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WebEx Training Wednesday, January 22 nd 2014 1. - 2 - Agenda Failed ID-Proofing Consumer not in DSS System Same Sex Marriages Couples Living Together.

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Presentation on theme: "WebEx Training Wednesday, January 22 nd 2014 1. - 2 - Agenda Failed ID-Proofing Consumer not in DSS System Same Sex Marriages Couples Living Together."— Presentation transcript:

1 WebEx Training Wednesday, January 22 nd

2 - 2 - Agenda Failed ID-Proofing Consumer not in DSS System Same Sex Marriages Couples Living Together Married Filing Single and Husky Eligibility Lawfully present without an alien or certificate number 5 Year Lawfully Present Rule for Medicaid Household Immigration Status and Child Eligibility Questions

3 Failed ID proofing can occur in two ways: o Consumer incorrectly answers the ID Proofing questions o There is not enough information on the applicant to create ID proofing questions If a consumer fails ID-Proofing then the consumer can call the Call Center to complete the application over the phone. The consumer’s application must be completed via the Worker Portal to bypass ID Proofing. No appeal is necessary. Scenario Failed ID Proofing Topic

4 If a consumer calls the Call Center claiming there is no record of their HUSKY eligibility in the DSS system, the call center has an escalation process that will transfer the consumer to the HUSKY enrollment center where the individual can speak with a representative. Scenario Consumer not found in DSS System Topic

5 As far as the system is concerned, there is no gender check on Married Filing Jointly, so the eligibility results generated by the system will not be affected. As long as the marital relationships are set up correctly, gender will not impact the eligibility result. If the couple is legally married and file taxes jointly, the couple could be eligible for APTC based on income. Scenario Same Sex Marriages Topic

6 If a couple is not legally married then they are treated as separate individuals and cannot enroll in the same QHP unless they meet one of these conditions: Residence* — the person lives with you as a member of your household for the whole year Support — taxpayer must provide more than half of the costs to support the person (unless joint support agreement (two different taxpayers contributing to care) is in place) Income— dependent’s gross annual income cannot exceed $3,900 Exclusivity— individual cannot be claimed as a dependent of another person Scenario Couples Living Together Topic * There are additional relationship conditions that may apply

7 If an individual is married and filing single, can the individual be eligible for Medicaid? If the household meets the Medicaid financial criteria, tax filing status does not affect Medicaid Eligibility. Scenario Married Filing Single and Husky Eligibility Topic

8 If an individual is married and filing single, can the individual be eligible for APTC? Tax status would only affect an eligibility determination if the applicant is in the APTC income range. In order to receive APTC a married applicant must be married filing jointly. A married applicant who's tax status is Married Filing Single will not be eligible for a tax subsidy. Scenario Married Filing Single and APTC Eligibility Topic

9 An individual is not considered as married if individual is married but files a separate return AND You have a son, stepson, daughter, or stepdaughter who lives with you for more than half the year AND you can claim that child as a tax dependent You furnish over half of the cost of maintaining such household during the taxable year; and During the entire taxable year such individual's spouse is not a member of such household. Scenario Someone who is married can be considered as not married Topic

10 How do applicants who are lawfully present but do not have a certificate number apply on the exchange via the Consumer Portal? Without the certificate # and alien #, the system will not be able to electronically verify the naturalized citizenship. U.S. citizenship is verified by the Social Security Administration (SSA) through the Federal Data Hub and non-citizen immigration status is verified by the Department of Homeland Security (DHS) via the Hub. These two numbers are required by the Hub, and therefore are required on our screen. There is a work around available using the Worker Portal for electronic entry, that training will take place later today for professional users If lawfully present individuals do not have those numbers, their immigration status cannot be verified electronically. It must be verified manually by paper. Scenario Online - Lawfully present without an alien or certificate number Topic

11 Steps to Manually Verify Lawful Presence of Applicants on the Consumer Portal: Consumer Portal Select “I don’t know” on the Naturalized Citizenship section o The screen will not check the required fields and user will be able to proceed o The system will skip the Verification of Lawful Presence process o Proof of lawful presence will be added to Verification Check List Scenario Manual - Lawfully Present Without an Alien or Certificate Number Topic

12 A family has applied on the exchange and the parents in the household are lawfully present but have not been living in the US for 5 years. The family includes a 6 year old daughter who is also lawfully present but has not been in the US for 5 years. The 5 year rule does not apply for applicants under 21 or women who are pregnant. However, the applicant must always be lawfully present and meet the financial requirements for Medicaid. As long as the child is lawfully present and meets the financial requirements for Medicaid, she can qualify for Medicaid. Scenario 5 Year Lawfully Present Rule for Medicaid Topic

13 The household is a family of 3. The mother has had a green card and lawful immigration status for more than 5 years. The father and 10 year old daughter just moved to the U.S. The father and daughter do not have a SSN. Can the daughter obtain a QHP or Medicaid? Even though one parent has eligible immigration status, the daughter does not have a SSN so the daughter will not be eligible for Medicaid on the exchange. Scenario Household Immigration Status and Child Eligibility Topic

14 About Deloitte Deloitte refers to one or more of Deloitte Touche Tohmatsu Limited, a UK private company limited by guarantee, and its network of member firms, each of which is a legally separate and independent entity. Please see for a detailed description of the legal structure of Deloitte Touche Tohmatsu Limited and its member firms. Please see for a detailed description of the legal structure of Deloitte LLP and its subsidiaries. Certain services may not be available to attest clients under the rules and regulations of public accounting. Copyright © 2014 Deloitte Development LLC. All rights reserved. 36 USC Member of Deloitte Touche Tohmatsu Limitedwww.deloitte.com/aboutwww.deloitte.com/us/about


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