Inability to Create a Separate Application WHEN DENIED AND TOLD SEPARATE APPLICATION NEEDED

Background When an individual is denied on an application and told “Separate Application Needed”, they will need to create a separate application for themselves as the Primary Applicant. This scenario will occur when... ◦An application includes an individual who is age 19 or older and that individual is not the primary applicant or spouse (which includes same-sex spouses) of the primary applicant and meets one of the below criteria. ◦The individual isn't a tax dependent of the primary applicant.; OR ◦The individual is a tax dependent of the primary applicant and is otherwise eligible for Medicaid. ◦"Otherwise eligible for Medicaid" means that the individual meets all other financial and non-financial Medicaid eligibility criteria. If either one of the following conditions is true, then ineligible individual shall be denied for both Washington Apple Health (reason code 605) and HIPTC (reason code 814)

**Important** A separate application should be initiated only when an individual was denied and told “Separate application needed” Or An individual was impacted by the eligibility service related defect in which they should be eligible for WAH but were approved for QHP coverage instead of receiving HIPTC denial (814) and told to apply separately as their own applicant. A second application is not intended for situations in which the original application erred out and has yet to be fixed. HBE is prioritizing data fixes to clean the original application up and to reset so that the issue on the original application issues may be resolved.

Issues... The ineligible individual is not allowed to create a separate application without the assistance of a privileged user (i.e., IPA, Navigator, Broker, Account worker). If “Create Another Application” link is selected, the application will result in the below error on the About You screen if additional steps are not first taken...

To avoid errors, privileged user should do the following... ◦Select “Create a new application” from their (privileged user) dashboard ◦Skip or Complete Account Creation ◦Complete the About You screen ◦If information was entered correctly, the Identity proofing questionnaire will be invoked ◦If successfully passed, the user will be routed to the applicant’s dashboard ◦If information was not entered exactly to trigger the identity proofing questionnaire, the “Partial Match” modal will appear If partial match is made, first try updating the members’ information to match the previous application, if this does not resolve the issue, a call to HBE or HCA will be required to override this security control measure

Once on the individual’s Dashboard... Select “Report a Change in Income or Household You must first update the original application to indicate that the applicant is no longer seeking coverage, otherwise, that is where the error is invoked

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In addition to updating the question to seeking coverage. The user must also take one additional step to ensure the application is processed correctly. User must update income by $0.01. This action is required when the only change being reported is a request for coverage update. The Healthplanfinder is not triggering a request for redetermination from the Eligibility Service. As a result, the change request is not completed. The error below will be received when completing the second application. One more step...

Return to the applicant’s dashboard Select “Create another application” Complete and submit the application **Note if additional members need to be added to the application for purposes of determining household composition, but are not seeking coverage, indicate as such. After successfully updating the initial application...

**Important** A separate application should be initiated only when an individual was denied and told “Separate application needed” Or An individual was impacted by the eligibility service related defect in which they should be eligible for WAH but were approved for QHP coverage instead of receiving HIPTC denial (814) and told to apply separately as their own applicant. A second application is not intended for situations in which the original application erred out and has yet to be fixed. HBE is prioritizing data fixes to clean the original application up and to reset so that the issue on the original application issues may be resolved.