Healthplanfinder letters

Revised Date: 
November 26, 2014
HPF Number HPF Letter Name Description Freeform Text Requirement Triggering Action/Sent When
EE001*** Additional Verification Required (conditionally approved - needs verification) Produce a correspondence to an individual who needs to provide additional verifications to finalize their eligibility status None - unable to add free form text

Auto generated

Status of conditionally eligible is returned for an individual for HIPTC/QHP

Status of active is returned for an individual for WAH

  • but citizenship is not verified.
  • But lawful presence is not verified
EE004*** Eligibility Decision Correspondence for determination of WAH, HIPTC, and QHP during the initial application process None - unable to add free form text

Auto generated

When an individual receives their eligibility determination as part of the initial application process

EE005 WAH Information Request Information request for individuals with outstanding verifications for WAH yes - able to add free form text

When an individual designates their application as "partially submitted".

When a worker manually triggers EE005 through an individual's dashboard

EE008 WAH Renewal Correspondence for automatic renewal for WAH (Medicaid/CHIP) coverage None - unable to add free form text

Auto generated

When an individual is currently enrolled in WAH and their new eligibility determination at renewal indicates a status of "approved" for WAH for the subsequent coverage period.

EE009 WAH Renewal - Action Required Correspondence notifying an individual of action required to complete a WAH renewal 60 days ahead of the end of the eligibility period. None - unable to add free form text

Auto generated

When HBE calls the Eligibility Service (ES) engine 60 days before the end of a household's WAH eligibility period and receives a status indicating that all members of the household cannot be auto renewed.

EE010 WAH Denial Correspondence notifying an individual who is denied for WAH yes - able to add free form text

When a worker forces "denial" on an individual's application with an eligibility status of "pending".

When an individual receives the EE005 Information Request for a partially submitted application and has not responded by the due date specified in the Information Request.

EE011 WAH Termination Correspondence notifying an individual who is being terminated for WAH coverage  

When a status of "denied" is returned for an individual or household who is currently part of WAH

When a worker forces termination of WAH through the Application Review screen.

NOTE: When HBE runs an eligibility determination for a household that has a 19 year old, HBE will receive a status of "denied" with a reason code of "failure to renew". At that point, HBE business logic will determine whether the household has a 19 year old and will add the appropriate tag next.

Forced termination reason code text is included in this correspondence.

EE013 General Correspondence Correspondence used by staff to provide custom information to individuals yes - able to add free form text

When a worker clicks the "next" button on the free form text screen

EE015 Updated Eligibility Decision Correspondence for determination of WAH, HIPTC, QHP during a change reporting or renewal period. None - unable to add free form text

Auto generated

When an individual receives their eligibility determination as part of the change reporting or renewal process