits), but their name has not yet been transmitted by the SWA for the month of February. 

Each state that has individuals losing eligibility will receive an email containing an encrypted list of names of individuals who will be declared ineligible for the HCTC Program for the month of February 2004 (if the numbers for a state are low, the state may be called directly).  These states will be expected to verify that each individual on that list has become ineligible.  If an individual is found still eligible, the state is expected to resubmit that person’s record with the correct eligibility code.  The submission is to be done using standard ICON file transmission.  Detailed instructions (including how to open the encrypted list) will be provided in the email. 

4. Timeline:

February Audit

Wed. Feb 25, Morning

Wed. Feb 25, Afternoon

·        HCTC Program runs Eligibility Query

·        Impacted SWAs receive email with encrypted list (if volume is low, some states may be called)

Wed. Feb 25 – Mon. March 1

·        SWA researches eligibility of names on list

Wed. Feb 25 – Tue. March 2

5:30 PM EST

·        SWA transmits by ICON remaining names for February

Wed. March 3

·        HCTC terminates names no longer listed as eligible

5. Action:  If you receive an email from the HCTC Program on February 25, please take the appropriate action as soon as possible. If you have questions on this process, please contact Thomas Mastal, HCTC Operations Support Lead at 703-947-2174, or Jessica Clark, State Liaison Team at 703-947-3185.

Thank you for your assistance.  The HCTC Program appreciates the support and cooperation received from our state partners.

Top of Page