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|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||
Status of conditionally eligible is returned for an individual for HIPTC/QHP
Status of active is returned for an individual for WAH
|EE004***||Eligibility Decision||Correspondence for determination of WAH, HIPTC, and QHP during the initial application process||None - unable to add free form text||
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||
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||
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||
When an individual receives their eligibility determination as part of the change reporting or renewal process