1. WebEx Training Immigrants & ACA Eligibility Friday, February 14, 2014 1

2. 2 Agenda Eligibility “Lawfully Present” and “Qualified Immigrant” Verification Requirements Categories of “Lawfully Present” and “Qualified Immigrant” Non-Lawfully Present Persons AHCT Consumer Portal Immigrant Information Screens Input of Immigrant Identification Numbers

3. Eligibility Must have a “Lawfully Present” status Eligibility for a Plan – Medicaid – Medicaid – requires US citizenship or 5 years legal residency (5 year bar doesn’t apply to pregnant women, children and refugees) – Medicare – Medicare – same – QHP – QHP - only required to be legally present for entire benefit year Eligibility for APTC and Cost Sharing Reduction – They must agree to file taxes in 2014 – They must not be claimed by any other person – They must be legally present – They must remain here (US) and legally present for rest of/or entire benefit year – They must not be eligible for qual. employer plans or forms of government provided health care/insurance – APTC and CSR eligibility are tied Source: AHCT, C. Booker, 1/9/2014 presentation: Immigration, Taxes and Medicaid: How They Can Affect Plan Choice and APTCs 3

4. Lawfully Present Immigrants in a "Lawfully present" status are immigrants or noncitizens who have been: inspected and admitted into the United States and not overstayed the period for which they were admitted, or have current permission from the U.S. Citizenship and Immigrant Services (CIS) to stay or live in the U.S. “Qualified Immigrants” are: Non-US citizens who have permission to live and/or work in the US. Old standard. The new expanded eligibility almost exclusively looks at legally present, not qualified immigrant. Legally present encompasses a larger eligibility group. Source: http://www.dshs.wa.gov/manuals/eaz/sections/CitizenshipAndAlienStatus/citizengenelig.shtmlhttp://www.dshs.wa.gov/manuals/eaz/sections/CitizenshipAndAlienStatus/citizengenelig.shtml 4

5. Verification Requirements VERIFICATION REQUIREMENTS Only those in a family who are applying for benefits are required to provide a Social Security number (SSN) and their immigration/citizenship status. However, those not legally present cannot be counted as part of the tax household and will not be factored into FPL limits. Citizenship or lawful presence must be verified for everyone enrolling in: – Private health insurance in the state exchanges. – Health insurance premium tax credits. – Medicaid and CHIP. Status will be electronically verified through: – Social Security Administration (SSA) for citizens. – U.S. Citizenship and Immigration Services (USCIS) for non–U.S. citizens via the Systematic Alien Verification for Entitlements (SAVE) database. – If unable to verify status electronically, enrollees have an opportunity to provide other documents or to fix the records. Social Security number of a non-applicant may be requested to electronically verify household income. If unavailable, other proof of income can be provided. Information about immigration status may be used only to determine an individual’s eligibility for coverage and/or affordability programs. Source: http://www.nilc.org/immigrantshcr.htmlhttp://www.nilc.org/immigrantshcr.html 5

6. So Who is Lawfully Present? Qualifying Immigration Statuses – Lawful Permanent Residents (LPR) – Applicants for Adjustment to LPR Status with Approved Visa Petitions – Persons Fleeing Persecution Refugees Conditional Entrants Asylees Granted Withholding of Deportation or Withholding of Removal Granted Withholding of Deportation/Removal under the Convention Against Torture (CAT) Applicants for Asylum or Withholding of Deportation/Removal – Humanitarian Immigrants Cuban and Haitian Entrants Paroled into the U.S. Temporary Protected Status Deferred Enforced Departure Special Immigrant Juveniles – Survivors of Domestic Violence, Trafficking, and Other Serious Crimes Domestic Violence Survivors Victims of Trafficking and Their Derivative Beneficiaries U Visa Holders – Persons with Valid Nonimmigrant Status Nonimmigrant Visa Holders (include tourists, students, and visitors on business, as well as individuals who are permitted to live and work in the U.S. indefinitely.) Citizens of Micronesia, the Marshall Islands, and Palau – Longtime Residents Lawful Temporary Residents and Applicants for Legalization Applicants for adjustment under The Legal Immigration and Family Equity (LIFE) Act who have been granted employment authorization are “lawfully present.” Family Unity Order of Supervision Registry Applicants

7. Categories of “Lawfully Present” Immigrants and “Qualified Aliens” Lawful Permanent Residents (LPR) – Permission to live and work permanently – “Green Card” – Can apply for naturalization after 5 years If married to a US citizen – can apply in 3 years If active duty military or a veteran – can apply 1 year Applicants for Adjustment to LPR Status with Approved Visa Petitions – Individuals with approved visa petitions and have applied adjustment to LPR status – Relatives or employers have petitioned to immigrate them No waiting period for “immediate family” – spouse, parent, child Longer waiting period for an eligible non-citizen Source: “Lawfully Present” Individuals Eligible under the Affordable Care Act”, National Immigration Law Center, September 2012, www.nilc.orgwww.nilc.org 7

8. Categories of “Lawfully Present” Immigrants and “Qualified Aliens” Persons Fleeing Persecution Refugees Conditional Entrants Asylees Granted Withholding of Deportation or Withholding of Removal Granted Withholding of Deportation/Removal under the Convention Against Torture (CAT) Applicants for Asylum or Withholding of Deportation/Removal Source: “Lawfully Present” Individuals Eligible under the Affordable Care Act”, National Immigration Law Center, September 2012, www.nilc.orgwww.nilc.org 8

9. Categories of “Lawfully Present” Immigrants and “Qualified Aliens” Humanitarian Immigrants Cuban and Haitian Entrants Paroled into the U.S. Temporary Protected Status Deferred Enforced Departure Special Immigrant Juveniles Source: “Lawfully Present” Individuals Eligible under the Affordable Care Act”, National Immigration Law Center, September 2012, www.nilc.orgwww.nilc.org 9

10. Categories of “Lawfully Present” Immigrants and “Qualified Aliens” Survivors of Domestic Violence, Trafficking, and Other Serious Crimes Domestic Violence Survivors Victims of Trafficking and Their Derivative Beneficiaries U Visa Holders Source: “Lawfully Present” Individuals Eligible under the Affordable Care Act”, National Immigration Law Center, September 2012, www.nilc.orgwww.nilc.org 10

11. Categories of “Lawfully Present” Immigrants and “Qualified Aliens” Persons with Valid Nonimmigrant Status Nonimmigrant Visa Holders (include tourists, students, and visitors on business, as well as individuals who are permitted to live and work in the U.S. indefinitely.) – Most non-immigrant visa holders will fail Medicaid eligibility due to lack of the 5 year legally present qualification. Medicaid gives preference to those with more permanent or indefinite eligibility to remain Citizens of Micronesia, the Marshall Islands, and Palau Source: “Lawfully Present” Individuals Eligible under the Affordable Care Act”, National Immigration Law Center, September 2012, www.nilc.orgwww.nilc.org 11

12. Categories of “Lawfully Present” Immigrants and “Qualified Aliens” Longtime Residents Lawful Temporary Residents and Applicants for Legalization under Immigration Reform and Immigrant Control Act of 1986 (IRCA) Applicants for adjustment under The Legal Immigration and Family Equity (LIFE) Act who have been granted employment authorization are “lawfully present.” Family Unity – spouses & children of non-citizens who legalized under IRCA Applicants for Cancellation of Removal or Suspension of Deportation Order of Supervision – individuals under final orders for removal, but cannot be removed may be under an Order of Supervision Registry Applicants – resided continuously in the US since 1/1/72 Source: “Lawfully Present” Individuals Eligible under the Affordable Care Act”, National Immigration Law Center, September 2012, www.nilc.orgwww.nilc.org 12

13. Non-Lawfully Present Persons No coverage access through AHCT (Medicaid, CHIP or QHP). Not allowed to purchase private health insurance at full cost in state insurance exchange(s). Not eligible for premium tax credits or lower copayments. Exempt from individual mandate. Not eligible for Medicare, nonemergency Medicaid, or CHIP. Remain eligible for emergency care under federal law. Eligible for Emergency Medicaid if low-income. Citizen or lawfully present children of undocumented parents are eligible: – To purchase from the state insurance exchange. – For premium tax credits and lower copayments. – For Medicaid or CHIP. May seek nonemergency health services at community health centers or safety- net hospitals. Source: http://www.nilc.org/immigrantshcr.htmlhttp://www.nilc.org/immigrantshcr.html 13

14. AHCT Consumer Portal Immigrant Information Screens 14 Naturalized citizen

15. AHCT Consumer Portal Immigrant Information Screens 15

16. AHCT Consumer Portal Immigrant Information Screens 16

17. AHCT Consumer Portal Immigrant Information Screens 17

18. AHCT Consumer Portal Immigrant Information Screens 18

19. 19 AHCT Consumer Portal Immigrant Information Screens

20. Eligible for Immigration Status

21. 21 AHCT Consumer Portal Immigrant Information Screens

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24. 24 AHCT Consumer Portal Immigrant Information Screens

25. 25 AHCT Consumer Portal Immigrant Information Screens

26. Older Green Card Numbers Card/Receipt Number Invalid Receipt/Card Number Error Message – “The Receipt Number is 13 characters long, with the he first 3 characters alpha and the remaining 10 numeric characters.” 26 Workers are encountering the field errors on the screen below when the Card Number is not acceptable. (Cards issued prior to 1989 are most likely to cause this error.)

27. Older Green Card Numbers 27 WHAT DO IF THIS HAPPENS? If you run into the error, verify these two things with the consumer: That you have entered A and zero before the Alien Number. If they provide you with an A number with no leading zero, (or less than 10 digits) you may have to enter it for the number to be accepted. If the consumer has an alien number but no card number or expiration date associated with the card, then the consumer must enter in the Card Number field AAA and 10 zeros (AAA0000000000) to proceed with the application. An expiration date is not a required field on the citizenship page so if the green card doesn’t have one, then the consumer does not have to enter one. If the card number rejects, verify when the card was issued. Cards older than 20 years may not have the proper format of the Card Number, and it will reject. The federal system design did not create the availability to use an identification number of another length. It is currently being redesigned by the Federal Government to accept such numbers and allow processing, however, this is still in the works.

28. 28 HOW DO I EXPLAIN IT TO THE CONSUMER? Versions of Green Card That Are No Longer Valid: If you have a previous version of the alien registration card. (e.g., USCIS Form AR-3, Form AR-103 or Form I-151), you must replace it with a current green card. An example is provided below. Older Green Card Numbers "Permanent residence (United States)." Wikipedia: The Free Encyclopedia. Wikimedia Foundation, Inc. 8 October 2013. Web. 08 Oct. 2013. http://en.wikipedia.org/wiki/Per manent_residence_(United_States )

29. Older Green Card Numbers 29 You can provide clients with the information below verbally. Link: I-90, Application to Replace Permanent Resident CardI-90, Application to Replace Permanent Resident Card The I-90 is an online process that is simple. There may be a cost for filing the I-90; $450 charge that includes the biometric fee. It’s similar to a passport process. We cannot advise them further about this matter.

30. Older Green Card Numbers 30 SC-EL 1.3.4.1-021 Individual Details wds12 Alien Number A unique number issued to a noncitizen at the time his or her A-file is created. The 9-digit U.S. Citizenship and Immigration Services number listed on the front of Permanent Resident Cards (Form I-551, Green Cards) issued after May 10, 2010 is the same as the Alien Registration Number. The A- number can also be found on the back of these Permanent Resident Cards. SC-EL 1.3.4.1-021 Individual Details Card NumberAn eligible document or card number, such as a Permanent Resident Card (Form I-551, Green Card) or Employment Authorization Card (EAD). Card Number format would be USA0123456789. (second digit is zero) This meets the 13 character requirement specified in the error message. If no card number or expiration date associated with the card, then the consumer must enter in the Card Number field AAA and 10 zeros (AAA0000000000) to proceed with the application An expiration date is not a required field on the citizenship page so if the green card doesn’t have one, then the consumer does not have to enter one. The following tool tips are available next to the fields for further details: HOW DO I GET THE SCREEN CORRECTED? Use the following formats as provided in the examples below. Bolded numbers are unique for each individual. ANumber is: A0123456789 (second digit is zero) Reads as USCIS# 123-45-6789 on the front of the card.

31. Questions? 31