19 Or Older in Household IBU

KEES is not building the correct IBU for adults under Non-Filer Rules when the household includes a child age 19 or older in the home. The Non-Filer Rules say to include the individual’s children (biological, adopted, and step) under age 19 if living in the home. KEES is not applying the “under age 19” part of the rule. The worker needs to build the adult’s IBU off system and determine what income is counted in their determination. This is only needed if KEES is inappropriately approving or denying coverage for the adult. Both assume that EDBC has already been run. Denied in Error

Approved in Error

From the Medical EDBC Summary page:

  1. Click the Cancel button. The EDBC List page displays.

  2. Click the Cancel button.

  3. Click Eligibility from Global Navigation and Customer Information from Local Navigation.

  4. Click the Customer Options hyperlink from Task Navigation. The Customer Options List page displays.

  5. Click the Add button. The Customer Option Detail page displays.

  6. Complete the following fields:

    NOTE: If more than one adult is being approved or denied incorrectly a separate record is needed for each adult.

  7. Click the Save and Continue button. The Customer Options List page displays.

  8. Click the Run EDBC hyperlink from Task Navigation.

  9. Run, Accept and Save EDBC for the appropriate months.

  10. Create a detailed Journal entry documenting the actions that were taken.

Denied in Error

  1. Navigate to the Household Status hyperlink from Task Navigation. The Household Status List page displays.

  2.  Click the Add button.

  3. Complete the following fields:

  4. Click the Save and Return button.

  5. Run and Accept EDBC if eligibility is correct.

  6. Edit the record to reflect In the Home once a user has ran through the come-up month for EDBC, by navigating to Household Status.

  7. Create a detailed Journal entry documenting the actions that were taken.