Letters 300 Series

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Letters 300 Series

Revised January 25, 2008

Purpose: 300 Series Reason Code Protocols

Go to the Reason Code Link chart to link directly to a specific reason code or scroll through the list below.

For ACES Procedures go to ACES Letters in the ACES User Manual.

Code Reason Code Title / Text WAC References Free Form Text

300 Non-Payment of Premium According to our records, you have not paid all required premiums. See WAC rule (Washington Administrative Code):
388-523-0120
None Required

301

Exceeds Income Standard
Your income is over the limit that is allowed for this program. See WAC rule (Washington Administrative Code):

388-478-0060 388-478-0055 388-478-0065 388-478-0070 388-478-0075 388-478-0080 388-478-0085 388-450-0165 388-450-0162 388-450-0015 388-450-0210

The limit for your household size is $____.

302

Change In Child Support
The amount of legally obligated child support that you pay has changed. See WAC rule (Washington Administrative Code):

388-450-0185

The amount of child support you must pay changed from $_______ to $_____.

304

Additional Requirements Change
The amount of assistance you get for additional requirements has changed. See WAC rule (Washington Administrative Code):

388-478-0050 388-473-0010 388-473-0020 388-473-0030 388-473-0040 388-473-0050 388-473-0060

The amount of money you get for (type of additional requirement) has changed from $__ to $__ because     .

305

Food Assistance Change Due To Change In Grant Amount
Your food assistance is changing because the amount of your cash assistance has changed. See WAC rule (Washington Administrative Code):

388-412-0015 388-450-0025

None Required

306

Change In Unearned Income
The amount of unearned income you get has changed. See WAC rule (Washington Administrative Code):

388-418-0020 388-450-0025 388-450-0162 388-450-0210

Your income from (source) has changed from $___ to $__.

307

Change In Gross Earned Income
The amount of money that you earn has changed. See WAC rule (Washington Administrative Code):

388-450-0030 388-450-0210 388-418-0020

Your gross earned income has changed from $___ to $___.

Code Reason Code Title / Text WAC References Free Form Text

320

Exceeds Gross Income Limit
Your income is higher than the income limit for this program. See WAC rule (Washington Administrative Code):

388-450-0015 388-450-0165 388-478-0060

The limit for your household size is $___.

321

Change In Net Deemed Income
The amount of income we consider available to you from an outside source has changed. See WAC rule (Washington Administrative Code):

388-450-0100 388-450-0105 388-450-0115 388-450-0120 388-450-0135 388-450-0155 388-450-0130 388-450-0150 388-450-0140 388-450-0160,
388-450-0125

We are counting $__ of (Name)'s income.

323

Change In Home Maintenance Exemption
The income amount that you are allowed to keep to pay for home expenses is called a home maintenance allowance. Yours is changing because:

You have been getting it for 6 months;

Your doctor says you have to stay longer; or

The amount of your home expense has changed.

See WAC rule (Washington Administrative Code):
388-513-1380

Your home maintenance amount has changed because ________. (add specific details, e.g. “Your rent has changed from $____ to $_____.” Or “On __(date)___, Dr. _____ told us you can’t return home before _____.”)

324

Child Support More Than Grant
Your regular monthly child support payment is more than the grant payment. See WAC rule (Washington Administrative Code):

388-422-0030

None Required

327

Change In Recoupment
We are taking a different amount from your benefits to repay an overpayment. See WAC rule (Washington Administrative Code):

388-410-0005 388-410-0010 388-410-0015 388-410-0030

None Required

328

Excess Net Income - Food Assistance
You can’t get food assistance because your income is above the limit for your household size. See WAC rule (Washington Administrative Code):

388-478-0060

The limit for your household size is $      .

329

Change In Dependent Care Costs
The amount you pay for childcare or dependent care has changed. See WAC rule (Washington Administrative Code):

388-450-0170 388-450-0185

The amount you pay has changed from $____ to $____.

Code Reason Code Title / Text WAC References Free Form Text

330

Lump Sum
Your resources are over the limit for this month because of your lump sum payment. See WAC rule (Washington Administrative Code):

388-450-0245
388-470-0005
You got $__ from __ on 00/00/00. Your countable resources are now $__. Your resources cannot be more than $_____ (specify resource limit for household size).
If the grant is suspended:
We will be subtracting $_____ from next month’s grant. This reduction is for one month only.

If the grant is terminated:
Your lump sum payment is more than the need standard for two months. You can reapply for a cash grant in (month).

331

Excess Net Income - Cash Assistance
Your net income is over the limit for this program. See WAC rule (Washington Administrative Code):

388-478-0020 388-478-0030 388-478-0040 388-478-0045 388-478-0050

The limit for your household size is $     .

332

Change In CPI Allowance
The amount of income you can keep for clothing and personal incidentals is called your CPI allowance. Your CPI is based on the type of facility you are in and whether you get certain veterans’ benefits. Your CPI has changed because you changed facility types or because the type of veterans’ benefits you get has changed. See WAC rule (Washington Administrative Code):

388-513-1380 388-478-0040 388-478-0045

Your CPI allowance has changed because     .

334

Exceeds Earned Income Limit
Your cash benefits will stop because of earnings. Medical benefits for your family will continue; please see the enclosed letter. Please see the attached sheet to find out what we counted. See WAC rule (Washington Administrative Code):

388-478-0035

The limit for your household size is $     .

335

Change In Uncovered Medical Expense Allocation
The amount you can use to pay medical expenses has changed. See WAC rule (Washington Administrative Code):

388-513-1380

The amount you can use to pay for the following medical expenses has changed: (Type of expense) from $      to $      .

336

Change In CSMA / FMMA Allocation
The amount we can allow for the maintenance of your family members at home has changed. See WAC rule (Washington Administrative Code):

388-513-1380

Your allocation changed from $      to $      because     .

337

Change In Extra Hardship Allocation
The amount that we can allow for your special needs has changed. See WAC rule (Washington Administrative Code):

388-513-1380

Your allocation changed from $      to $      because     .

338

Not Eligible Until Month After Application Month
The person listed above cannot get food assistance for the month they applied in. See WAC rule (Washington Administrative Code):

388-418-0020

None Required

339

Medical Extension Ends
Your medical extension expired and we did not get your review form. If we get it before the end of the month, we will reconsider our decision. If you have already sent it, let me know. If your medical benefits stop and you decide that you still want them, you need to reapply. See WAC rule (Washington Administrative Code):

388-400-0035 388-523-0100 388-462-0015

None Required.

Code Reason Code Title / Text WAC References Free Form Text

340

QMB Ineligible - Client Is Not Institutional Related
You are no longer eligible for assistance that pays for all or part of your Medicare costs and premiums. The department must count your income differently when you are no longer eligible for Long-Term Care Services, such as Nursing Facility Care, COPES or CAP/OBRA Services. See WAC rule (Washington Administrative Code):

388-450-0005

None Required

341

The state supplemental payment rate for all SSI recipients has changed. See WAC rule (Washington Administrative Code):

388-478-0055

None Required

342

Medical coverage stopped for the children listed above because you got 3 months behind in premium payments. They cannot get back on this program until you: Wait 3 months; and Pay the balance that you owe. You do not have to pay a premium for a child who is pregnant, an American Indian or an Alaska Native. Please tell us if this applies to any of the children. We may ask you to provide proof. See WAC rule (Washington Administrative Code):

388-505-0211

None Required

343

The amount of Third Party Resources you get has changed. See WAC rule (Washington Administrative Code):

388-501-0200

The amount of your third party resource has changed from $___ to $__.

Code Reason Code Title / Text WAC References Free Form Text

386

Diversion Cash Assistance - No Bona Fide Need
The expenses you need help with are not covered by the Diversion Cash Assistance program. DCA can only be used to pay for childcare, housing, transportation, expenses to get or keep a job, food and medical expenses. See WAC rule (Washington Administrative Code):

388-432-0005
You asked for help with the following expenses:
(List expenses)

We cannot cover these expenses because (specify why need is not “bona fide” or is not covered. For example, “You did not give us a written estimate of how much it would cost to fix your car.” Or “You told us you have income of $____ and expenses of $ ____. Based on that, you should have enough money to pay for move-in expenses without our help.”).

388

WA Fund CAP For ESLMB Already Reached
Washington gets a limited amount of money for the Qualified Individual (QI-1) Program. There are no more funds available for this year. You can reapply in December for next year. See WAC rule (Washington Administrative Code):

388-517-0300

None Required

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