FAA6.A Changes : 12 Effecting Changes : C Benefit Decreases - Overview : .01 Effecting Benefit Decreases or Stopping Benefits
.01 Effecting Benefit Decreases or Stopping Benefits
 
(01/01/20 - 12/31/20)
When enough information is provided with a reported change, effect the decrease or stop benefits without verification.
 
Allow for Notice of Adverse Action (NOAA), when decreasing or stopping benefits. In certain situations, no notice is required. (See Changes Requiring No Notice)
 
When enough information is provided with the reported change to decrease benefits, verification shall be obtained at the next renewal.
 
When enough information is provided with the reported change to stop benefits, do not request verification.
 
WARNING
When a change is reported about an optional CA participant, before decreasing CA benefits complete the following:
Determine the benefit amount with the change effected.
Determine the benefit amount with the optional CA participant removed from the CA budgetary unit.
Inform the PI of the results
Allow the PI to decide whether to remove the optional CA participant from the CA budgetary unit.
Document the case file(g).
 
Changes may be reported more than 20 days before the first calendar day of the following month. When this occurs, the change must be completed, and NOAA requested in time to effect the change for the following month.
 
When a reported change does not include enough information to effect the decrease, request verification by completing the following:
 
Request verification no later than close of business on the workday(g) after the date the change is reported.
Attempt a collateral contact to verify the reported change.
Send the appropriate information request notice to the participant, when information cannot be obtained by a collateral contact.
Allow the participant ten calendar days to provide verification.
 
When a reported change is verified timely, decrease the benefits for the first regular benefit issued after the date the change is reported, allowing for NOAA.
 
NOAA must expire prior to the first day of the affected month
 
When enough information to effect a decrease cannot be obtained and the participant has not provided necessary information by the information due date, complete the following:
 
Stop the benefits allowing for NOAA on the next workday after the information due date
Send the appropriate closure notice
 
When verification is received after the information due date and benefits have been stopped, the following apply:
 
When verification is received before the first day of the month the benefits stopped, review the affect of the change on the case.
When the change would cause ineligibility, leave the case closed.
When the case would be eligible after effecting the change, send a C502 notice to inform the participant that the case is reopened. (See Administrative Corrections)
Reopen the case on REPT, effect the change, and send the appropriate change notice. (See Change Notice Requirements)
 
NOTE There is no requirement to allow for NOAA when the participant has been notified previously that their benefits will be stopped.
 
When the verification is received on or after the first day of the month the benefits stopped, do not reopen the benefits. The participant must reapply.
 
NA EXCEPTION
Reopen the case when the participant has provided the verification within 30 days of the closure and all requirements at NA Compliance After Closure are met.
 
Policy and procedures regarding effecting decreases are outlined as follows: